Abstract
BackgroundExpressing breast milk has become increasingly prevalent, particularly in some developed countries. Concurrently, breast pumps have evolved to be more sophisticated and aesthetically appealing, adapted for domestic use, and have become more readily available. In the past, expressed breast milk feeding was predominantly for those infants who were premature, small or unwell; however it has become increasingly common for healthy term infants. The aim of this paper is to systematically explore the literature related to breast milk expressing by women who have healthy term infants, including the prevalence of breast milk expressing, reported reasons for, methods of, and outcomes related to, expressing.MethodsDatabases (Medline, CINAHL, JSTOR, ProQuest Central, PsycINFO, PubMed and the Cochrane library) were searched using the keywords milk expression, breast milk expression, breast milk pumping, prevalence, outcomes, statistics and data, with no limit on year of publication. Reference lists of identified papers were also examined. A hand-search was conducted at the Australian Breastfeeding Association Lactation Resource Centre. Only English language papers were included. All papers about expressing breast milk for healthy term infants were considered for inclusion, with a focus on the prevalence, methods, reasons for and outcomes of breast milk expression.ResultsA total of twenty two papers were relevant to breast milk expression, but only seven papers reported the prevalence and/or outcomes of expressing amongst mothers of well term infants; all of the identified papers were published between 1999 and 2012. Many were descriptive rather than analytical and some were commentaries which included calls for more research, more dialogue and clearer definitions of breastfeeding. While some studies found an association between expressing and the success and duration of breastfeeding, others found the opposite. In some cases these inconsistencies were compounded by imprecise definitions of breastfeeding and breast milk feeding.ConclusionsThere is limited evidence about the prevalence and outcomes of expressing breast milk amongst mothers of healthy term infants. The practice of expressing breast milk has increased along with the commercial availability of a range of infant feeding equipment. The reasons for expressing have become more complex while the outcomes, when they have been examined, are contradictory.
Highlights
Expressing breast milk has become increasingly prevalent, in some developed countries
There has been some discussion about increasing numbers of women in Australia, United States of America, the United Kingdom and Singapore expressing to give breast milk feeds rather than breastfeeding directly from the breast [1,2,3,4,5,6]
The aim of this paper is to systematically explore the literature related to breast milk expressing by women who have healthy term infants, including the prevalence of breast milk expressing, and the reported reasons for, methods of, and outcomes related to expressing
Summary
Expressing breast milk has become increasingly prevalent, in some developed countries. In the past, expressed breast milk feeding was predominantly for those infants who were premature, small or unwell; it has become increasingly common for healthy term infants. There has been some discussion about increasing numbers of women in Australia, United States of America, the United Kingdom and Singapore expressing to give breast milk feeds rather than breastfeeding directly from the breast [1,2,3,4,5,6]. One conducted in Australia and one in Singapore [2,6], measured expressing over time. Both reported an increase [2,6]. During a time when there was concern about the undesirable effects of feeding colostrum to the newborn in preindustrial Europe, the sucking glass was used as an alternative to employing children or puppies to remove this early milk while the baby was fed by a wet nurse [7]
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