Use of short duration breast milk pump‐expression to predict 24‐hr milk output

Abstract

Test weighing (TW) is traditionally used to assess adequacy of infant breast milk (BM) intake. TW however intrudes on the breastfeeding process. We compared a brief BM expression procedure with 24‐hour TW among 20 rural and peri‐urban dwelling Ghanaian lactating women. TW was performed using standard procedures and milk intake was recorded by trained personnel in participants' homes. Within 48 hours of the TW, the brief procedure was carried out, involving hourly pump‐expression of BM over a 4‐hr duration. Total 24‐hr BM output in TW was compared to hourly expressed BM, multiplied by 24. Study participants were between 18 and 38 y, with a median age of 25 y. One half of the 20 participants were breastfeeding exclusively; the remaining practiced mixed breastfeeding. Average intake of 53 g (95% CI: 48, 58) per feed was recorded in TW with a range of 7 to 19 feeds per infant. BM intakes did not differ between feeds. Hourly pump‐expressed BM averaged 34 g (95% CI: 28, 41) and did not differ across breasts nor between women but decreased over time (p<0.01). Mean BM intake during 24‐hr TW was 598 + 230 g and did not differ by infant feeding. Mean 24‐hr TW intake was predicted by 4th hr pump‐expressed BM from the left breast only multiplied by 24 (95% CI: ‐39, 303 g) but not by the BM from the right breast (95% CI: 178, 465 g). Breast preference may affect the usefulness of the brief pumping method to estimate BM intake of young children.