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From:
Rachel Myr <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Thu, 28 Jul 2011 12:53:24 -0400
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Please read the abstract of the article as it was posted.  This is not a study comparing milk yields between women expressing for the long term by hand or with a pump.  I would love to have the reference for the study on long term yields you mention, Jane, it sounds like it's worth taking a look at.  It would be a good idea to see who funded it and whether it was published in a peer-reviewed journal too.  About the current study, the main difference was in rates of premature weaning after giving birth to a baby who didn't latch or suckle well in the early post partum period.

"The goal of the study was to compare the effects of bilateral electric breast pumping vs those of hand expression among mothers of healthy term infants who were latching or sucking poorly at 12 to 36 hours postpartum. At a well-baby nursery and postpartum unit, 68 participants were allocated to undergo either 15 minutes of bilateral electric pumping or 15 minutes of hand expression. The primary study endpoints were milk transfer, maternal pain, confidence in breast-feeding, and breast milk expression experience (BMEE) immediately after the intervention, as well as breast-feeding rates at age 2 months.

With hand expression, the median volume of expressed milk was 0.5 mL (range, 0 - 5 mL) vs 1 mL (range, 0 - 40 mL) with electric pumping (P .07). Both techniques were associated with similar maternal pain, confidence in breast-feeding, and BMEE. However, 96.1% of mothers randomly selected to hand expression were breast-feeding at 2 months, compared with 72.7% of mothers randomly assigned to breast pumping (P =2)."

More than one in four women who underwent pumping in the first 12 to 36 hours post partum because the baby wasn't latching or suckling well in that time, had stopped breastfeeding by 2 months.  Of women whose babies weren't latching or suckling well in the first 12 to 36 hours who underwent hand expression instead of pumping, less than one in 25 had stopped breastfeeding by 2 months.   The author goes on to say that if a woman has a strong preference for one method she should use it.  But in settings comparable to the one in the study (don't know anything about that from the abstract), in the lack of any preference we should probably teach women to express by hand rather than present them with a pump in the first couple of days.  It may have nothing to do with volume of colostrum transferred and everything to do with making breastfeeding seem like something doable, normal, within the range of other bodily functions, rather than emphasizing our kinship with dairy animals.

Rachel Myr
Kristiansand, Norway, where the terrorist attack by an extreme right-wing xenophobic Islamophobic gun worshipper has led to an outpouring of donations by Norwegians to aid funds for those affected by the famine around Africa's Horn, so it may even benefit breastfeeding in the end 

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