Dear all:

With the assistance of an email off list I was able to track down one peer reviewed article.  The cost of over $50 for 24 hour access was prohibitive so I have only looked at the abstract. Ching Tat Lai, Thomas W. Hale, Karen Simmer, and Peter E. Hartmann. Breastfeeding Medicine. June 2010, 5(3): 103-107. doi:10.1089/bfm.2009.0074. 

So, the sample size for the study was only 20 women. This is not adequate for testing the wide range of circumstances that I encounter in clinical situations where women sometimes do not release well to the pump.  Since I did not have access to the full journal article, it is unclear whether the authors purposively selected a group of women who respond well to the pump.  If they did, this could have ramifications for how we consider the usefulness of such a method.

The authors compared the estimated average hourly rate of milk synthesis from each breast using hourly removal with the pump
 to the average hourly rate of milk synthesis estimated from 24 hour test weighing.  

The authors did NOT conclude that this should be adopted an assessment tool by lactation consultants as a standard of practice.  In their own words they stated that:

"The average hourly volumes of milk from the 2nd to 7th hour expressions COULD provide an estimate of the rate of milk secretion. FURTHER STUDY IS REQUIRED TO FULLY VALIDATE THESE FINDINGS."  

So, I cannot find the missing link that took this highly theoretical exploratory finding and turned it into something that is what we SHOULD do without very explicit parameters for what and why it is being used.  If anyone is aware of additional articles that might have come out since this article with larger samples sizes and a more fully thought out rationale for what it will provide in terms of additional information or ease than test weighing, please let me know.

Sincerely,
Susan E. Burger, MHS, PhD, IBCLC, RLC

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