10/6/09
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Marianne Vanderveen said “I am in need of one or more articles showing that fulltime pumping is a risk factor for bf duration.”
Pediatrics published a supplement a year ago with a series of articles based on the Infant Feeding Practices Study II, (IFPS II) done by the CDC (Centers for Disease Control & Prevention) and the FDA (Food & Drug Administration) in the USA. This study and the previous one (IFPS I) were huge surveys done by mail, following mothers and babies from pregnancy to the first birthday. 4902 pregnant women began the study and about 2000 completed it.
Here are a couple of quotes from an article in this supplement that mentions exclusive pumping.
Shealy KR, KS Scanlon, J Labiner-Wolfe, SB Fein, L Grummer-Strawn (2008) Characteristics of breastfeeding practices among US mothers. Pediatrics 122, Oct 2008, S50-S55.
”The AAP’s formal position on breastfeeding recommends exclusive breastfeeding for the first 6 months with continued breastfeeding past 12 months, but the role of ‘exclusive pumping’ (providing expressed milk without ever feeding the infant at the breast) in breastfeeding guidance has not been explored yet.” P S50
“Among all mothers who were breastfeeding during the IFPS II, exclusive pumping was reported by 5.6% of the mothers, which means that their infants never fed directly at the breast. Breastfeeding durations among this group were short. Only one third of exclusively pumping mothers had durations of any breastfeeding beyond 1 month.” p S51
In another article, this one about expressing milk, the authors found that 85% of these US mothers expressed milk at some time, and half started expressing in the baby’s first week. In a list of reasons for expressing, “When mother does not want to breastfeed” was chosen by 18-31% of mothers (depending on baby’s age) but three other reasons (“For someone else to feed infant,” “For an emergency supply,” and “To relieve engorgement”) were the top three reasons selected from the list. P S66
Labiner-Wolfe J, SB Fein, KR Shealy, C Wang (2008) Prevalence of breast milk expression and associated factors. Pediatrics 122, Oct 2008, S63-S68.
I gathered information for a talk on exclusive pumping earlier this year, and I did not find much in the way of research. There were some very useful websites, though, that seem to indicate that there is A LOT of interest in exclusive pumping, especially in the USA.
http://parenting.ivillage.com/newborn/nbreastfeed/0,,98xx,00.html
http://www.exclusivelypumping.com
http://thelactivist.blogspot.com/2005/11/exclusively-pumping-why-does-it-get.html
I think that LCs must pay attention to this phenomenon of exclusive pumping. Women will use pumps “because they are there” (the same reason that people climb mountains). Our job is to inform women about their options (including what happens for both mother and child when the child is at the breast compared to feeding through the technological medium of pump and bottle).
Women writing to some of these websites reported that they spent about 2 hours a day pumping in order to maintain a full supply. Some were exclusively pumping because they and their babies had struggled with feeding at the breast and never achieved it. Others had chosen to pump so their baby would get their milk but the mother didn't want the baby at the breast. Of course, those are the mothers that I worry about. Nils Bergman says that breastfeeding is really "brain-wiring." How much are baby and mother missing if they don't have the chance to "wire their brains" simultaneously many times a day and night?
Chris Mulford
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