Analysis Offers Guidance on Breast Milk Expression

New mothers needing to express breast milk should start early, but they can also benefit from a number of low-cost aids. Relaxing, listening to music, breast massage, warming the breasts, hand expression and lower cost breast pumps may all be helpful in trying to pump milk for infants, an updated meta-analysis of available studies found. Still, the body of scientific evidence on expressing breast milk is varied and doesn't easily identify the best tools to help new mothers maximize their comfort and output.

Key Findings:

- Listening to music, relaxing, massaging the breasts, and warming the breasts may all help improve the process of pumping breast milk.

- Different techniques used for expressing breast milk were associated with not only the volume of milk produced but also the properties of the breast milk.

“Small sample sizes, large standard deviations, and the diversity of the interventions argue caution in applying these results beyond the specific method tested in the specific settings,” the authors warned.

The updated meta-analysis looked included 34 randomized controlled studies, with 17 studies involving slightly less than 1,000 women being used in the Cochrane data analysis. The studies also included significant global diversity, with mothers from the United States, the United Kingdom, Australia, Malaysia, Brazil, Egypt, India, Mexico, Turkey, Kenya, and Nigeria.

For mothers who give birth to low birth weight and premature babies, beginning to pump within the hour of giving birth does increase the amount of milk expressed, the analysis showed. The various techniques not only affected the volume of milk expressed but also the milk’s properties. For instance, more milk was expressed when mothers listened to an audio relaxation tape, warmed their breast, and massaged the breast. One study found sodium concentration was higher when women hand expressed milk compared with manual and electric pumps, and fat content was higher with breast massage and with listening to an audiotape while pumping.

Several small studies focused on pump comparisons, but no consistent difference in milk volume was found between the pumps studied. This included a finding that lower cost pumps may be as effective as the large electric pumps, the authors noted. Furthermore, any milk contamination was similar for hand expressed and pumped milk, and the level of maternal breast or nipple pain was no different between the two pump types.