Pump-dependent mothers of preterm infants commonly experience insufficient production. We observed additional milk could be expressed following pumping using hand techniques. We explored the effect on production of hand expression of colostrum and hands-on pumping (HOP) of mature milk.
A total of 67 mothers of infants <31 weeks gestation were enrolled and instructed on pumping, hand expression of colostrum and HOP. Expression records for 8 weeks and medical records were used to assess production variables.
Seventy-eight percent of the mothers completed the study. Mean daily volumes (MDV) rose to 820 ml per day by week 8 and 955 ml per day in mothers who hand expressed >5 per day in the first 3 days. Week 2 and/or week 8 MDV related to hand expression (P<0.005), maternal age, gestational age, pumping frequency, duration, longest interval between pumpings and HOP (P<0.003). Mothers taught HOP increased MDV (48%) despite pumping less.
Mothers of preterm infants may avoid insufficient production by combining hand techniques with pumping.
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We thank Birt Harvey, MD for his critical review of the article and Medela for project facilitation. Also, we acknowledge Sarah Nomanbhoy, Ranee Bhutani, Stewart Carlson and Ian Rhine for assistance with data entry and analyses, and the Stanford GCRC nurses: Patricia Hartsell, Barbara Piane, Elizabeth Kogut and Dorothy Inguillo for their hard work. This work was supported, in part, by Grant M01 RR-000070 from the National Center for Research Resources, National Institutes of Health, and in part by Medela Inc. Medical Research, Switzerland.
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Morton, J., Hall, J., Wong, R. et al. Combining hand techniques with electric pumping increases milk production in mothers of preterm infants. J Perinatol 29, 757–764 (2009). https://doi.org/10.1038/jp.2009.87
- hand expression
- insufficient milk production
- preterm infants
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