Practices and predictors of expressed breast milk feeding among mothers of healthy term infants

Abstract

Breastfeeding provides numerous benefits to mother-infant pairs. The advent of high-quality electric breast pumps provides mothers with the option of elective expression. However, inadequate research have been conducted to explore breast milk expression intentions and to describe breast milk expression practices. The objectives of this study are to determine the prevalence of and reasons for obtaining a breast pump and to identify factors associated with expressed breast milk feeding. This study used a prospective cohort design. From 2017-2018, we recruited 821 healthy mother-infant dyads who gave birth in two public hospitals in Hong Kong. Participants completed self-administered questionnaires, which gathered information about sociodemographic characteristics, expressed breast milk feeding and pumping intentions. Participants were followed-up for six months or until they stopped breastfeeding. The proportion and type of infant feeding (at-the-breast feeding, expressed breast milk feeding and infant formula feeding) were assessed at telephone follow-up. The rate of any expressed breast milk feeding ranged from 56.8% to 68.2% within the first six months postpartum. 81.1% (95% Confidence interval [CI]= 0.78-0.84) of participants obtained a breast pump before giving birth while 62.6% (95% CI= 0.59-0.66) of participants purchased a new electric pump. The major reason for obtaining a breast pump was their return to employment. Nonetheless, experiencing breastfeeding difficulties (29%) was the main reason for breast milk expression within the first 1.5 months postpartum. Returning to employment was a strong predictor of expressed breast milk feeding (adjusted odds ratio [aOR]=8.74, 95% CI= 5.13-14.89). New mothers are increasingly viewing breast pumps as an essential device. Increased support should be given to mothers who encounter breastfeeding difficulties, especially in the early postpartum period.