Effect of expressed human milk feeding on breastfeeding duration in term infants: A systematic review and meta-analysis

Abstract

<p>Background: The mode of breastfeeding is evolving, with an increasing trend of expressed human milk feeding. However, previous studies that examined the association between expressed human milk feeding and breastfeeding duration showed inconsistent findings. Objective: To understand the association between any and only expressed human milk feeding and breastfeeding duration and to describe the prevalence of expressed human milk feeding among parents of healthy term infants. Search Strategy: We systematically searched CINAHL, EMBASE, PubMed, PsycINFO, Cochrane Library, and Google Scholar, up to December 2023. Selection Criteria: Observational studies written in English and which reported at least one of the intended incomes mentioned were included. Data Collection and Analysis: The association between expressed human milk feeding and breastfeeding outcomes was evaluated by combining study-specific hazard ratios (HRs) and 95% confidence intervals (CIs). The degree of heterogeneity was measured using the I² statistic. Main Results: Any expressed human milk feeding within 3 months postpartum (HR 1.34, 95% CI 1.04–1.73) increased the risk of breastfeeding cessation. Only expressed human milk feeding within 3 months and ≥3 months postpartum were associated with 43% and 81% increased risk of breastfeeding cessation, respectively. Furthermore, 81% of breastfeeding persons had ever expressed human milk feeding. Only seven out of 31 studies were rated as good quality. Conclusion: To date, only a few recent high-quality studies have explored the prevalence of expressed human milk feeding and its association with breastfeeding duration among parents of healthy term infants. Further high-quality research is required to investigate these aspects further.</p>