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Practices, predictors and consequences of expressed breast-milk feeding in healthy full-term infants

  • Dorothy Li Bai (a1), Daniel Yee Tak Fong (a1), Kris Yuet Wan Lok (a1), Janet Yuen Ha Wong (a1) and Marie Tarrant (a2)...
Abstract
Abstract Objective

To investigate the prevalence and predictors of expressed breast-milk feeding in healthy full-term infants and its association with total duration of breast-milk feeding.

Design

Prospective cohort study.

Setting

In-patient postnatal units of four public hospitals in Hong Kong.

Subjects

A total of 2450 mother–infant pairs were recruited in 2006–2007 and 2011–2012 and followed up prospectively for 12 months or until breast-milk feeding had stopped.

Results

Across the first 6 months postpartum, the rate of exclusive expressed breast-milk feeding ranged from 5·1 to 8·0 % in 2006–2007 and from 18·0 to 19·8 % in 2011–2012. Factors associated with higher rate of exclusive expressed breast-milk feeding included supplementation with infant formula, lack of previous breast-milk feeding experience, having a planned caesarean section delivery and returning to work postpartum. Exclusive expressed breast-milk feeding was associated with an increased risk of early breast-milk feeding cessation when compared with direct feeding at the breast. The hazard ratio (95 % CI) ranged from 1·25 (1·04, 1·51) to 1·91 (1·34, 2·73) across the first 6 months.

Conclusions

Mothers of healthy term infants should be encouraged and supported to feed directly at the breast. Exclusive expressed breast-milk feeding should be recommended only when medically necessary and not as a substitute for feeding directly at the breast. Further research is required to explore mothers’ reasons for exclusive expressed breast-milk feeding and to identify the health outcomes associated with this practice.

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Corresponding author
* Corresponding author: Email baili1204@gmail.com
References
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1. Duijts L, Ramadhani MK & Moll HA (2009) Breastfeeding protects against infectious diseases during infancy in industrialized countries. A systematic review. Matern Child Nutr 5, 199210.
2. Horta BL, Bahl R, Martinés JC et al. (2007) Evidence on the Long-Term Effects of Breastfeeding: Systematic Reviews and Meta-Analysis. Geneva: WHO.
3. Ip S, Chung M, Raman G et al. (2007) Breastfeeding and maternal and infant health outcomes in developed countries. Evid Rep Technol Assess (Full Rep) 153, 1186.
4. Thulier D & Mercer J (2009) Variables associated with breastfeeding duration. J Obstet Gynecol Neonatal Nurs 38, 259268.
5. Dennis CL (2002) Breastfeeding initiation and duration: a 1990–2000 literature review. J Obstet Gynecol Neonatal Nurs 31, 1232.
6. World Health Organization (1998) Evidence for the Ten Steps to Successful Breastfeeding. Geneva: WHO.
7. Meier PP (2001) Breastfeeding in the special care nursery: prematures and infants with medical problems. Pediatr Clin North Am 48, 425442.
8. Furman L, Minich N & Hack M (2002) Correlates of lactation in mothers of very low birth weight infants. Pediatrics 109, e57.
9. Walker M (2010) Breast pumps and other technologies. In Breastfeeding and Human Lactation, 4th ed., pp. 379424 [J Riordan and K Wambach, editors]. Sudbury, MA: Jones and Bartlett.
10. Labiner-Wolfe J, Fein SB, Shealy KR et al. (2008) Prevalence of breast milk expression and associated factors. Pediatrics 122, Suppl. 2, S63S68.
11. Clemons SN & Amir LH (2010) Breastfeeding women’s experience of expressing: a descriptive study. J Hum Lact 26, 258265.
12. Binns CW, Win NN, Zhao Y et al. (2006) Trends in the expression of breastmilk 1993–2003. Breastfeed Rev 14, 59.
13. Johnson S, Williamson I, Lyttle S et al. (2009) Expressing yourself: a feminist analysis of talk around expressing breast milk. Soc Sci Med 69, 900907.
14. Johnson S, Leeming D, Williamson I et al. (2013) Maintaining the ‘good maternal body’: expressing milk as a way of negotiating the demands and dilemmas of early infant feeding. J Adv Nurs 69, 590599.
15. Boo N, Nordiah A, Alfizah H et al. (2001) Contamination of breast milk obtained by manual expression and breast pumps in mothers of very low birthweight infants. J Hosp Infect 49, 274281.
16. García-Lara NR, Escuder-Vieco D, García-Algar O et al. (2012) Effect of freezing time on macronutrients and energy content of breastmilk. Breastfeed Med 7, 295301.
17. Geraghty SR (2011) Photo album of pumped breastmilk. Breastfeed Med 6, 433434.
18. Ohyama M, Watabe H & Hayasaka Y (2010) Manual expression and electric breast pumping in the first 48 h after delivery. Pediatr Int 52, 3943.
19. Qi Y, Zhang Y, Fein S et al. (2013) Maternal and breast pump factors associated with breast pump problems and injuries. J Hum Lact 30, 6272.
20. Flaherman VJ, Gay B, Scott C et al. (2013) Development of the breast milk expression experience measure. Matern Child Nutr 9, 425430.
21. Thorley V (2011) The dilemma of breastmilk feeding. Breastfeed Rev 19, 57.
22. Johns HM, Forster DA, Amir LH et al. (2013) Prevalence and outcomes of breast milk expressing in women with healthy term infants: a systematic review. BMC Pregnancy Childbirth 13, 212.
23. Hornbeak DM, Dirani M, Sham WK et al. (2010) Emerging trends in breastfeeding practices in Singaporean Chinese women: findings from a population-based study. Ann Acad Med Singapore 39, 8894.
24. Chapman DJ, Young S, Ferris AM et al. (2001) Impact of breast pumping on lactogenesis stage II after cesarean delivery: a randomized clinical trial. Pediatrics 107, E94.
25. Geraghty SR, Khoury JC & Kalkwarf HJ (2005) Human milk pumping rates of mothers of singletons and mothers of multiples. J Hum Lact 21, 413420.
26. Maastrup R, Hansen BM, Kronborg H et al. (2014) Factors associated with exclusive breastfeeding of preterm infants. Results from a prospective national cohort study. PLoS One 9, e89077.
27. Forster DA, Johns HM, McLachlan HL et al. (2015) Feeding infants directly at the breast during the postpartum hospital stay is associated with increased breastfeeding at 6 months postpartum: a prospective cohort study. BMJ Open 5, e007512.
28. Jiang B, Hua J, Wang Y et al. (2015) Evaluation of the impact of breast milk expression in early postpartum period on breastfeeding duration: a prospective cohort study. BMC Pregnancy Childbirth 15, 268.
29. Meehan K, Harrison GG, Afifi AA et al. (2008) The association between an electric pump loan program and the timing of requests for formula by working mothers in WIC. J Hum Lact 24, 150158.
30. Win NN, Binns CW, Zhao Y et al. (2006) Breastfeeding duration in mothers who express breast milk: a cohort study. Int Breastfeed J 1, 28.
31. Schwartz K, D Arcy HJ, Gillespie B et al. (2002) Factors associated with weaning in the first 3 months postpartum. J Fam Pract 51, 439444.
32. Tarrant M, Fong DY, Wu KM et al. (2010) Breastfeeding and weaning practices among Hong Kong mothers: a prospective study. BMC Pregnancy Childbirth 10, 27.
33. Tarrant M, Lok K, Fong DYT et al. (2015) Effect of a hospital policy of not accepting free infant formula on in-hospital formula supplementation rates and breast-feeding duration. Public Health Nutr 18, 26892699.
34. Panel on Health Services (2012) Latest Arrangement for Non-Local Pregnant Women Giving Birth in Hong Kong [Food and Health Bureau, editor]. Hong Kong: Panel on Health Services.
35. Census and Statistics Department of Hong Kong (2016) Hong Kong annual digest of statistics: 2015 edition. http://www.statistics.gov.hk/pub/B10100032015AN15B0100.pdf (accessed June 2016).
36. Hong Kong Labour Relations Promotion Unit (2010) Maternity Protection. Hong Kong: Labour Relations Promotion Unit.
37. Bai DL, Fong DYT & Tarrant M (2014) Factors associated with breastfeeding duration and exclusivity in mothers returning to paid employment postpartum. Matern Child Health J 19, 990999.
38. Labbok M & Krasovec K (1990) Toward consistency in breastfeeding definitions. Stud Fam Plann 21, 226230.
39. World Health Organization (1991) Indicators for Assessing Breast-Feeding Practices. Geneva: WHO.
40. Xu F, Qiu L, Binns CW et al. (2009) Breastfeeding in China: a review. Int Breastfeed J 4, 6.
41. Hosmer DW, Hosmer T, Le Cessie S et al. (1997) A comparison of goodness-of-fit tests for the logistic regression model. Stat Med 16, 965980.
42. Hair JF, Black WC, Babin BJ et al. (2010) Multivariate Data Analysis: A Global Perspective, 7th ed. Upper Saddle River, NJ: Prentice-Hall.
43. Cleves M, Gould W, Gutierrez RG et al. (2010) An Introduction to Survival Analysis Using Stata, 3rd ed. College Station, TX: Stata Press.
44. Cox DR & Oakes D (1984) Analysis of Survival Data. London: Chapman and Hall.
45. Lumbiganon P, Martis R, Laopaiboon M et al. (2012) Antenatal breastfeeding education for increasing breastfeeding duration. Cochrane Database Syst Rev issue 9, CD006425.
46. Sheehan A & Bowcher WL (2016) Messages to new mothers: an analysis of breast pump advertisements. Matern Child Nutr (Epublication ahead of print version).
47. Fein SB, Mandal B & Roe BE (2008) Success of strategies for combining employment and breastfeeding. Pediatrics 122, Suppl. 2, S56S62.
48. Geraghty S, Davidson B, Tabangin M et al. (2012) Predictors of breastmilk expression by 1 month postpartum and influence on breastmilk feeding duration. Breastfeed Med 7, 112117.
49. Bureau of Labor Statistics, US Department of Labor, The Editor’s Desk (2012) Happy Mother’s Day from BLS: working mothers in 2012. http://www.bls.gov/opub/ted/2013/ted_20130510.htm (accessed November 2015).
50. Walling A (2005) Families and work. Labour Market Trends 113, 275283.
51. Bandura A (1977) Self-efficacy: toward a unifying theory of behavioral change. Psychol Rev 84, 191215.
52. Dennis CLE (2006) Identifying predictors of breastfeeding self-efficacy in the immediate postpartum period. Res Nurs Health 29, 256268.
53. Dykes F & Williams C (1999) Falling by the wayside: a phenomenological exploration of perceived breast-milk inadequacy in lactating women. Midwifery 15, 232246.
54. Lok KY, Bai DL & Tarrant M (2015) Predictors of breastfeeding initiation in Hong Kong and Mainland China born mothers. BMC Pregnancy Childbirth 15, 286.
55. Neifert M, Lawrence R & Seacat J (1995) Nipple confusion: toward a formal definition. J Pediatr 126, issue 6, S125S129.
56. Parry JE, Ip DK, Chau PY et al. (2013) Predictors and consequences of in-hospital formula supplementation for healthy breastfeeding newborns. J Hum Lact 29, 527536.
57. Kelleher CM (2006) The physical challenges of early breastfeeding. Soc Sci Med 63, 27272738.
58. Flaherman VJ, Hicks KG, Huynh J et al. (2014) Positive and negative experiences of breast pumping during the first 6 months. Matern Child Nutr 12, 291298.
59. Goldfield EC, Richardson MJ, Lee KG et al. (2006) Coordination of sucking, swallowing, and breathing and oxygen saturation during early infant breast-feeding and bottle-feeding. Pediatr Res 60, 450455.
60. Mizuno K & Ueda A (2006) Changes in sucking performance from nonnutritive sucking to nutritive sucking during breast-and bottle-feeding. Pediatr Res 59, 728731.
61. Ogbuanu IU, Karmaus W, Arshad SH et al. (2009) Effect of breastfeeding duration on lung function at age 10 years: a prospective birth cohort study. Thorax 64, 6266.
62. Håland G, Carlsen KCL, Sandvik L et al. (2006) Reduced lung function at birth and the risk of asthma at 10 years of age. N Engl J Med 355, 16821689.
63. Li R, Fein SB & Grummer-Strawn LM (2010) Do infants fed from bottles lack self-regulation of milk intake compared with directly breastfed infants? Pediatrics 125, e1386e1393.
64. Li R, Magadia J, Fein SB et al. (2012) Risk of bottle-feeding for rapid weight gain during the first year of life. Arch Pediatr Adolesc Med 166, 431436.
65. Harris R, Nicoll AD, Adair PM et al. (2004) Risk factors for dental caries in young children: a systematic review of the literature. Community Dent Health 21, 7185.
66. Geraghty SR, Sucharew H & Rasmussen KM (2013) Trends in breastfeeding: it is not only at the breast anymore. Matern Child Nutr 9, 180187.
67. Rasmussen KM & Geraghty SR (2011) The quiet revolution: breastfeeding transformed with the use of breast pumps. Am J Public Health 101, 13561359.
68. Hector DJ (2011) Complexities and subtleties in the measurement and reporting of breastfeeding practices. Int Breastfeed J 6, 5.
69. Geraghty SR & Rasmussen KM (2010) Redefining ‘breastfeeding’ initiation and duration in the age of breastmilk pumping. Breastfeed Med 5, 135137.
70. Felice JP & Rasmussen KM (2015) Breasts, pumps and bottles, and unanswered questions. Breastfeed Med 10, 412415.
71. Center for Health Protection (2014) Optimising Breastfeeding Practices: A Link to Life Long Health. Hong Kong SAR: Department of Health.
72. Natland ST, Andersen LF, Nilsen TIL et al. (2012) Maternal recall of breastfeeding duration twenty years after delivery. BMC Med Res Methodol 12, 179.
73. Li R, Scanlon KS & Serdula MK (2005) The validity and reliability of maternal recall of breastfeeding practice. Nutr Rev 63, 103110.
74. Becker GE, Cooney F & Smith HA (2011) Methods of milk expression for lactating women. Cochrane Database Syst Rev issue 12, CD006170.
75. World Health Organization (2008) Indicators for Assessing Infant and Young Child Feeding Practices. Part 1: Definitions. Geneva: WHO.
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