Abstract
PURPOSE: To assess whether adding 5 minutes of slower, nutritive suction cycles to a standard 15-minute breast pump initiation program increases expressed milk volume during the first 4 days postpartum. Background : Early and effective colostrum removal is critical for breastfeeding success and neonatal health. Standard initiation suction patterns are primarily non-nutritive and may be suboptimal for colostrum extraction. METHODS: This prospective pilot study was conducted at OLVG hospital in the Netherlands. Breastfeeding patients (n = 40) who gave birth after 36 weeks gestation with an infant aged ≤96-hour old and a clinical indication to express milk with a breast pump were recruited. Patients participated in one single 20-minute breast expression session using a hospital-grade electric breast pump with a 15 minute predominantly non-nutritive standard suction pattern followed by 5 minutes with a nutritive suction pattern. The primary outcome was the difference in the total expression volume after 20 min compared to 15 min of expression. Secondary outcomes were differences in expression volume by postpartum day, parity, mode of birth, and prior experience breastfeeding. RESULTS: The study found that the primary outcome total colostrum/milk expression volume after 20 minutes was significantly improved compared to 15 minutes of pumping (4.69 ml vs 7.6 ml, P < .001). With the additional 5 minutes yielding 36% of the total milk yield. CONCLUSIONS: This study suggests an improvement in milk expression volume driven by the implementation of 5 minutes of additional of nutritive breast pump suction cycles. IMPLICATIONS FOR PRACTICE AND RESEARCH: This pilot study contributes to novel insights into milk removal dynamics in the first days after birth. TRIAL REGISTRATION: Registered on clinical trials.gov NCT04619212. Date of registration: November 6, 2020.