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Table 1 Studies exploring prevalence of breast milk expressing

From: Prevalence and outcomes of breast milk expressing in women with healthy term infants: a systematic review

Author, year, country Design Location, participants, year of study and recruitment Study aims and outcome measures Results Strengths/Limitations
Geraghty et al. 2005 USA [1] Retrospective cohort Cincinnati, Ohio n = 346 2002 Random selection postal recruitment when infants were between 2 and 3 years old Quantify breast pump use 77% (182/236) ever used a breast pump Large sample size
  Identify relationships between breast pump use and No significant difference in expressing between 4 groups of mothers; those of Clear differentiation between breastfeeding and breast milk feeding
  - singleton vs. multiple pregnancy - term singletons Periodic reports re. proportion of expressing versus breastfeeding (at 1 day, 3 days, 2 weeks and monthly until 6 months)
  - gestation at birth - preterm singletons Retrospective data, possible recall bias, initial contact made when children between 2–3 years of age-requesting detailed information about infant feeding at 24 hrs, 3 days, 2 weeks and then at monthly intervals to 6 months.
  - breastfeeding outcomes - term multiples Expressing methods not distinguished between hand, manual or electric pump
- preterm multiples
- 68% (236/346) received at least some breast milk.
- 5% (12/236) exclusively expressed to feed – all mothers of premature babies
Binns et al. 2006 Australia [2] Longitudinal Perth, Western Australia - Explore determinants of breastfeeding - PIFS I 38% (211/556) expressing by 6 weeks Large sample
PIFS I n = 556 - Measure and compare prevalence of expressing - PIFS II 69% (405/587) expressing by 4 weeks Comparison of similar groups 10 years apart
1992–93   - Expressing rates steadily decline after 6 weeks: Limited detail about expressed breast milk/ breastfeeding proportions.
PIFS II n = 587   26% (145/556) at 24 weeks in PIFS I 28% (164/587) at 22 weeks in PIFS II Public patients only, perhaps not representative
2002–03    Differing interview schedules – less clarity for comparison
Recruited in hospital in early postpartum period    
Labiner-Wolfe et al. 2008 USA [3] Longitudinal National study - Reasons why women express - Most common reason: for someone else to feed baby Large sample
n = 4606 - Amount and prevalence of milk expression - 85% (1329 /1564) between 1.5 and 4.5 months postpartum had expressed at some time since birth Maternal recall previous 7 days
2005–2007 - Associated socio-demographic factors - 68% (1015/1493) of this group had expressed in 2 weeks before survey, 25% (373/1493) regularly Measures frequency of expressing (asked how many times expressed in previous 2 weeks and if expressed on a regular schedule)
from IFPS II   - Expressing associated with: maternal employment, higher income, first breastfeeding experience Not nationally representative: Older, more educated, more likely to be white, employed, higher income, less likely to smoke. More likely to breastfeed and for longer
Mail survey 2, 5 and 7 months postpartum    
Shealy et al. 2008 USA [4] Longitudinal National study Describe breastfeeding in first 12 months to identify: - 0.06% of babies fed expressed breast milk exclusively – 2/3 of these ceased breast milk feeding by 4 weeks Detailed analysis of feeding type/frequency/duration of individual feeds
n = 2587 - Prevalence of exclusive pumping and formula supplementing   Limited data re. expressing – except when it was exclusive
2005–2007 - Patterns and trends in breastfeeding related to common advice given   
from IFPS II    
Monthly postal questionnaires    
Clemons & Amir 2010 Australia [5] Cross-sectional State-wide study, Victoria - Prevalence of breast milk expression - 67% (602/898) had fully breastfed prior to hospital discharge Large study
n = 903 - Demographic characteristics of women who express, why and how they do it - 14% (125/898) had breastfed and expressed to feed their baby Possible selection bias (members of the Australian Breastfeeding Association)
2008 - Women’s experience of using breast pumps - Of those whose youngest child was over six months 95% (628/661) fully breastfed for at least six months Timing of questionnaire, possible recall bias
Online questionnaire sent to Australian Breastfeeding Association members who had an email address   - 4% (34/898) expressed and exclusively fed EBM  
Baby any age   - 98% (885/903) ever expressed  
Hornbeak et al. 2010 Singapore [6] Retrospective cohort Singapore - Prevalence and patterns of breastfeeding in Singaporean Chinese mothers from birth to 6 months - Initiation of breast milk feeding increased from 69% (144/210) in 2000-2001 to 82% (538/656) in 2006/2008 Large representative sample of Chinese Singaporean mothers
n = 3009   - Exclusive expressing increased from 9% (18/144) in 2000-2001 to 18% (118/538) in 2006/2008 Limited detail about expressed breast milk/breastfeeding proportions.
2006-2008   - Direct breast milk feeding decreased from 34% (72/210) in 2000–2001 to 27% (142/656) in 2006/2008 Possible recall bias - recruitment 6–72 months after birth
Recruited mothers of 6-72 month Chinese Singaporean children through Strabismus, Amblyopia and Refractive Error in Singaporean Children (STARS) Study    Gestational age not indicated
Mailed invitation    
Face-to-face interview    
Geraghty et al. 2012 USA [29] Prospective longitudinal cohort Cincinnati, Ohio - Describe who commences expressing early - 14% (8/59) commenced some expressing in first week Prospective design assisting recall
n = 60 - Explore breastfeeding duration in women who express - By four weeks: 63% (37/59) expressing Initial weekly visits; used weekly and 24 hour recall to enquire about feeding and expressing
2004–2007   - Expressing had no effect on duration of breast milk feeding Clear differentiation between ‘breastfeeding’ and ‘breast milk feeding’
Recruited face to face in first week after hospital discharge.    Small study
    Recruitment of women who planned to breastfeed for 6 months or more
    Mothers recruited for study knew they were going to be assisted to pump and may have been more likely to be comfortable with this.
      Possible introduction of bias as weekly collection of breast milk was initiated at 1 week by research nurse using an electric breast pump