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Table 2 Studies exploring methods of expressing

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

Author, year, country


Location, participants, year of study and recruitment

Study aims and outcome measures



Binns et al. 2006 Australia [2]


Perth, Western Australia

- Explore determinants of breastfeeding

- Approx. 60% (n = 1143) using manual pumps in both studies

Large study

PIFS I n = 556

- Measure and compare prevalence of expressing 1992-93 and 2002-03

- Use of electric pumps increased by 31% in 10 years

Comparison of similar groups 10 years apart



Actual figures not given

PIFS II n = 587


Public patients only, perhaps not representative



Recruited in hospital in early post-partum period


Labiner-Wolfe et al. 2008 USA [3]


National study

- Reasons why women express

- Birth to 1.5 -4.5 months

Large sample size

n = 4606

- Amount and prevalence of milk expression

80% (105/1302) battery or electric 44% (573/1302) manual pump 14% (18/1302) hand

3 mailed questionnaires seeking information re. feeding in previous fortnight - recall bias unlikely

2005-2007 IFPS II

- Associated socio-demographic factors

- Previous 3 months to 6.5-9.5 months

Detailed information re. methods of expression over time

Mail survey 2, 5 and 7 months postpartum


73% (39/529) battery or electric) 33% (18/529) manual pump 13% (69/529) hand

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

Ohyama et al 2010 Japan [31]

Sequential crossover

Yokohama, Kanagawa

- Comparison of effectiveness and comfort of manual and electric breast expression in first 48 hours after birth

- Manual expressing associated with greater milk volume: net milk yield per woman 2 ml.

Limited other exploration of this area

n = 11


- Manual expression 2 ml (median; range: 0-12.6 ml.)

Small study



- Electric expression 0.6 ml. (0-7.2 ml.) (P < 0.05).

Infant gestation and health status not indicated

Mothers of infants admitted to neonatal intensive care recruited in hospital soon after birth


- Manual pump associated with more reports of pain


Flaherman et al 2012 USA [32]


San Francisco & Sacramento, California

Comparison of hand and electric expression measured;

- At 2 months mothers assigned to hand expressing were more likely to be breastfeeding (97%, 47/48) than mothers assigned to breast pumping (73%,35/48) (RR:1.32, 95% CI 1.01,1.73)

Limited other exploration of this area, no previous studies linking type of expressing to breastfeeding outcomes

n = 68

- Milk transfer


Thorough discussion


- Breast pain


Small study, final outcome assessment based on 48 participants

Recruited12-36 hours after birth

- Breastfeeding confidence


Possible bias- recruited infants experiencing feeding difficulty


- Breast milk expression experience


No control group


- Breastfeeding rates at 2 months


Becker et al. 2011 UK [30]

Systematic review


- Assessment and review of randomised and quasi randomised trials comparing methods of milk expression any time after birth and crossover trials commencing at least 28 days after birth

- More milk with relaxation tape

Systematic review


n = 642 women from 23 studies


- No difference in mean vol. with simultaneous or sequential pumping, or between manual and electric pumps studied

Most studies specifically related to the care of the pre-term infant