Table 2 Studies exploring methods of expressing
Author, year, country | Design | Location, participants, year of study and recruitment | Study aims and outcome measures | Results | Strengths/Limitations |
|---|---|---|---|---|---|
Binns et al. 2006 Australia [2] | Longitudinal | 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 | ||
1992–93 |  |  | Actual figures not given | ||
PIFS II n = 587 | Â | Â | Public patients only, perhaps not representative | ||
2002–03 |  |  |  | ||
Recruited in hospital in early post-partum period | Â | Â | Â | ||
Labiner-Wolfe et al. 2008 USA [3] | Longitudinal | 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 | Â | 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 | Â | - Manual expression 2 ml (median; range: 0-12.6 ml.) | Small study | ||
2003-2004 |  | - 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 | Â | - Manual pump associated with more reports of pain | Â | ||
Flaherman et al 2012 USA [32] | RCT | 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 | Â | Thorough discussion | ||
2007-2009 | - Breast pain | Â | Small study, final outcome assessment based on 48 participants | ||
Recruited12-36 hours after birth | - Breastfeeding confidence | Â | Possible bias- recruited infants experiencing feeding difficulty | ||
| Â | - Breast milk expression experience | Â | No control group | ||
| Â | - Breastfeeding rates at 2 months | Â | Â | ||
Becker et al. 2011 UK [30] | Systematic review | International | - 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 |
| Â | Â | n = 642 women from 23 studies | Â | - 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 |