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Table 3 Studies exploring reasons women express

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
Dykes & Williams 1999 UK [34] Longitudinal, phenomenological study Northern England, - Explore women’s experience of expressing particularly perception of adequacy of milk supply - Beliefs re. adequacy of breast milk supply influenced by interplay of feeding management, infant behaviour, lactation physiology and maternal mental health. Small mono-cultural group
n = 10    
Postnatal primiparas recruited face-to-face in hospital, home visits at 6, 8 &12 weeks    
Binns et al. 2006 Australia [2] Longitudinal cohort Perth, Western Australia - Explore determinants of breastfeeding - Early breastfeeding difficulties, Comparison of similar groups 10 years apart
PIFS I n = 556 - Measure and compare prevalence in expressing - Engorgement, sore nipples, mastitis Mainly women who expressed to manage breastfeeding difficulties
1992–93   - Feed to be given by someone else Public patients only, perhaps not representative
PIFS II n = 587   - To store extra milk  
2002–03   - Father to feed  
Recruited in hospital in early post-partum period.   - To increase supply  
   - Feeding/attachment problems  
   - To get baby to drink from a bottle  
   - Just to try it out  
Labiner-Wolfe et al. 2008 USA [3] Longitudinal cohort National study - Reasons why women express - to allow someone else to feed Large sample
n = 3606 - Amount and prevalence of milk expression - maternal employment Not nationally representative Participants older, more likely to be educated, white, employed, higher income
2005–2007 - Associated socio-demographic factors - to have an emergency milk supply  
from IFPS II   - no previous breastfeeding experience  
   - geographic location (Midwest Vs. West)  
   - embarrassed to breastfeed in public  
Buckley 2009 USA [33] Focus groups Washington, DC - Ascertain lactation consultant’s beliefs and experiences re. impact of breast pumps on breastfeeding practice - Technological birth contributes to technological breastfeeding Exploration of professional attitudes to change in feeding practice -no previous exploration of this area
n = 12   - Engorgement, plugged ducts, to increase supply, to stimulate the let-down reflex, to pull out inverted nipples. Small sample size
Lactation consultants   - Return to work Volunteer participants
Purposeful sampling   - Measuring milk, diminished confidence in ability to provide enough milk Date of study not indicated
Clemons & Amir 2010 Australia [5] Cross-sectional State-wide study, Victoria - Prevalence of breast milk expression - Premature baby/sick mother or baby Large study
n = 903 - Demographic characteristics of women who express, why and how they do it - Attachment problems/not drinking well Possible selection bias (members of ABA)
2008 - Women’s experience of using breast pumps - Advised Timing of questionnaire, possible recall bias
Online questionnaire sent to Australian Breastfeeding Association (ABA) members who had an email address - Not enough milk/To store extra milk  
- Nipple pain  
- Engorged breasts/mastitis  
- So someone else can feed baby  
- Maternal work  
- Just to try it out  
- To allow mother to drink alcohol  
  - Uncomfortable breastfeeding in public  
Geraghty et al. 2012 USA [29] Prospective longitudinal cohort Cincinnati - Duration of breast milk feeding - Planned return to work by 6 months Prospective design
n = 60 - Describe who commences expressing early   Small study
2004–2007    Recruitment of women who planned to breastfeed for 6 months or more
recruited face to face    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