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Table 5 Other implications of 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
Clemons & Amir 2010 Australia [5] Cross sectional State-wide study, Victoria - Prevalence of breast milk expression - 17% (126/737) experienced nipple pain associated with pump use Large study
n = 903 - Demographic characteristics of women who express, why and how they do it Possible selection bias (members of ABA)
2008 - Women’s experience of using breast pumps Timing of questionnaire, possible recall bias
Online questionnaire sent to Australian Breastfeeding Association (ABA) members who had an email address  
Baby any age    
Li et al. 2010 USA [49] Longitudinal cohort National study - Test infant ability to self-regulate intake – compare active sucking (breastfeeding) with passive feeding (EBM via bottle) - Infants bottle fed early more likely to empty bottle/cup in late infancy Large national longitudinal study Minimal reporting bias for exposure and outcome – 7 day retrospective recall
n = 1597 - Complete empting of bottle or cup in late infancy used to indicate self-regulation - bottle a totally different feeding mode Multivariate analysis
2005–2007    Maternal report of feeding behaviour/bottle emptying - reporting error possible
from IFPS II    
Li et al. 2012[50] Longitudinal cohort USA - Multi level analysis to estimate weight gain X type of milk & feeding mode at 3,5, 7.and 12 - Among infants fed only breast milk, Breast milk fed infants gained 780g per month in the first year compared with breastfed infants who gained 729g Large national longitudinal study Minimal reporting bias for exposure and outcome – 7 day retrospective recall
n = 1899   - Possible association between bottle feeding EBM and increased weight gain  
Geraghty et al. 2012 USA [28] Retrospective cohort Cincinnati, Ohio - Examination of methods of maternal expression and infant consumption of breast milk - All expressed, all babies fed some expressed milk Limited other exploration of this area
n = 40   95% (38/40) infants breastfed and EBM Small size
2008   37% (15/40) fed EBM same day Retrospective data collection
Outpatients attending breastfeeding clinic, recruited by mail   30% (12/40) fed EBM same week Possible recall bias
   25% (8/40) fed EBM 1 and 4 weeks later  
     13% (5/40) fed EBM more than 4 weeks later