“We Just Kind of Had to Figure It Out”: A Qualitative Exploration of the Information Needs of Mothers Who Express Human Milk

Abstract

Background Human milk expression, primarily by pump, is practiced by the majority of breastfeeding mothers in affluent countries. Existing literature is focused on determining prevalence and duration rates and the factors behind this trend. There is less research exploring mothers’ perspectives and experiences related to expression. Research aim To gather the experiential wisdom of mothers with a focus on their information needs and sources related to human milk expression. Methods Audiotaped interviews were conducted with 35 mothers of infants, aged birth to 24 months, who had expressed milk at least once in western Canada. This study was guided by interpretive description, an applied qualitative research approach. Results Registered nurses and international board-certified lactation consultants were the most common sources of information, with Internet, friends/family, and other mothers also important. Inconsistent expression advice was confusing for participants, and many reported health care providers did not address all their expression learning needs. Desired topic areas included practical advice on how to express, determining expression frequency/timing/duration, milk storage guidelines, the influence of expression on milk supply, product information, and general support/encouragement. Conclusions Assessment of expression learning needs should be part of routine lactation support at each encounter. Nonjudgmental, factual guidance will assist mothers in making evidence-informed decisions related to expression practices that are consistent with their unique breastfeeding goals. This should be supplemented by reputable online resources that provide timely and accurate information as well as efforts to connect mothers with peer support groups.

Unseen, unheard: a qualitative analysis of women’s experiences of exclusively expressing breast milk

“…Dietrich Leurer et al found that participants who had ever expressed at all reported feeling negatively judged by healthcare providers for feeding expressed milk [ 33 ]. Some participants in the current study echoed similar sentiments.…”

“…This is similar to findings by Strauch and colleagues that information sources included online parenting forums and one-way information websites and blogs but did not find any scholarly articles examining support for EE [ 35 ]. Similarly, Dietrich Leurer and colleagues also found that for women needing to express milk at all, milk expression information needs were often not addressed by healthcare providers [ 33 ]. With respect to EE, there are few information sources or classes available leaving many to do their own research from websites and online forums [ 36 ] which creates a vacuum of quality, reliable information.…”

Exclusive breastmilk pumping: A concept analysis

“…Information on EP was often missing from prenatal classes, and there were no formal EP support programs, therefore, persons who exclusively pumped seeked information support, and guidance by doing their own research online and asking other parents on social media 9,35,37,42,49–51 . Healthcare providers often miss opportunities to give education and support on exclusive pumping 35,49 .…”

“…Information on EP was often missing from prenatal classes, and there were no formal EP support programs, therefore, persons who exclusively pumped seeked information support, and guidance by doing their own research online and asking other parents on social media 9,35,37,42,49–51 . Healthcare providers often miss opportunities to give education and support on exclusive pumping 35,49 . Education and support can help parents increase their knowledge and self‐efficacy around infant feeding and reinforce that breastmilk successfully can be fed in the absence of direct breastfeeding.…”

“…Insufficient milk supply was a common reason for premature breastfeeding cessation and having an adequate milk supply and a breastmilk stash provide flexibility if they encounter temporary problems with supply, illnesses, or separation 52,53 . Often, breastfeeding families seeked information on managing their breastmilk supply 9,49,51 . Parents may interpret the volume of breastmilk produced by pumping to indicate their supply, with those who perceived they had a low milk supply more likely to stop feeding breastmilk 12,13,42 .…”