202709 Breast pump use among Maryland WIC mothers: Implications for education, distribution, and breastfeeding success

Wednesday, November 11, 2009: 1:10 PM

Caitlin Cross-Barnet, MA , Department of Population, Family and Reprodutive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Marycatherine Augustyn, PhD , Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Amy Resnik, MS, RD, CSP, LDN , Maryland WIC Program, Maryland State Department of Health and Mental Hygiene, Balitmore, MD
Susan M. Gross, PhD, MPH, RD , Food Supplement Nutrition Education, University of Maryland Cooperative Extension, Columbia, MD
Joy P. Nanda, DSc, MS, MHS, MBA , Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
David M. Paige, MD MPH , Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
Introduction: The Maryland WIC program supports breastfeeding through various methods, including peer counselor education and support and distributing breast pumps. WIC recommends against pump use until infants are three weeks; however, many clients begin pumping soon after giving birth. Using qualitative analysis, we identify causes and consequences of early pump use. Design: A convenience sample of 55 mothers with infants was interviewed at five geographically representative Maryland WIC clinics. In addition, 7 WIC breastfeeding peer counselors were interviewed about clients' pump use. Preliminary Results: Women's most common reasons for pumping are to allow others to feed the baby, to use bottles of pumped milk in public, and to mitigate breastfeeding difficulties. Many women have concerns about milk supply even when their babies gain adequate weight and produce an appropriate number of wet diapers. Discussion: Maryland WIC distributes pumps to clients who are employed or in school. Quantitative studies of pump distribution in other states' WIC programs indicate that pump receipt furthers breastfeeding duration. However, our findings show that clients who begin using a pump soon after birth usually discontinue breastfeeding long before returning to work or school. Most breast pumps do not provide enough suction to establish a milk supply. Indiscriminate pump use can cloud perceptions of milk adequacy, cause pain, and undermine confidence. Using bottles in an infant's early weeks can lead to nipple confusion. These findings may have relevance beyond the WIC population. WIC's breastfeeding peer counselors and others should consider expanding education specifically regarding pumps to include more information about delaying use, proper use, and reasonable expectations about milk production.

Learning Objectives:
Identify mothers' reasons for early breast pump use Identify consequences of early breast pump use Discuss potential areas for education regarding pumps and successful breastfeeding

Keywords: Breastfeeding, WIC

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been active in breastfeeding advocacy for 15 years and have been a primary researcher for the current research project (evaluation of the Maryland WIC breastfeeding peer counselor program) for two years.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.