Breastfeeding Without Nursing: Why do some breastfeeders exclusively pump and what can we do to support them?

Fiona Jardine, MA (Cantab.), LLM, MLS, ALC
University of Maryland, College Park, MD

APHA's 2019 Annual Meeting and Expo (Nov. 2 - Nov. 6)

The rates of exclusive milk expression or pumping (EPing) are increasing. However, little is known about the reasons for EPing initiation and cessation, or the durations achieved by those who breastfeed without nursing. To describe the reasons given by EPers for initiating and ceasing EPing and explore the durations of EPing achieved, a cross-sectional, self-report, mixed-methods survey was administered online to a convenience sample of current and/or former EPers (N = 2,007). To identify trends, quantitative data were analyzed in SPSS and thematic analysis of qualitative data was performed in Atlas.ti.

Latch problems dominated the reasons given for EPing: 69% (1,394) of respondents reported latch problems; 25% (496) reported their infant did not transfer milk well while nursing; 23% (463) had a NICU infant; and 8% (157) “just wanted to.” The health benefits of breastfeeding to their child (98%; 1964) and themselves (43%; 859), as well as the cost of formula (57%; 1,138), were cited as reasons not to exclusively formula feed.

Out of 696 (35%) former EPers, reasons for cessation included: reaching their goal (37%; 257); supply issues (low/“drying up”) (35%; 242); logistical difficulties (caring for child/time to pump) (32%; 222); and infant(s) successfully latching (7%, 48). Excluding those who ceased EPing because of latching, mean EPing duration was approximately 8.6 months (SD = 5.18; median = 8; range = >1 week–54 months).

In addition, respondents reported poor experiences with lactation care providers, primarily relating to unhelpful or non-existent information and a sense of feeling judged. The duration of EPing achieved, while greatly varied, provides evidence that EPing is a sustainable long-term breastfeeding option, but only, for many, because of online information and support. This presentation will discuss the findings above, but also suggest programmatic and educational ideas for improving the information and support provided to this growing community.

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