Comparison of Maternal Milk (Breastmilk) Expression Methods in an African Nursery

Objective: This study compares maternal milk volumes (MMVs) of Ugandan mothers whose infants were in a special care nursery and who used one of three maternal milk expression techniques: double electric breast pump, single non-electric manual breast pump, and hand breastmilk expression. Subjects and Methods: A convenience sample of 161 Ugandan mothers of infants who were either too immature or ill to independently feed from the breast yet healthy enough to survive in an environment without ventilator support (birth weights, 0.84-3.8 kg) were assigned to one of three maternal milk expressions: Group 1, double electric breast pump (n = 55); Group 2, single non-electric manual breast pump (n = 59); and Group 3, hand breastmilk expression (n = 47). Data were collected over a 7-day period (from day 1 postpartum to day 7 postpartum), and mean MMVs were measured and compared among the groups. Results: The mean daily MMVs were as follows: Group 1, mean 647 mL (SD = 310); Group 2, mean = 520 mL (SD = 298); and Group 3, mean = 434 mL (SD = 291). Results from one-way analysis of variance revealed significant differences in the mean MMV based on the method of maternal milk expression (p = 0.0019). Further analysis using Tukey's HSD Test revealed significant differences in the MMV between Groups 1 and 3 (p < 0.01), but not between Groups 1 and 2 or between Groups 2 and 3. Conclusions: Electric breast pumps provided the highest mean MMV; however, many mothers obtained adequate feeding volumes for their infants' daily nutritional needs with the single non-electric manual breast pump and hand breastmilk expression.