Results of a recent study show that hand expression and breast massage combined with breast pumping did a better job of stimulating milk production than breast pumping alone.

Dr. Jane Morton and a research colleague at Stanford University investigated the effect of two methods of milk removal in mothers of infants born at less than 30 weeks’ gestation. The study has been accepted for publication in an upcoming issue of the Journal of Perinatology.

Because breastfeeding is typically delayed for weeks or months in mothers of infants born prematurely, these mothers often rely upon breast pumps to stimulate milk production. To test the theory that frequent and effective milk removal in the first three days after birth is critical to establishing full milk production at two months, mothers participating in the study were taught to hand express during this period. Once they began to produce larger amounts of milk, they were taught what is described by the researchers as “hands-on pumping”—a technique that combines breast massage, hand expression, and breast pumping.

Study results
Researchers found that mothers who relied solely on breast pumping, and stopped each pumping session when the flow of milk ended, left available milk in the breast. Mothers who combined breast massage with breast pumping, and followed breast pumping with hand expression, removed more of the available milk. Mothers who used hand expression (five times or more each day) in addition to hands-on pumping produced an average of 955 ml per day (approximately 32 ounces) by 2 months—an amount that would satisfy most healthy, full-term, breastfed 3-month-olds. Moreover, those factors thought to compromise milk production such as advanced maternal age, obesity, cesarean birth, and preterm birth had no impact on long-term milk production in the mothers in the study.

Before these preliminary findings can be applied to a wider population of mothers, more research is needed. While these results are not meant to challenge the importance of breast pumps, they are meant to highlight the effect of combining breast pumping with other techniques as a means for maximizing long-term milk production. Given that insufficient milk is the most common reason mothers give for stopping breastfeeding, any strategy for increasing milk production could have a profound impact on exclusive breastfeeding rates as well as duration rates.

With increasing reliance on gadgets and gizmos to support continued breastfeeding, it’s encouraging to think that the best strategy for helping mothers make more milk is a no-cost, no-risk, hands-on solution.