title: Impact of breast pumping on lactogenesis stage II after cesarean delivery: a randomized clinical trial.
abstract: OBJECTIVE
  Women at risk for delayed onset of lactation are often advised to pump their breasts before lactogenesis stage II to hasten the timing of this process. The effectiveness of this clinical practice has not been previously evaluated. This study investigates the effects of breast pumping before the onset of lactation on early milk transfer and subsequent breastfeeding duration among women giving birth by cesarean delivery.
  
  
  METHODS
  Sixty women were randomly assigned to either the pumping group (n = 30), which used a double electric breast pump for six 10- to 15-minute sessions from 24 to 72 hours postpartum, or to the control group (n = 30), which held the pump to their breasts without suction for the same amount of time. Milk transfer was assessed by test weighing infants before and after 3 breastfeeding sessions daily. Test weight data were fitted to a second-order polynomial curve, to predict milk transfer over time.
  
  
  RESULTS
  Breast pumping between 24 and 72 hours after cesarean delivery did not improve milk transfer. Participants in the pumping group tended to have lower milk transfer than did controls. Primiparae in the pumping group breastfed for ~5 months less than their counterparts in the control group; however, this difference was not statistically significant.
  
  
  CONCLUSIONS
  Breast pumping did not improve milk transfer during the first 72 hours postpartum and may negatively affect breastfeeding duration among primiparous women. lactation, lactogenesis, breast milk, breast pumping, milk expression, breastfeeding, cesarean delivery.
authors.affiliation: Department of Nutritional Science, University of Connecticut, Storrs, Connecticut, USA.
authors.forename: D J
authors.initials: DJ
authors.lastname: Chapman
authors.forename: S
authors.initials: S
authors.lastname: Young
authors.forename: A M
authors.initials: AM
authors.lastname: Ferris
authors.forename: R
authors.initials: R
authors.lastname: Pérez-Escamilla
mesh_terms: D000328:Adult; D001835:Body Weight; D001940:Breast / Q000378:metabolism*; D001942:Breast Feeding; D002585:Cesarean Section; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007774:Lactation / Q000502:physiology*; D008895:Milk, Human / Q000378:metabolism*; D017063:Outcome Assessment, Health Care; D010298:Parity; D013396:Suction / Q000379:methods*