title: Combining hand techniques with electric pumping increases milk production in mothers of preterm infants.
abstract: OBJECTIVE
  Pump-dependent mothers of preterm infants commonly experience insufficient production. We observed additional milk could be expressed following pumping using hand techniques. We explored the effect on production of hand expression of colostrum and hands-on pumping (HOP) of mature milk.
  
  
  METHODS
  A total of 67 mothers of infants <31 weeks gestation were enrolled and instructed on pumping, hand expression of colostrum and HOP. Expression records for 8 weeks and medical records were used to assess production variables.
  
  
  RESULTS
  Seventy-eight percent of the mothers completed the study. Mean daily volumes (MDV) rose to 820 ml per day by week 8 and 955 ml per day in mothers who hand expressed >5 per day in the first 3 days. Week 2 and/or week 8 MDV related to hand expression (P<0.005), maternal age, gestational age, pumping frequency, duration, longest interval between pumpings and HOP (P<0.003). Mothers taught HOP increased MDV (48%) despite pumping less.
  
  
  CONCLUSIONS
  Mothers of preterm infants may avoid insufficient production by combining hand techniques with pumping.
authors: Department of Pediatrics, Stanford University School of Medicine, Stanford, CA 94025, USA. janemorton@sbcglobal.net
authors: J
authors: J
authors: Morton
authors: J Y
authors: JY
authors: Hall
authors: R J
authors: RJ
authors: Wong
authors: L
authors: L
authors: Thairu
authors: W E
authors: WE
authors: Benitz
authors: W D
authors: WD
authors: Rhine
mesh_terms: D001942:Breast Feeding; D003126:Colostrum / Q000378:metabolism; D004867:Equipment Design; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal; D007774:Lactation; D008895:Milk, Human / Q000378:metabolism*; D013396:Suction / Q000379:methods*