title: Milk ejection patterns: an intra- individual comparison of breastfeeding and pumping.
abstract: BACKGROUND
  Milk ejection is a transient episode critical to milk removal and women typically have multiple milk ejections during breastfeeding and pumping. Recently it was found that milk ejection characteristics such as number of milk ejections and periodicity were consistent throughout 12 months of lactation in women who expressed their milk with an electric breast pump. It is not known whether the stimulation of an infant at the breast influences milk ejection patterns or whether this is a programmed event. The aim of this study was to compare milk ejection patterns during breastfeeding and expressing milk with an electric pump within mothers.
  
  
  METHODS
  Twelve lactating mothers with normal milk production (502-1356 mL) had milk ejection recorded by measuring the diameter of a major milk duct with ultrasound imaging throughout an entire breastfeed and a 15-min pumping session. Scans were analysed for timing, duration of duct dilation and maximum duct diameter.
  
  
  RESULTS
  The initial milk ejection defined as the first increase in duct diameter was observed earlier during breastfeeding than during two phase pumping sessions but was not statistically significant (p = .057). There were no significant differences between the duration of the first or second milk ejection for mothers when breastfeeding or pumping at their maximum comfortable vacuum (p = .18; p = .99). The times taken to reach the peak duct diameter, or the first half of the milk ejection were also not found to be significantly different between breastfeeding and pumping.
  
  
  CONCLUSIONS
  This study suggests that milk ejection patterns remain consistent within individual mothers regardless of whether the mother is breastfeeding or expressing milk indicating a likelihood of the process either being programmed or innate to the individual.
authors.affiliation: School of Chemistry and Biochemistry, M310, The University of Western Australia, 35 Stirling Highway, Crawley, 6009, Western Australia. Hazel.Gardner@uwa.edu.au.
authors.forename: Hazel
authors.initials: H
authors.lastname: Gardner
authors.affiliation: School of Chemistry and Biochemistry, M310, The University of Western Australia, 35 Stirling Highway, Crawley, 6009, Western Australia. jacqueline.kent@uwa.edu.au.
authors.forename: Jacqueline C
authors.initials: JC
authors.lastname: Kent
authors.affiliation: School of Chemistry and Biochemistry, M310, The University of Western Australia, 35 Stirling Highway, Crawley, 6009, Western Australia. ching-tat.lai@uwa.edu.au.
authors.forename: Ching Tat
authors.initials: CT
authors.lastname: Lai
authors.affiliation: School of Chemistry and Biochemistry, M310, The University of Western Australia, 35 Stirling Highway, Crawley, 6009, Western Australia. leon.mitoulas@medela.ch.|Medela AG, Lättichstrasse 4b, 6341, Baar, Switzerland. leon.mitoulas@medela.ch.
authors.forename: Leon R
authors.initials: LR
authors.lastname: Mitoulas
authors.affiliation: School of Chemistry and Biochemistry, M310, The University of Western Australia, 35 Stirling Highway, Crawley, 6009, Western Australia. mark.cregan@medela.ch.|Medela AG, Lättichstrasse 4b, 6341, Baar, Switzerland. mark.cregan@medela.ch.
authors.forename: Mark D
authors.initials: MD
authors.lastname: Cregan
authors.affiliation: School of Chemistry and Biochemistry, M310, The University of Western Australia, 35 Stirling Highway, Crawley, 6009, Western Australia. peter.hartmann@uwa.edu.au.
authors.forename: Peter E
authors.initials: PE
authors.lastname: Hartmann
authors.affiliation: School of Chemistry and Biochemistry, M310, The University of Western Australia, 35 Stirling Highway, Crawley, 6009, Western Australia. donna.geddes@uwa.edu.au.
authors.forename: Donna T
authors.initials: DT
authors.lastname: Geddes
mesh_terms: D000328:Adult; D001942:Breast Feeding; D061186:Breast Milk Expression; D005260:Female; D006801:Humans; D007223:Infant; D007774:Lactation / Q000502:physiology; D042361:Mammary Glands, Human / Q000502:physiology*; D008893:Milk Ejection / Q000502:physiology*; D016217:Ultrasonography, Mammary