P4A049: Factors Influencing the Decision to Express Human Milk: A U.S. Based Mixed Method Study

Background: Breast pumps are a useful tool to allow feeding of human milk (HM) when the mother is apart from her child, or instances where the baby cannot feed directly from the breast. Exclusive feeding of human milk is recommended for the first 6 months of an infant’s life.1 However, many U.S. parents return to work far earlier than that, meaning expressed HM is a critical part of their infant feeding plans. As breast pump use becomes more widespread, there is a need to better understand motivations and reasons for breast pump use to ensure that all lactating people are supported in achieving their HM feeding goals.

Methods: Small focus groups (4 x 60 min, 4 participants per group) collected qualitative data from U.S. based breast pump users to capture key journey moments and phraseology used to inform design of an online survey. The online survey was completed by U.S. based pump users (n=400) to identify and segment the surveyed population based on attitudes and reasons for using a breast pump.

Results: Primiparous parents were more likely to wait until after birth to decide to pump, while those who pumped previously often made the decision pre-pregnancy. There was a strong desire to feed their infant breast milk, so reasons for deciding to pump were largely practical: focused around increasing supply (41%), building a stash of frozen milk (41%), planning to be away from the infant (35%) and sharing of feeding responsibilities (32%). Medical reasons for pump use were less common; unable to produce enough milk (18%), struggling to latch my infant (18%), pumping due to a premature infant (11%).

Conclusion: Historically, breast pumps were most frequently utilized to help initiate milk production after preterm birth or when an infant was in the NICU. However, as breast pump use becomes more widespread, their use is often a practical choice rather than driven by necessity. Better understanding the motivations for breast pump use will allow optimized support, education and technology to help parents achieve their breastmilk feeding goals.