246 EFFECT OF EARLY HAND EXPRESSION ON MILK PRODUCTION IN PUMP-DEPENDENT MOTHERS OF PRETERM INFANTS.

The volume of milk produced by a pump-dependent mother is the strongest determinant of the duration and exclusivity of breast-feeding the very low birth weight (VLBW, n = 8); group II (medium, 2-5 per day, n = 17); and group III (high, > 5 per day, n = 16). The mean frequency of pumping in groups I, II, and III over the first 3 days postpartum was 3.7 ± 0.8, 4.4 ± 1.7, and 5.1 ± 1.7/d, respectively, and the mean frequency over 14 days was 5.7 ± 1.0, 5.8 ± 1.3, and 6.5 ± 1.3/d, respectively. No statistical differences were found between the three groups at either time points. By week 2, group I, II, and III mothers produced a mean milk volume of 497 ± 226, 484 ± 352, and 802 ± 540 mL/d, respectively. There was a statistically significant difference in milk production by group III mothers compared with groups I and II (p ≤.04 and 5 per day) in the first 3 postpartum days, can produce larger than average volumes of breast milk by week 2. This suggests that mothers with risk factors for underproduction (eg, preterm or near-term delivery, cesarean section, separation of mother and infant) may benefit from using hand expression in conjunction with pumping or breast-feeding to reduce the likelihood of insufficient milk production, the most common reason given by mothers for early termination of breast-feeding. Supported in part by grant M01 RR-00070 from the National Center for Research Resources, National Institutes of Health, and by Medela, Inc. We thank P. Hartsell, D. Inguillo, B. Kogut, and B. Piane for their invaluable help.