Pumping Behaviors, Pumped Milk Volume, and Maternal Opportunity Cost for Breast Pump-Dependent Mothers of Preterm Infants in the First 14 Postpartum Days

<b><i>Objectives:</i></b> Describe pumping behaviors and pumped mother's own milk (MOM) volume by achievement of secretory activation (SA; MOM sodium [Na] concentration ≤16 mM), coming to volume (CTV; ≥500 mL pumped MOM/day), SA maintenance (continued daily Na ≤16 mM), and opportunity costs in the first 14 postpartum days for pump-dependent mothers of preterm infants in the neonatal intensive care unit. <b><i>Methods:</i></b> A secondary analysis of two prospective cohorts. Mothers recorded pumping and MOM volume for each pumping session during the first 14 postpartum days. Daily MOM Na concentration was measured to determine SA. The opportunity cost was the dollar value of time spent pumping. Regression models evaluated pumping behaviors, pumped MOM volume, and opportunity cost by SA and CTV achievement and SA maintenance. <b><i>Results:</i></b> Of 66 mothers, 94% and 41% achieved SA and CTV, respectively, and 44% of mothers who achieved SA maintained it through 14 days postpartum. Mothers who achieved SA had more pumping sessions (5.6 versus 4.3/day, <i>p</i> < 0.001), longer pumping duration (108 versus 83 minutes/day, <i>p</i> < 0.001), and higher pumped MOM volume (349 versus 218 mL/day, <i>p</i> < 0.001). Mothers who achieved versus did not achieve CTV pumped 5.6 versus 4.9 times/day (<i>p</i> = 0.050). Opportunity costs were $376 for mothers achieving SA, $155 higher than not achieving, and $441 for mothers maintaining SA, $94 higher than not maintaining SA. <b><i>Conclusion:</i></b> Pumped MOM volume and opportunity costs were higher for mothers who achieved and maintained SA. Strategies offsetting opportunity costs during the stressful early postpartum period for breast pump-dependent mothers of preterm infants are needed.