Modification of a breast pump suction pattern increases milk yield during the first 4 days postpartum

INTRODUCTION: This prospective study aimed to assess if the addition of 5 min nutritive suction cycles, following 15 min of predominantly non-nutritive suction cycles used to initiate breastfeeding, would result in an increase in milk yield during an expression session in the first 4 days postpartum. MATERIAL AND METHODS: A prospective interventional study was conducted in the Netherlands, enrolling 90 breastfeeding patients who delivered at ≥36 weeks gestation and had infants aged ≤96 h old with a clinical indication to express milk using a breast pump. One of the participants' clinically indicated pumping sessions was used for a 20-min breast expression assessment. The session comprised 15 min of predominantly non-nutritive standard suction followed by 5 min of nutritive suction using a hospital-grade electric breast pump. The primary outcome measured the difference in milk volume between 15- and 20-min pumping in total and per postpartum day in the first 4 days postpartum. Secondary outcomes included expression volume at 15 and 20 min pumping per patient characteristic and milk yielded milliliters per minute. RESULTS: The primary outcome measure of the difference in milk volume between 15- and 20-min pumping was significantly increased both overall (1.39 vs. 2.83 mL, p < 0.001) and per postpartum day (p < 0.001). Milk yield per minute was significantly lower during the initial 15 min compared to the additional 5 minutes pumping (0.09 vs. 0.29 mL/min, p < 0.001). CONCLUSIONS: This study demonstrates a significant incremental improvement in milk removed during pumping episodes conducted in the first 4 days postpartum by the implementation of a 5 minute additional nutritive suction pattern to a 15 min predominantly non-nutritive suction cycle pattern. These findings could play a crucial role in supporting early access to colostrum and improving long-term breastfeeding outcomes.