'Breast is best' but often isn’t the easiest option to feed a newborn: UBCO

The best but not always easy

New research from the University of British Columbia Okanagan is looking at the best ways to support new mothers with breastfeeding.

Health-care professionals and researchers have long maintained that direct breastfeeding is the most healthy choice for infants, but they recognize it's not always possible for many new mothers.

Postdoctoral researcher with UBCO’s School of Nursing, Dr. Heidi Sze Lok Fan, has published a study that looks at the benefits and struggles of expressing breast milk—and the impacts not only on the infant but also the mom.

Dr. Fan conducted much of her research in Hong Kong, where until recently, maternity leave was limited to 10 weeks. It has now been extended to 14 weeks, and Dr. Fan says Chinese mothers are the ideal candidates to study when it comes to expressing milk because they often return to work when the infant may still be relying solely on breastmilk.

“Along with a short maternity leave, new mothers also have a one-month confinement after delivery where they are expected to stay at home with their infant. They usually don't go out of the home except to visit a health clinic, so during those first few weeks more than 90 per cent of their time is at home with their baby," says Dr. Fan.

In China during this so-called confinement time, new mothers are expected to develop a breastfeeding routine. For her study, Dr. Fan interviewed new mothers at 1.5 months postpartum.

“We thought this might be an ideal time as mothers spend most of their time at home with the baby and can have direct breastfeeding as they do not need to go out often or return to work,” she explains. “However, these mothers chose to feed their baby with expressed breast milk. This study looks into their reasons for choosing expressed breast milk feeding and their experiences.”

Dr. Fan reports most mothers choose to express their milk because they are having difficulties breastfeeding. Other women start expressing breastmilk as they try to establish a routine for when their maternity leave ends.

“In Hong Kong, the breastfeeding initiation rate is high at more than 84 per cent. However, sustaining breastfeeding poses challenges, and less than one-half of new mothers continue to breastfeed their children at six months postpartum,” says Dr. Fan.

“Understanding the experiences of those who feed expressed milk may also help improve breastfeeding support strategies.”

Previous research conducted by Dr. Fan followed women who had just given birth. They were recruited shortly after delivery and were followed for about six months. This second research paper, published recently in Sexual and Reproductive Healthcare, stems from qualitative interviews with those participants and examines why they express and how they feel about it.

“We do find that expressing milk does give many women a greater sense of control, especially for time management, because the infant’s feedings can be scheduled. With expressed milk, a woman can have more freedom, allowing family members to feed the baby. And that also helps with the preparation of returning to work.”

Dr. Fan notes many parents who have expressed milk have a shorter breastfeeding duration as they tend to stop breastfeeding earlier than parents who do not express milk. She also says that breastfeeding women need support and, she would like to see an improvement in strategies provided by health-care professionals to support post-partum women.

“We know that direct breastfeeding is the best option, and that expressed breastfeeding is still better than providing the infant with formula. That’s why it is crucial to strengthen the breastfeeding support programs provided in the early postpartum period to ensure that all breastfeeding women can feed directly for as long as they choose,” says Dr. Fan.

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