Short-term efficacy of two breast pumps and impact on breastfeeding outcomes at 6 months in exclusively breastfeeding mothers: a randomised trial.

The provision of breast pumps is a potential strategy to increase breastfeeding duration. This trial compared the effectiveness and acceptability of two breast pumps in mothers exclusively breastfeeding (EBF) their healthy term infant. It also tested whether provision of pumps versus vouchers of equivalent value influenced breastfeeding or attainment of mothers' goals at 3 and 6 months. Mothers were randomised at 3-4w post-partum (Beijing (n=30), Moscow (n=34), London (n=45), New York (n=3)) to group A (Philips single-electric pump, Natural bottle), B (Medela Swing single-electric pump, Calma bottle) or C (Control; vouchers). At 6w, group A and B mothers expressed for 10 minutes/breast; milk weight and provided opinions of pump/bottle. Feeding practices were assessed using questionnaires at 3 and 6mo. Milk weight/flow pattern did not differ between groups. Pump A scored significantly better for ease-of-use, cushion-feel, need-to-lean-forward, pleasant, comfort. At 3 and 6mo, %EBF or meeting their goal was not significantly different; (3mo 86, 85, 84%; 6mo 20, 15, 26%; meeting goal 24, 17, 27% for A, B C). Expressed breast milk (EBM) provision was higher in groups A and B (3mo 76, 76, 24% (p<0.001); 6mo 83, 87, 32% (p<0.001); and negatively predicted EBF at 6mo (OR no EBM 5.07 (95% CI 1.56-16.5)). The pumps were equally effective for milk expression at 6w. Pump provision did not significantly influence breastfeeding practices or attainment of goals but resulted in higher EBM provision, which was associated with lower EBF but not other breastfeeding categories at 6mo.