Effective initiation
Time to read: 3 min.
Early pumping is an evidence based intervention to achieve effective initiation of lactation. When the infant cannot breastfeed effectively, pumping within 3 hours after birth has been shown to have a significant impact on future milk supply, infant feeding and subsequent health outcomes.
Early breast stimulation (feeding or pumping ) after birth has significant impact on future milk supply and subsequent feeding outcomes.2,3,5
Studies highlight that NICU mothers who initiate pumping within 3 hours after birth significantly:
In the antenatal period, identify and provide women with known risk factors women with known risk factors, information around importance of early initiation within 3 hours of birth
Support mothers whose infants cannot breastfeed in the first hours or have a poor, ineffective breastfeed to commence pump expression within 3 hours of birth
Ensure that early expression commences within the delivery theatre, recovery room
Start with a hospital-grade double pump with researchbased initiation technology7,8
Implement strategies to identify a delay in time to first expression greater than 3 hours
Support cohesive lactation practices within maternity and NICU services to initiate expression within 3 hours of birth
Track and document time of first expression in a pumping log
Track and document the reasons for delayed first expression in maternal medical records
Collect data on time to first expression after delivery with a data collection tool
1. WHO, UNICEF. Global strategy for infant and young child feeding. Geneva: World Health Organization; 2003. 1-30 p.
2. Spatz DL et al. Pump early, pump often: A continuous quality improvement project. J Perinat Educ. 2015; 24(3):160–170.
3. Meier PP et al. Evidence-based methods that promote human milk feeding of preterm infants: An expert review. Clin Perinatol. 2017; 44(1):1–22.
4. UNICEF, WHO. Protecting, promoting and supporting breastfeeding: The baby-friendly hospital initiative for small, sick and preterm newborns. Geneva, New York: WHO; UNICEF; 2020. 42 p.
5. Parker LA. Optimizing Mother's Own Milk Production in Mothers Delivering Critically Ill Infants. J Perinat Neonatal Nurs. 2020; 34(1):13–15.
6. Parker LA et al. Association of timing of initiation of breastmilk expression on milk volume and timing of lactogenesis stage II among mothers of very low-birth-weight infants. Breastfeed Med. 2015; 10(2):84–91.
7. Meier PP et al. Which breast pump for which mother: An evidencebased approach to individualizing breast pump technology. J Perinatol. 2016; 36(7):493–499.
8. Prime DK et al. Simultaneous breast expression in breastfeeding women is more efficacious than sequential breast expression. Breastfeed Med. 2012; 7(6):442–447.
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