The recently published study by Hoban et al. is nothing short of revolutionary. As a clinician and advocate deeply committed to maternal-infant health, I believe this work has the potential to transform lactation care in the NICU, not just for clinicians but for the mothers we serve. It shifts our approach from assumption to evidence, from generalized advice to an individualized plan of care.
For years, we’ve encouraged mothers to pump 8 to 12 times a day to establish a full milk supply, based on the best available evidence from term-infant breastfeeding patterns. However, with advancements in efficient and effective pumping technology, notably the Initiation Technology™ designed to mimic non-nutritive sucking, research now demonstrates that fewer pumping sessions can still achieve a full milk supply. This study reinforces the importance of early lactation strategies. It provides the much-needed data to refine our approach, moving beyond general recommendations to solutions tailored to the unique physiology of preterm lactation.
What excites me about this study is that it redefines our understanding of secretory activation, or what we often refer to as “milk coming in.” Hoban and colleagues demonstrate that this process is not just delayed in NICU mothers, but it’s often impermanent. This is why skilled clinicians must monitor their progress closely over the first two weeks. The authors also demonstrate a powerful finding: each additional daily pumping session increases the odds of achieving secretory activation within the next two days by 48%. That’s a game-changer. It tells us that small, specific behavioral changes can have an enormous physiological impact.
Here's where the innovation truly shines: the use of biomarkers, specifically sodium levels in milk, to track lactation progress. This enables us to provide mothers with real-time, individualized feedback. No more one-size-fits-all pumping schedules. Instead, we can give each mother a tailored plan based on her unique milk biochemistry. One mum may need to pump six times a day, while another may need eight. We can finally offer anticipatory guidance that is precise, personalized, and grounded in measurable outcomes.
As a board member of the March of Dimes, I’ve heard too many stories from NICU mums describing pumping as traumatic, isolating, exhausting, and, too often, fruitless. That should never be the case. This study offers a path toward empowerment. By removing the guesswork and providing targeted recommendations, we empower mothers to take control of their lactation journey. And we’re supporting their mental health in the process.
This is more than a clinical breakthrough. It’s a call to action. We must integrate this evidence into NICU protocols, nursing education, and our conversations with every mother we support. We need to focus intensely on the first five to six days postpartum, the critical window for stimulating secretory activation, and support mothers with the right tools, data, and guidance.
At Medela, we’re proud that our pumps enabled this level of insight. But this isn’t just about innovation, it’s about transformation. The Hoban study is ushering in a new era of lactation care, one where mothers are no longer expected to conform to outdated norms but are empowered through evidence, empathy, and personalized support.
Let’s never again ask a mother to pump 12 times a day just because “that’s what we’ve always said.” Instead, let’s tell her: “Here’s what your body is saying. And here’s how we can help you succeed.”
If you want to learn more, Dr. Rebecca Hoban will be the keynote speaker at Medela’s Symposium September 11-12, 2025. The Symposium will provide a unique opportunity to collaborate with researchers and develop quality improvement projects tailored to your practice environment.
