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Mothers’ reasons for human milk expression and associations with human milk expression practices (131.3)

Most breastfeeding (BF) women in the U.S. use human milk (HM) expression (HME), or pumping, to feed HM. HME is used for many reasons that may affect how they implement HME. The characteristics of those who use HME for lactational (L) (engorgement, soreness, low supply), dyadic (D) (nursing unavailable or undesired by mother) or elective (E) (use in solids, emergency stock, donation) reasons are unknown as is whether these types of reasons affect HME practices. To address these issues, we used data from the Infant Feeding Practices Study II cohort of ~3,000 dyads. Among women feeding HM, we used regression analysis to compare (L or D) v. E‐only reasons and found that the (L or D) group was more likely to use HME regularly than the E‐only group (OR 4.15, p = 0.03). Several maternal characteristics predicted both L and D reasons for HME. Cesarean birth and late lactogenesis II onset also predicted L reasons. Mothers who used HME for L reasons v. non‐L reasons had earlier start of regular HME (p = 0.026), which was not significant when adjusted for confounders. Mothers who used HME for D reasons v. non‐D reasons had later start of any HME after adjustment (p < 0.0001). These findings suggest that reasons for HME differ across sociodemographic groups, and may affect the start and regularity of HME. Given the importance of and public health push for HM feeding, and ongoing rise in HME, these phenomena must be explored further.