Randomized trial comparing the efficacy of a novel manual breast pump witha standard electric breast pump in mothers who delivered preterm infants

Objective. The benefits of human milk for preterm infants are widely recogn ized, yet technological advances in milk expression have been slow. We comp ared the efficacy of a standard electric pump (EP; Egnell) used in 94% of U nited Kingdom neonatal units with a novel manual pump (MP; Avent ISIS) desi gned to operate more physiologically by simulating the infant's compressive action on the areola during breastfeeding. Methods. We randomized 145 women who delivered infants of <35 weeks' gestat ion to use the MP or the EP and measured total milk volume expressed while using the randomized pump during the infant's hospital stay, pattern of mil k output and creamatocrit of milk expressed during a test period in the sec ond week, and pump characteristics by maternal questionnaire. Results. Mothers who used the EP, who frequently double pumped, showed shor ter expression times but produced no more milk than mothers who used the MP . When both pumped sequentially, however, mothers who used the MP showed si gnificantly greater milk flow and total volume over 20 minutes. Creamatocri t was unaffected by pump type. The MP was rated significantly higher than t he EP on 5 major characteristics. Conclusions. When compared on equal terms (sequential pumping), mothers who used the MP showed greater milk flow, perhaps reflecting more physiologic pump design. Even with double pumping, mothers who used the EP did not adva ntage their infants with greater milk production. We believe that this nove l, effective MP, preferred by mothers and costing a fraction of the EP pric e, reflects a significant advance in milk expression for high-risk infants.