Use of Hand Expression of Breastmilk Within First Hour of Delivery to Increase Exclusive Hospital Breastfeeding Rate [40O]

INTRODUCTION: Although most mothers in the United States initiate breastfeeding, formula supplementation during the hospital stay after delivery is common. Formula use may reflect a limited breastmilk supply. The impact of hand expression of breastmilk within 60 minutes of delivery as a means of improving breastfeeding outcomes in full term infants has not been studied. METHODS: Physicians and nurses were taught to instruct mothers on hand expression techniques during the first hour after delivery. Breastfeeding rates within the first hour of delivery and exclusive breastfeeding rates were determined via retrospective chart review of eligible patients admitted over a 7-month time frame. Patients were excluded if the infant was admitted to the neonatal intensive care unit. IRB waiver was obtained. RESULTS: Hand expression improved exclusive breastmilk feeding, even if there was no skin-to-skin care or breastfeeding within the first 60 minutes (53.3% vs 34.4%, P= .05). Hand expression resulted in significant improvements in actual breastfeeding within the first 60 minutes for both cesarean (90.1% vs 50.0%, P<.001) and vaginal deliveries (93.0% vs 68.5%, P<.001). Breastfeeding within 60 minutes of delivery was associated with a 62.2% rate of exclusive breastfeeding vs 46.3% (P<.0001) if first breastfeed took place after 60 minutes. CONCLUSION: Hand expression of breastmilk within the first hour of delivery was associated with increased rates of breastfeeding within that hour. Hand expression of breastmilk in the first hour was also associated with higher exclusive breastmilk feeding rates during the hospital stay. This practice could be a beneficial tool to improve breastfeeding outcomes.