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Objective: To determine the effect of providing antenatal education regarding milk expression to the support person (SP) of mothers of preterm infants on time to initial milk expression following delivery and daily volume of expressed mother's own milk. Methods: Sixty-one mothers delivering infants <35 weeks gestation and their SP were randomized to receive antenatal education regarding milk expression or to receive standard care. Time to initiation of milk expression was determined through self-report and verified through the electronic medical records. Expressed milk volume was measured on days 1-7 and weekly for 3 weeks. Results: No difference in time to first expression or expressed milk volume was found between groups. Posthoc analysis suggests those in the antenatal education group were more likely to express without nursing assistance and expressed more frequently during days 1-5. Conclusions: SP antenatal education may be an important step in supporting lactation in mothers of critically ill infants. Further research is needed to determine whether SP education during both the antenatal and early postpartum periods could improve lactation success. Clinical Trial Registration: ClinicalTrials.gov Identifier: NCT04006509.

Introduction: The Baby-Friendly Hospital Initiative has had a positive impact on breastfeeding initiation; however, posthospital exclusive breastfeeding (EBF) rates remain low. We aimed to analyze thoughts and attitudes toward breastfeeding at the postpartum visit among women who deliver at a Baby-Friendly hospital. Methods: Women ≥14 years who delivered a live-born infant at our center were eligible. Participants completed an infant feeding questionnaire at the postpartum visit recording patient and delivery characteristics, antepartum care and infant feeding details, reasons for breastfeeding discontinuation or formula initiation, workplace environment, and cultural beliefs about breastfeeding. Thematic coding via line-by-line analysis of the free responses was performed using NVivo12 by QSR international. Results: Of 263 participants, 110 responded to the open-ended question. Of these, 53 and 46 were negative-toned and positive-toned, respectively. Negative breastfeeding responses related to the mother addressed the need for more support, low milk supply, pressure to breastfeed and feelings of guilt if unsuccessful, maternal health issues, painful breastfeeding, and high time requirements. Negative breastfeeding responses about the baby included concerns about infant health, latching issues, and disinterest. Positive responses focused on the support system, maternal weight loss, health benefits for baby, and mom-baby bonding. Some women (27) commented specifically on pumping. Negative comments noted that pumping led to less milk production, was time consuming, and was too much work. Positive comments about pumping noted that it is a convenient alternative to breastfeeding. Conclusion: Efforts to improve posthospital EBF rates in accordance with national guidelines must acknowledge the complex experience of breastfeeding mothers.

Objective: American women are consistently tasked with breastfeeding, while returning to work, but little research examines how women perceive support in the workplace and their own working outcomes. This study examined the associations among breastfeeding women's perceptions of breastfeeding support in the workplace (i.e., managerial, organizational, co-worker, time, and physical environment), attitudes toward multiple roles, and workplace outcomes (i.e., affective commitment, job satisfaction, and workplace productivity). Materials and Methods: Survey data from 109 mothers who have or are currently breastfeeding/pumping human milk at their workplace were collected and analyzed. Results: Results indicated significant positive relationships among attitudes toward multiple roles and workplace productivity. In addition, perceptions of breastfeeding support were significantly associated with both affective commitment as well as job satisfaction. Finally, our sample of breastfeeding employees returned to work after having a baby primarily for financial reasons, and do not generally feel very supported in the workplace. Conclusions: Overall, organizations can promote more investment and satisfaction in employees by providing explicit communication about breastfeeding-supportive policies to all employees. These findings underscore the importance of organizational breastfeeding support for mothers as well as their coworkers, which ultimately influences the success of the organization as a whole.

Background: In light of the widespread use of breast milk pumping, or, "pumping," mothers are seeking clear, adequate breast pumping guidelines. We aimed at characterizing the information in web pages that mothers might find online when searching for answers related to breast pumping. Materials and Methods: We used Google to search for answers to 10 questions about pumping that mothers might ask. This search used Boolean search. We screened the first three pages of search results for each computer Google search. Each eligible hit (web pages) was evaluated for accuracy, readability, and credibility of its source. Results: Our search strategy produced 241 hits eligible for analysis. The majority of these contained accurate, readable information and were authored by credible sources. The proportion of eligible hits from questions that had a quantifiable (numeric) answer, (e.g., number of days that refrigerated milk remains safe for consumption) differed significantly ( p  = 0.024) from searches that did not. Search inquiries related to milk supply adequacy produced a disproportionately high number of inaccurate hits. Conclusion: Our findings indicate that accurate and credible information about breast pumping is accessible on the internet. However, practitioners should be aware that inaccurate information is present among mothers' likely hits. Our findings also underscore the fact that there are aspects of breast pumping that do not yet have guidelines available, and that these areas warrant further research. In addition, there is a need for guidelines that reflect the individual nature of the experience of breast pumping.