Best for baby? Pumped breastmilk under the microscope

Best for baby? Pumped breastmilk under the microscope

By Sharon Ní Chonchúir

A new study says feeding at the breast is better for baby than using expressed milk. Is it time mothers reconsidered their use of breast pumps, asks Sharon Ní Chonchúir.

Comedian Amy Schumer did it in a hotel bedroom. Actress Rachel McAdams did it while wearing full makeup, diamonds and Versace. Ultra-athlete Sophie Power did it during a rest break from the 268-mile Montane Spine Race, which she then went on to win. What did these women do? They all posed for photographs while they were hooked up to breast pumps as they expressed milk for their babies.

While expressing milk appears to be growing in popularity, a new study may give mothers cause for concern.

The study looked at 393 mother and infant pairs enrolled in the long-term Canadian Healthy Infant Longitudinal Development birth cohort study, which explores the effect of genetic and environmental factors on participants’ health over time.

An analysis of the mothers’ breastmilk showed that those who only fed at the breast had a different mix of bacteria to those who used a pump. Pumped milk had lower levels of beneficial bifidobacteria and higher levels of potentially harmful pathogens.

Such a finding could concern the growing number of breastfeeding mothers who pump regularly. According to breastfeeding support groups Cuidiú and La Leche League, there has been a noticeable increase in the number of mothers who express breastmilk in this country.

“Many mothers choose to pump when they return to paid employment as they realise the nutritional and emotional benefits of breastfeeding past the first few months,” says Sharon Beehan, a spokesperson for La Leche League Ireland.

We also meet mothers whose babies were unable to latch for a variety of reasons. Many mothers who pump do it either temporarily — until their babies can breastfeed — or on a part-time basis, while they are separated from their babies.

"But some pump exclusively. They find comfort in knowing that their babies are receiving their breastmilk even when they cannot nurse directly from the breast.”

Cuidiú lactation consultant Caoimhe Whelan highlights additional benefits to expressing. “Some mothers have low supply and pumping can encourage the body to make more milk. Others think that pumping will allow their partner to share the feeding and make caring for their newborn easier,” she says.

This latter point is an important factor for new mothers. “Knowing they have milk they have pumped can make them feel a little less trapped and pressurised to always be available to feed the baby,” says Whelan.

Pump action

The growing range of high-quality pumps makes expressing easier and quicker.

“Good quality double pumps are much more affordable and available now than they were years ago,” said Whelan. “Prices range from €150 to €400.”

She mentions new wearable hands-free pumps such as the Elvie, which was one of the controversial items contained in a goodie bag given to the attendees at this year’s Oscars. “I have heard mixed reviews, but they are very popular in the US,” she says. “They are expensive though. The double Elvie set is €549.99.”

Whelan also points to a free option when it comes to expressing milk.

“Hand expression is a skill that many overlook because they think it sounds too difficult, but some women find that it works better than pumping,” she says.

Breast is best

No matter how a mother chooses to pump, Beehan says she should not be too worried about this new study. “Following the official guidelines regarding the safe storage of fresh human milk will minimise the causes of bacteria overgrowth and maintain the milk’s healthy properties,” she says. “Anyone who has any concerns is welcome to contact their local La Leche League leader or attend a meeting in their area.”

Whelan is just as reassuring.

“All the research is really telling us is that the profile of bacteria in pumped milk versus milk received by baby through direct breastfeeding is different,” she says. “Further research, which might have an impact on current guidelines on the pumping and storing of breastmilk, is needed.”

Raising questions

To be fair, the study’s co-author Dr Megan Azad, research scientist at the Children’s Hospital Research Institute of Manitoba, said as much herself in New York’s

Insider Magazine.

“Breastmilk is beneficial for many reasons and for some moms, pumping might be the only way they can provide it to their babies. So, we don’t want to discourage pumping but rather to raise the question of what our finding means.”

Azad’s research group previously published studies showing different feeding methods were linked with different health outcomes for babies. Babies exclusively breastfed at the breast had healthier body weights and a lower risk of developing asthma than babies who were exclusively fed formula. Breastfed babies who received some pumped breastmilk were in between the two. They had a higher risk than babies fed exclusively at the breast but a lower risk than formula-fed babies.

Her latest findings may explain these different health outcomes. Azad hopes that further research can help parents.

“If we understand more we’ll be able to make new recommendations about bottle feeding, cleaning breast pumps and storing pumped milk,” she said. “These are all things we’ll learn by doing more research.”

While this study proves we still have a lot to learn about the science behind breastfeeding, mothers who pump are encouraged to continue.

“Breastmilk, whether it’s pumped or direct from the breast, is always going to be a vastly superior option to infant formula,” says Whelan.

“There are inherent risks to not breastfeeding and giving babies infant formula and that fact hasn’t changed since this study was published.

“Mothers who are pumping need to keep doing what they are doing and know they are providing the best possible milk for their babies.”

  • Breastmilk storage

  • You’ve done the research, purchased a pump and are ready to start expressing.
  • Here’s how to do it safely, according to the latest HSE guidelines.
  • Breastmilk should be stored in small quantities. This minimises waste.
  • Any container will do as long as it is clean, has an airtight seal and can be sterilised easily.
  • Breastmilk storage bags don’t need to be sterilised before use and take up much less room in the freezer.
  • Hard containers, plastic or glass, need to be washed, rinsed and sterilised before use. They can take up a lot of space in the freezer. However, you lose fewer milk fats and antibacterial cells when you use them.
  • Leave some space for expansion.
  • Label each container with the date and use the older milk first.
  • You can keep expressed milk sealed outside of the fridge for up to four hours in temperatures less than 20C.
  • You can keep it in the fridge for up to five days. Make sure you place it on a shelf and not inside the door.
  • You can keep it in the fridge freezer for three months and in a deep freezer for up to six months.

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