Breast Milk Pumping in 2026: Two Studies and a Literature Review

Breast Milk expression in 2026: Two Studies and a Literature Review

We invite you to explore two studies on breast pumping that examined the profile of mothers who pump and the specific challenges they encounter. A literature review on this topic was also published in 2026 in the Journal of Human Lactation, and we present a summary here.

An entire ecosystem of "Pumping coaching" (offered by non-professional lactation influencers) is developing, representing a new marketing niche in the breastfeeding field. However, as this review highlights, much of the information in circulation is not evidence-based.

1. Presentation of the Rosenbaum & McAlister (2025) Study on Breast Pumping

Exclusive pumping (EP) is a practice in full expansion. Yet, despite its growing prevalence, many families feel isolated and poorly supported by healthcare professionals.

This integrative review of 27 studies published between 2012 and 2022 provides key insights for lactation consultants seeking to optimise their support.

Family Profiles and Motivations

The study reveals that the majority of mothers practising EP had not initially chosen this method. Most had planned to breastfeed directly at the breast but turned to the pump following difficulties encountered in the immediate postpartum period:

• Latch difficulties: Sucking problems, flat or inverted nipples, or pain.

• Specific contexts: A significantly higher prevalence is observed among mothers of premature infants, those hospitalised in neonatal units, or in cases of multiple births.

• Need for control: In certain contexts (particularly in Asia), EP is chosen to monitor precisely the quantities ingested by the infant.

  
  

Gaps in Professional Support

The study reports that advice provided by healthcare staff is often inconsistent or incomplete.

• Knowledge deficit: Many mothers report never having heard of EP before giving birth and not receiving the necessary technical information (frequency, stock management, equipment care).

• The role of social media: In the absence of adequate professional support, families turn en masse to Facebook groups and other online platforms for practical and emotional advice.

  
  

Key Practices for Success

For lactation consultants, several technical parameters are identified as critical for establishing and maintaining adequate milk production:

• Early initiation: Expression should begin very early (ideally within the first hours after birth).

• Frequency: A schedule of 8 pumping sessions per 24 hours (every 2–3 hours) is recommended to simulate a newborn's demand and stimulate production.

• Techniques: The use of hospital-grade breast pumps and learning techniques such as hands-on pumping (combined manual and electric expression) significantly improve milk volumes.

  
  

Outcomes and Long-Term Challenges

• Breastfeeding duration: Mothers who exclusively pump tend to stop breastfeeding earlier than those who breastfeed directly, often due to fatigue, a perceived drop in production, or return to work.

• Preserved benefits: Despite administration via bottle or tube, infants fed through EP benefit from the biological properties of breast milk, with cognitive and motor development scores superior to those fed on commercial formula.

Reference: Rosenbaum K, McAlister B. An Integrative Review of Exclusive Breast Milk Expression. J Midwifery Womens Health. 2025 Mar-Apr;70(2):325-335. doi: 10.1111/jmwh.13713. Epub 2024 Dec 2. PMID: 39618242; PMCID: PMC11980767.

2. Presentation of the Gridneva et al. (2025) Study

This recent study published in Nutrients (January 2025) reports data on mothers practising partial (PPE) or exclusive pumping (EPE).

Who Are the Mothers Who Pump?

As in the Rosenbaum et al. study, this study describes more complex trajectories for pumping mothers compared to the general population.

• Pregnancy complications: They show a higher frequency of gestational diabetes (28%) and gestational hypertension (8%).

• Medicalised deliveries: 53% of mothers practising EP delivered by caesarean section, a rate significantly higher than national averages.

• Early breastfeeding difficulties: The main motivations are not a choice of convenience but real obstacles: latch/attachment difficulties (49%), nipple pain (41%), and infant breast refusal.

  
  

Is Milk Production Maintained with Exclusive Pumping?

Exclusive pumping practised with effective equipment does not appear to impair lactation over a 24-hour period.

• Mothers in the "Normal Production" group produced an average of 937 ± 263 g of milk per 24 hours, equal to or greater than mothers breastfeeding directly (reference group: 773 ± 233 g).

• However, vigilance is required for mothers with "low production", who produced approximately 379 g/24h and required formula supplementation to meet the infant's needs.

The study compared pumping flow parameters between mothers who predominantly pump and those who pump occasionally. The results show distinct response profiles to the pump:

• Let-down reflexes: Predominantly pumping mothers need more let-down reflexes to empty the breast.

• Flow duration: They show a longer active flow duration, suggesting physiological adaptation to repeated use of the pump.

• Efficiency: Despite these differences, the total percentage of milk removed and perceived comfort do not differ from the reference group, demonstrating that the body "learns" to respond effectively to the machine.

  
  

The Role of the Lactation Consultant

As in the Rosenbaum study, this study highlights a lack of support for these families. Many turn to social media in the absence of appropriate professional guidance. The authors recommend early identification of at-risk mothers (caesarean section, complications) to implement an effective expression protocol immediately, including double pumping sessions and maintaining night pumping sessions. EP is time-consuming and demanding. Optimising the pump settings is also essential to ensure sustained long-term production.

Note: this study was funded by Medela.

Reference: Gridneva Z, Warden AH, McEachran JL, Perrella SL, Lai CT, Geddes DT. Maternal and Infant Characteristics and Pumping Profiles of Women That Predominantly Pump Milk for Their Infants. Nutrients. 2025 Jan 20;17(2):366. doi: 10.3390/nu17020366. PMID: 39861496; PMCID: PMC11768336.

3. Literature Review on Breast Pumping by DiTomasso et al., 2026

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Breast Milk Expression in Mothers of Full-Term Infants

This review compiles 69 studies (2014–2024) on breast pumping (partial or exclusive) for full-term infants and addresses the following themes:

Breastfeeding duration: Unlike premature infant mothers for whom early and frequent expression is a protective factor for lactation, regular milk expression in mothers of full-term infants is associated with a higher risk of early weaning (before 6 months) and lower exclusive breastfeeding rates.

Maternal perspectives: Milk pumping helps cope with difficulties encountered during direct breastfeeding and is often initiated in cases of engorgement, pain, or to improve production or control quantities given. While the pump is perceived as "useful", it is also time-consuming. Partial effectiveness in emptying the breasts and the lack of connection with the infant are also reported, as is milk overproduction.

Need for information: A lack of professional support is again reported in this review; mothers turn to the Internet/social media (often inaccurate).

Exclusive pumping: In China, 15–20% of mothers exclusively pump for the first 6 months.

Studies highlight a lack of support and recognition for these mothers' breastfeeding journey and of information to manage this mode of pumping. Half of the mothers in the Bhattarai et al. study had never heard of this option in antenatal preparation.

Breast pump technology: Here are the various pieces of information we found interesting:

• New wearable pumps are the subject of publications with mixed results: some studies report good efficacy, others variable efficacy, at a high cost.

• One study indicates that gentle breast compressions combined with suction improved the let-down reflex (Alekseev and Ilyin 2016).

• One study (Sakalidis et al., 2020) reports that widening the angle of the breast shield improves comfort and pumping efficiency with better milk output.

The review highlights caution points:

• Avoid interchanging pumping kits and pumps, as this risks increasing discomfort.

• Flange fitting: It is recommended to measure the nipple before pumping, and the "2–4 mm" rule added to nipple size appears obsolete for adjusting flange size.

Flange fit is not just a matter of comfort — it is also a matter of efficacy: standard-sized flanges (21–24 mm) yield less milk than smaller flanges (13–19 mm) (Anders et al. 2025).

• Vacuum (suction) variation: Different studies report maximum efficacy at different suction levels, with high suction levels potentially generating pain.

DiTomasso et al. highlight that the studies conducted are often funded by breast pump manufacturers (Medela, Philips Avent) and that authors declare conflicts of interest. The breast pump market is worth $3 billion, and it is regrettable that clinical trials are not independent of commercial influences. Moreover, while pumping protocols are well established for mothers of premature infants, there is to date no evidence-based study on the frequency and duration of pumping sessions for mothers of full-term infants.

Reference: DiTomasso, Diane & Basley, Sandra & DeSanto-Madeya, Susan & Palmer, Michelle. (2026). Breast Milk Expression in Mothers of Full-Term Infants: A Scoping Review of Available Information. Journal of Human Lactation: official journal of International Lactation Consultant Association. 8903344251414355. 10.1177/08903344251414355.

Journal of Human Lactation

Conclusion

Exclusive pumping must be recognised by society as a valid and demanding mode of breastfeeding. Lactation consultants can legitimise this choice (chosen or constrained) by providing expression protocols, while offering psychological support in the face of the significant workload this method entails.

A great deal of information based solely on clinical experience rather than randomised clinical trials circulates on this topic. It seems important to clarify to mothers that pumping protocols seen on the internet and social media can be tried but do not represent a consensus in the field of breastfeeding.