Clinical Experience and Lactation Outcomes with Electric Breast Pump Usage in Mothers of Preterm Infants in a Neonatal Intensive Care Unit: A Prospective Observational Study

Abstract

Background: Mother's own milk is the optimal nutrition for preterm infants admitted to the Neonatal Intensive Care Unit (NICU). Because most preterm infants are initially unable to breastfeed directly, effective and comfortable mechanical milk expression is critical for establishing and sustaining lactation. Aim: This study evaluates maternal experience, milk yield kinetics, tissue safety, and neonatal outcomes among mothers of preterm infants using electric breast pumps. Methodology: This prospective observational study was conducted over six months (November 2025 – April 2026) at Setu Newborn Care Centre, Ahmedabad. Fifty mothers of preterm infants (< 34 weeks' gestation) who exclusively utilised personal-use electric breast pumps with standard vacuum cycles during their infant's hospital stay were enrolled. Primary and secondary outcomes assessed included expressed milk volumes on Days 3, 7, 14, and 21, cumulative volume gains, incidence of nipple injury, mean nipple pain scores (Numerical Rating Scale), daily pumping duration, maternal usability ratings, and infant daily weight gain. Results: The mean maternal age was 31.60 ± 4.36 years, and all mothers delivered via lower segment caesarean section (LSCS). The mean infant gestational age was 30.57 ± 2.64 weeks, with a mean birth weight of 1.34 ± 0.42 kg. Expressed milk volume demonstrated a statistically significant progressive increase over time (p < 0.001), rising from 11.78 ± 18.76 mL on Day 3 to 143.00 ± 124.97 mL on Day 7, 268.50 ± 168.18 mL on Day 14, and 364.10 ± 161.94 mL on Day 21. Mean volume gain from Day 3 to Day 21 was 352.32 ± 161.91 mL. Nipple injury occurred in only 12.0% (n = 6) of participants. The overall mean nipple pain score was remarkably low (0.92 ± 0.80). Average daily expression time was 74.44 ± 23.87 min/day, and infants achieved a steady mean weight gain of 17.62 ± 5.14 g/day. Questionnaire ratings reflected highly favourable maternal satisfaction regarding ease of use, flange fit, and pain minimisation. Conclusion: Electric breast pumps provide a highly effective, safe, and comfortable solution for establishing and maintaining lactation in mothers of preterm infants. The low incidence of nipple trauma and minimal pain scores support electric pumping as an optimal strategy to enhance maternal compliance and secure essential enteral nutrition in the NICU.