Table 3.

Effect of Expression Methods

Authors (Year)	Key Findings
Breast pump versus hand expression
Lussier et al.21 (2015)	Exclusive EE compared to exclusive HE over the first week was associated with greater daily MV (p<.05) and cumulative MV (1,371 vs. 456 mL; p=.003) days 1–7 postpartum and higher MV of 119 mL/day (coefficient −119, 95% CI: −175, −63, p<.001) and cumulative MV days 1–28 (13,639 [3,020, 17,770] vs. 7,208 mL [4,240, 14,279].
Slusher et al.23 (2007)	Use of a double electric BP was associated with greater daily MV over 10 days than HE (578 vs. 323 mL; p<0.01). Similar MV was obtained between an electric BP and pedal pump (463 mL) and between pedal pump and HE.
Slusher et al.39 (2012)	Mothers who expressed using a double electric BP had greater daily MV over 7 days than mothers using HE (647 vs. 434 mL; p<.01), but similar to those using a single non-electric manual BP (520mL). Similar MV was obtained between mothers expressing with single non-electric manual BP and HE.
Combining the use of breast pumps with hand expression or hands-on-pumping
Morton et al.33 (2009)	Hands-on-pumping was associated with increased daily MV 583±383 to 863±506 mL; p<.003).
Simultaneous versus sequential expression
Fewtrell et al.26 (2016)	MV was positively predicted by simultaneous vs. sequential expression (109 mL/day 95%CI 31–186, p=.007) on day 1–10 (288 [168, 386] vs. 147mL/day [78, 275]) and during the infant’s hospital stay (218 mL/day 95% CI 80 to 356, p=.003; 561 (202, 708) vs 220 (112, 349) mL/day).
Köroğlu et al.40 (2017)	Mothers who expressed using simultaneous vs. sequential expression achieved similar MV in a shorter amount of time (11.57 – 15.62 minutes vs.18.16 – 20 minutes.

Abbreviations: BP, breast pump; CI, confidence interval; EE, electric breast pump expression; HE, hand expression, MV, milk volume.