Breastfeeding Without Nursing: The Lived Experiences of Exclusive Pumpers

Abstract

Worldwide, the overwhelming majority of parents initiate chest/breastfeeding at birth. Human milk is regarded as optimal nutrition for infants and the perfect version of milk for the first years of life; lactation also prevents disease in chest/breastfeeders. Most birth parents want to chest/breastfeed and it is seen as central to motherhood. Chest/breastfeeding is often challenging, resulting in early cessation. Exclusive pumping—that is, only expressing/pumping milk rather than nursing directly at the breast/chest—provides an alternative for those who cannot or do not want to nurse, while retaining most chest/breastfeeding benefits. Existing literature on EPing predominantly focuses on neonatal intensive care unit settings, milk composition, and quantitative data, such as secondary analyses of nationwide surveys. Despite the growing numbers of exclusive pumpers, there is little-to-no data concerning the lived experiences of exclusive pumpers, particularly pertaining to support needs and information provision.

Through a retrospective, cross-sectional survey of over 2,000 exclusive pumpers and longitudinal follow-up with over 300 participants, the Breastfeeding Without Nursing study collected qualitative and quantitative data to explore their lived experiences, including: why some chest/breastfeeding exclusively pump; how they feel about it; and what information and support they need and where they find it. Themes within four domains—the circumstances surrounding exclusive pumping, affective experiences, information, and support—were identified through inductive thematic analysis. The findings of this analysis, combined with descriptive and statistical analysis of quantitative data, demonstrate that exclusive pumpers, in general, wanted to nurse at the breast, but as a result of a variety of socioecological influences, were unable to. This led to feelings of loss, grief, and anger, but also determination and pride. Participants needed earlier and better information, many having been incognizant of exclusive pumping despite receiving chest/breastfeeding education. Online support groups were vital sources of information and support; lactation consultants were often not regarded supportive or providing useful information. Having identified gaps in exclusive pumping information, education, and support, I suggest best practices and future research. Contributions to information science include recognizing the importance of education in overcoming incognizance and using a socioecological perspective to analyze the influences on information experience.