Feeding and refusal of expressed and stored human (FRESH) milk study - a short communication

Breastfeeding is recognized as the best feeding method and as optimal food for infants as it contains all the nutrients that infants need to grow and develop. In the United States, there appears to be a strong desire to breastfeed, with 83.2% (more than 3 million per year) mother/infant dyads breastfeeding at least once shortly after the infants were born.1 This number has exceeded the Healthy People 2020 guideline that challenged healthcare providers to better support breastfeeding initiation.2 With increased awareness of the benefits of providing human milk to infants and the availability of breast pumps, mechanical expression has become more common. Researchers have reported that between 68% and 92% of breastfeeding women express their milk at some point during lactation.3–5 A common reason cited for expressing milk was to store the milk for later use.6,7 Women frequently use a breast pump to increase their milk supply8 and to allow someone else to feed the infant expressed breastmilk.4 Many women begin expressing their milk within the first few days postpartum.8 As using expressed milk becomes increasingly more common, so too, in clinical practice are the anecdotes regarding infants who are refusing to drink the expressed, stored milk. There is a gap in the literature of this event. The purpose of this study was to document the prevalence of infant refusal of expressed, stored human milk and identify any association with how the milk was expressed and how the milk was stored.