Target-Guided Milk Expression to Improve Early Milk Volume in Mothers of Late Preterm Infants During Separation: A Randomized Controlled Trial

Objective: To determine whether a target-guided milk expression approach improves cumulative milk volume during the first postpartum week among mothers of late preterm infants experiencing maternal–infant separation. Methods: A parallel-group randomized controlled trial was conducted at a university hospital in Thailand. Thirty mothers of late preterm infants who were separated from their infants were randomized to receive the target-guided milk expression approach or usual care. The primary outcome was cumulative milk volume across postpartum Days 1–7; secondary outcomes included daily milk expression frequency. Exploratory outcomes assessed the timing of achieving 2 consecutive days meeting prespecified expression frequency and milk-volume targets. Results: Mothers in the intervention group produced greater cumulative milk volume than controls (1,791.4 ± 637.7 versus 894.4 ± 351.1 mL; mean difference 896.9 mL, 95% confidence interval 506.9–1,287.0; p < 0.001) and expressed milk more frequently across Days 1–7 (7.14 [interquartile range (IQR): 7.00–8.14] versus 5.29 [IQR: 5.00–5.86] sessions/day; p < 0.001). Higher expression frequency in the intervention group was observed during hospitalization and after hospital discharge. Exploratory outcomes showed that more mothers in the intervention group achieved the predefined 2-day frequency and volume criteria. Conclusion: A target-guided milk expression approach improved early expressed milk volume and supported more frequent milk expression during the first postpartum week, including after hospital discharge. A longer follow-up is needed to determine whether these early differences are sustained after maternal–infant reunion.