Date of Award

Spring 2021

Document Type


Degree Name

Doctor of Philosophy (PhD)



First Advisor

Robinson, Karen

Second Advisor

Ohlendorf, Jennifer M.

Third Advisor

Hanson, Lisa


Breast milk feeding has numerous benefits for women and infants. Although positive maternal experiences with breast milk feeding impacts exclusivity, duration, and maternal mental health, most research focuses on women feeding directly at the breast. Breast milk can also be expressed and bottle-fed to the infant. This practice is encouraged in instances of maternal-infant separation or in cases of prematurity. However, there is an increasing number of women electing to feed exclusively expressed breast milk to term infants rather than feed directly at the breast. Little is known about what constitutes a positive, or salutary breastfeeding, experience in this population. Therefore, the aim of this study was to explore women’s experiences of exclusive expression. Narrative interviews were conducted to collect qualitative data from a purposive sample of 21 women practicing exclusive expression of breast milk. After thematic analysis, three themes: Unseen and Unheard, Doing it My Way, and Getting into the Groove, along with 8 subthemes: Breast is Best, Missed Opportunities for Healthcare Provider Support, Fighting for it, What Works for Us, A Sense of Control, Preparation, Tricks of the Trade, and Making it Manageable were identified. Despite challenges including a lack of support from healthcare providers, and a lack of acknowledgement as breastfeeding mothers, exclusive expression offered participants a method to continue breast milk feeding in a way they found to be satisfying. This study provides insight into experiences of exclusive expression. Societal pressure to feed from the breast may have negative emotional consequences for women electing to exclusively express breast milk. There is a need for more information and support for breast milk expression from healthcare providers along with a reframing of how breast milk feeding is discussed and promoted.

Included in

Nursing Commons