Mothers’ Experiences of Breast Milk Expression: A Qualitative Meta-Synthesis

Breast milk expression is a common practice among human milk feeding mothers. Although research about breastfeeding has been widespread, expression and how it is practiced, experienced and perceived is often overlooked. The aim of this study was to synthesize existing qualitative research exploring breast milk expression experiences of mothers with healthy term infants. Literature search was conducted for peer-reviewed articles on milk expression using PubMed, ProQuest, CINAHL Plus, Web of Science and Scopus online databases. PRISMA 2020 guidelines were followed during study selection. Twenty-eight qualitative and mixed method studies met the inclusion criteria. The data from included studies were analyzed using Noblit and Hare’s interpretive approach to develop a line-of-argument understanding of the practice. Five domains were identified; Expression was experienced as: a socially influenced practice, a form of care work, a self-managed project, a means of freedom, and a site of identity mediation. Findings suggest that milk expression is best understood as a socially influenced practice shaped by cultural norms, relational expectations, and structural constraints. Within this context, expression emerged as care-work, a self-driven project requiring ongoing regulation and management, and practice through which mothers negotiated freedom, bodily autonomy, and competing roles. Across themes, providing expressed milk was closely tied to moral expectations of good motherhood, with persistence despite discomfort or exhaustion often framed as meaningful sacrifice. Results also suggest that expression also influences identity, changing how mothers perceived themselves and wished to be perceived by others, particularly in professional and public settings. Overall, the synthesis suggests milk expression is not merely a feeding method, but a psychologically and socially rooted practice.