Peer-reviewed article
Effect of antenatal colostrum expression teaching on breastfeeding practices and birth outcomes: a retrospective case-control chart review.
Niessen C, Hawkins N, Yen TW, Cochrane KM ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study evaluated whether teaching pregnant people to express colostrum (early breast milk) in late pregnancy affects breastfeeding after birth. Researchers compared 96 pregnant people who received this teaching at 36 weeks of pregnancy with 79 who did not. Those who learned colostrum expression were more than three times more likely to be fully breastfeeding at their first postpartum check-up, and their babies needed fewer repeat screening tests for high bilirubin levels. The study found no differences in when babies were born or how they were delivered.
Key points
- Antenatal colostrum expression teaching increased odds of full breastfeeding at postpartum check-ups by over 3-fold (aOR = 3.09; 95% CI = 1.35-7.09)
- Odds of repeat hyperbilirubinemia screening were 59% lower in the teaching group compared to controls (aOR = 0.41; 95% CI = 0.18-0.92)
- No significant differences found in gestational age at delivery or mode of delivery between groups
- Teaching involved self-massage of breasts starting at 35-36 weeks gestation to stimulate lactation and allow colostrum collection
- Authors note results should be confirmed in a randomized trial to understand effects on longer-term breastfeeding rates
Limitations
This is a retrospective chart review from a single obstetrical practice in Saskatchewan, which limits generalizability. The study cannot determine whether observed improvements in breastfeeding persist beyond the first postpartum check-up or establish the mechanism by which colostrum expression teaching improves outcomes.
Abstract
Background Antenatal colostrum expression is a practice involving self-massage of the breasts starting in late pregnancy (typically 35-36-weeks of gestation), which is thought to stimulate lactation and allow individuals to secrete and store colostrum prior to delivery. To support successful breastfeeding initiation and continuation among patients, some clinicians provide antenatal colostrum expression teaching as part of standard prenatal care. However, the impact of antenatal colostrum expression teaching is unclear due to limited evidence which is largely anecdotal. The primary aim of this case-control chart review was to evaluate the effect of antenatal colostrum expression teaching as part of standard obstetrical care on breastfeeding practices at first postpartum checkups, gaining pilot data to inform future research. Secondary outcomes included the evaluation of preterm delivery, mode of delivery, and repeat hyperbilirubinemia screening between groups. Methods A retrospective case-control chart review before (n = 79) and after (n = 96) antenatal colostrum expression teaching was incorporated into standard care at 36-gestational week visits in an obstetrical practice in North Battleford, SK, Canada (2016-2020). Odds of fully breastfeeding at first postpartum check-ups in cases vs. controls was evaluated with logistic regression, adjusted for parity, mode of delivery, and infant age at postpartum check-ups. Odds of repeat hyperbilirubinemia screening in cases vs. controls was evaluated with logistic regression, adjusted for parity, mode of delivery, and infant sex. Results Antenatal colostrum expression teaching increased the odds of fully breastfeeding at postpartum check-ups by > 3-fold as compared to controls (aOR = 3.09; 95% CI = 1.35-7.09). Odds of repeat hyperbilirubinemia screening was 59% lower in cases vs. controls (aOR = 0.41; 95% CI = 0.18-0.92). No significant differences in gestational age at delivery or mode of delivery were found between groups. Conclusion Antenatal colostrum expression presents a promising intervention to help prepare patients mentally and physiologically for breastfeeding and labour. While these findings suggest that advocacy efforts are warranted to increase standard provision of antenatal colostrum expression teaching in late gestation, results should be confirmed in a randomized intervention trial, which further aims to understand the effect on longer-term breastfeeding rates and infant health.