Feasibility of the effects and experience of a gestational diabetes and antenatal human milk expression (GAME) programme: A pilot randomized controlled trial

Abstract

<p>Exclusive breastfeeding is globally recognized as the optimal infant feeding, with evidence showing that breastfeeding significantly improves postpartum glucose metabolism. However, women with GDM may have a shorter breastfeeding duration when compared with women without GDM. There is growing evidence of antenatal milk expression (AME) and found that AME increased confidence and contribute to better preparation on breastfeeding, consequently improving breastfeeding duration. However, AME is not widely practice with inconsistent evidence. This study aims to examine the acceptability and feasibility of antenatal human milk expression program to improve breastfeeding outcomes among women with GDM. We recruited 20 mother-infant dyads diagnosed with GDM in one public hospital in Hong Kong. Participants completed self-administered questionnaires, which included sociodemographic characteristics, infant feeding status and breastfeeding self-efficacy. Participants were followed up for 8 weeks postpartum. After completing the study, five participants in the intervention group were interviewed to understand their perceptions of the intervention. This study shows that AME is feasible and acceptable to women with GDM. Twenty eligible GDM women agreed to participate, and 100% completed follow-up. Participants have not tried AME previously, after the intervention they perceived the program positively and affected their breastfeeding experience. It increased their breastfeeding confidence as it showed that they can express before delivery and knowing they have milk, participants believed this consequently affected their breastfeeding motivation. Although there were concerns with uterine contraction, however most viewed highly the beneficial effect of AME for GDM. It serves as an early preparation and education before delivery and gave participants time to adapt to breastfeeding. Further suggestion included beneficial for primiparious women and this program can further extend to non GDM women. This study shows that AME is feasible and acceptable to GDM women. A full-scale study should be conducted to understand the effect of AME on breastfeeding outcomes.</p>