Infants born to women with diabetes are at increased risk of neonatal hypoglycemia and subsequent admission to neonatal intensive care, events that can interrupt early breastfeeding and increase the likelihood of supplemental feeding. Antenatal expression of colostrum in late pregnancy has been proposed as a strategy to provide a ready supply of the mothers milk for early supplementation and to support breastfeeding initiation, but evidence of its effect on exclusive breastfeeding after discharge remains limited.
The study aimed to determine whether antenatal expression of breast milk in late pregnancy by women with diabetes affected exclusive breastfeeding during the first days after birth and at 2 months postpartum.
This research was conducted as a prospective cohort study. Recruitment occurred over a 2-year period at one outpatient maternity clinic and three local maternity units. The study was published online ahead of print in J Hum Lact and is indexed with PMID 42638454 and DOI 10.1177/08903344261460170.
A total of 106 pregnant women with diabetes were enrolled. The source reports the recruitment sites (one outpatient clinic and three local maternity units) and the overall sample size but does not provide further breakdowns in the abstract (for example, by type of diabetes, parity, socioeconomic measures, or glycemic control).
Data were collected from patient medical records and via structured telephone interviews conducted 2 months after birth. The abstract states that the data were analyzed statistically; however, specific statistical tests, effect estimates, confidence intervals, or p values are not reported in the abstract.
Most participants reported they had expressed breast milk antenatally in late pregnancy. On average, women who antenatally expressed did so for approximately 10 days before birth. The source does not provide detailed information on the technique, volume distribution across days, clinical guidance given, or timing relative to gestational age in the abstract.
Overall breastfeeding findings in the cohort included that about half of the women experienced breastfeeding challenges after birth. Only 14% of the study population were exclusively breastfeeding at the follow-up timepoint (2 months postpartum).
When comparing women who antenatally expressed milk with those who did not, the proportion of mothers exclusively breastfeeding at home after discharge was similar between the two groups according to the reported results. Thus, antenatal expression did not demonstrate an effect on the rate of exclusive breastfeeding later at home in this cohort.
The study reports that women who had antenatal expressed milk were slightly more likely to use their own expressed milk as a supplemental feed in the early postnatal period. Furthermore, a higher amount of antenatally expressed milk was associated with increased rates of exclusive breastfeeding at the hospital. Women who reported antenatal expression to be easy had higher exclusive breastfeeding rates. The abstract does not quantify these associations or provide adjusted analyses.
In this prospective cohort of 106 pregnant women with diabetes, antenatal expression of milk in late pregnancy was a common practice but did not increase the likelihood of continued exclusive breastfeeding at home by 2 months. A notable finding was that greater antenatal volumes were linked to higher exclusive breastfeeding rates while the infant was still in hospital, and antenatal expression facilitated the use of maternal milk for supplementation. Despite these observations, the overall exclusive breastfeeding rate in the cohort was low (14%), and half of the mothers reported breastfeeding challenges.
Clinically, the findings suggest that while antenatal expression may help secure maternal milk for early in-hospital supplementation and may be easier for some women, it did not translate into improved exclusive breastfeeding at home in this sample. Infants of diabetic mothers remain at high risk of receiving supplemental feeding after birth, underscoring the need for comprehensive perinatal breastfeeding support tailored to this population.
The abstract does not report several details that could inform interpretation, including:
These unreported elements limit the ability to assess generalizability and to identify subgroups who might derive the greatest benefit from antenatal expression.
This summary is based on the abstract of the prospective cohort study as indexed on PubMed (PMID 42638454). The full article may provide additional methodological and numerical detail that are not included in the abstract.