Antenatal Breastmilk Expression From Week 34 of Gestation

NCT ID: NCT05516199

Last Updated: 2024-01-16

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-08-31

Study Completion Date

2023-11-30

Brief Summary

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In this pilot study, the investigators aim to examine if antenatal breastmilk expression from week 34 of pregnancy is a safe and feasible procedure for the mother and fetus. Furthermore, the investigators want to evaluate breastfeeding rates.

Detailed Description

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In a randomized pilot study, 60 healthy pregnant women will be randomized either to antenatal breastmilk expression from week 34+0 until delivery or no antenatal breastmilk expression. Furthermore, all participants will have an individual breastfeeding consultation with a trained midwife in week 33 of pregnancy. At the consultation, the intervention group will also be taught how to perform antenatal expression by hand and store any expressed breastmilk correctly. All women included in this study will receive standard care.

To detect signs of uterine contractions or fetal reaction in relation to stimulation of the breast, a cardiotocography (CTG) will be performed before, during and after the first expression in the intervention group. If the CTG is normal the women can perform breastmilk expression by hand 5 minutes at each breast two times per day until birth, and collect and store any expressed milk.

During the intervention and 8 weeks after birth the participating women will receive weekly push-messages through an application on their smartphone. The messages include short questions about the handexpression of milk in pregnancy as well as regarding feeding of the infant after birth. At the end of the study the mothers will be invited for an interview to investigate their experience with the procedure, but this is an independent study and therefore not a part of this protocol.

Conditions

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Breastmilk Expression Collection, Breastmilk Breastfeeding Healthy

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Parallel Assignment
Primary Study Purpose

OTHER

Blinding Strategy

NONE

Study Groups

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Antenatal breastmilk expression

Breastfeeding consultation with trained midwife in week 33 + antenatal breastmilk expression from week 34

Group Type EXPERIMENTAL

Antenatal breastmilk expression

Intervention Type BEHAVIORAL

Stimulation of the breast by hand/handexpression of breastmilk during pregnancy from week 34

Breastfeeding consultation

Intervention Type BEHAVIORAL

60 min standardized breastfeeding consultation with a trained midwife, with focus on practical breastfeeding skills

Control

Breastfeeding consultation with trained midwife in week 33

Group Type OTHER

Breastfeeding consultation

Intervention Type BEHAVIORAL

60 min standardized breastfeeding consultation with a trained midwife, with focus on practical breastfeeding skills

Interventions

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Antenatal breastmilk expression

Stimulation of the breast by hand/handexpression of breastmilk during pregnancy from week 34

Intervention Type BEHAVIORAL

Breastfeeding consultation

60 min standardized breastfeeding consultation with a trained midwife, with focus on practical breastfeeding skills

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

1. Healthy nulliparous women with no major chronic or pregnancy related diseases
2. BMI \<27
3. Danish speaking
4. Singleton pregnancies
5. Planning to exclusively breastfeed their infants and deliver at Odense University Hospital (Odense and Svendborg)

Exclusion Criteria

1. Suspected fetal intrauterine growth restriction or known major fetal anomaly
2. Women at risk of preterm birth with one of the following diagnoses: Placenta previa, premature preterm rupture of membranes (PPROM) or previous cervical conization
3. Women taking medications where breastfeeding is contraindicated
4. Women with prior breast surgery: Breast reductive surgery or breast implants
Minimum Eligible Age

18 Years

Maximum Eligible Age

45 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

Yes

Sponsors

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University of Southern Denmark

OTHER

Sponsor Role collaborator

Odense University Hospital

OTHER

Sponsor Role lead

Responsible Party

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Marie Bendix Simonsen, M.D.

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Marie B Simonsen, M.D

Role: PRINCIPAL_INVESTIGATOR

OUH & SDU

Locations

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Odense University Hospital

Odense, , Denmark

Site Status

Countries

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Denmark

References

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Ford SL, Lohmann P, Preidis GA, Gordon PS, O'Donnell A, Hagan J, Venkatachalam A, Balderas M, Luna RA, Hair AB. Improved feeding tolerance and growth are linked to increased gut microbial community diversity in very-low-birth-weight infants fed mother's own milk compared with donor breast milk. Am J Clin Nutr. 2019 Apr 1;109(4):1088-1097. doi: 10.1093/ajcn/nqz006.

Reference Type BACKGROUND
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Wagner KJP, Rossi CE, Hinnig PF, Alves MA, Retondario A, Vasconcelos FAG. ASSOCIATION BETWEEN BREASTFEEDING AND OVERWEIGHT/OBESITY IN SCHOOLCHILDREN AGED 7-14 YEARS. Rev Paul Pediatr. 2021 Feb 24;39:e2020076. doi: 10.1590/1984-0462/2021/39/2020076. eCollection 2021.

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Laine MK, Kautiainen H, Gissler M, Pennanen P, Eriksson JG. Impact of gestational diabetes mellitus on the duration of breastfeeding in primiparous women: an observational cohort study. Int Breastfeed J. 2021 Feb 16;16(1):19. doi: 10.1186/s13006-021-00369-1.

Reference Type BACKGROUND
PMID: 33593367 (View on PubMed)

Victora CG, Bahl R, Barros AJ, Franca GV, Horton S, Krasevec J, Murch S, Sankar MJ, Walker N, Rollins NC; Lancet Breastfeeding Series Group. Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. Lancet. 2016 Jan 30;387(10017):475-90. doi: 10.1016/S0140-6736(15)01024-7.

Reference Type BACKGROUND
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Ballard O, Morrow AL. Human milk composition: nutrients and bioactive factors. Pediatr Clin North Am. 2013 Feb;60(1):49-74. doi: 10.1016/j.pcl.2012.10.002.

Reference Type BACKGROUND
PMID: 23178060 (View on PubMed)

Yu X, Li J, Lin X, Luan D. Association between Delayed Lactogenesis Ⅱ and Early Milk Volume among Mothers of Preterm Infants. Asian Nurs Res (Korean Soc Nurs Sci). 2019 May;13(2):93-98. doi: 10.1016/j.anr.2019.02.001. Epub 2019 Feb 16.

Reference Type BACKGROUND
PMID: 30776448 (View on PubMed)

Underwood MA. Human milk for the premature infant. Pediatr Clin North Am. 2013 Feb;60(1):189-207. doi: 10.1016/j.pcl.2012.09.008. Epub 2012 Oct 18.

Reference Type BACKGROUND
PMID: 23178065 (View on PubMed)

Parker LA, Sullivan S, Krueger C, Mueller M. Association of timing of initiation of breastmilk expression on milk volume and timing of lactogenesis stage II among mothers of very low-birth-weight infants. Breastfeed Med. 2015 Mar;10(2):84-91. doi: 10.1089/bfm.2014.0089. Epub 2015 Feb 6.

Reference Type BACKGROUND
PMID: 25659030 (View on PubMed)

Forster DA, Moorhead AM, Jacobs SE, Davis PG, Walker SP, McEgan KM, Opie GF, Donath SM, Gold L, McNamara C, Aylward A, East C, Ford R, Amir LH. Advising women with diabetes in pregnancy to express breastmilk in late pregnancy (Diabetes and Antenatal Milk Expressing [DAME]): a multicentre, unblinded, randomised controlled trial. Lancet. 2017 Jun 3;389(10085):2204-2213. doi: 10.1016/S0140-6736(17)31373-9.

Reference Type BACKGROUND
PMID: 28589894 (View on PubMed)

Lopez-Fernandez G, Barrios M, Goberna-Tricas J, Gomez-Benito J. Breastfeeding during pregnancy: A systematic review. Women Birth. 2017 Dec;30(6):e292-e300. doi: 10.1016/j.wombi.2017.05.008. Epub 2017 Jun 19.

Reference Type BACKGROUND
PMID: 28642112 (View on PubMed)

Lamba S, Chopra S, Negi M. Effect of Antenatal Breast Milk Expression at Term Pregnancy to Improve Post Natal Lactational Performance. J Obstet Gynaecol India. 2016 Feb;66(1):30-4. doi: 10.1007/s13224-014-0648-7. Epub 2015 Jan 20.

Reference Type BACKGROUND
PMID: 26924904 (View on PubMed)

Foudil-Bey I, Murphy MSQ, Dunn S, Keely EJ, El-Chaar D. Evaluating antenatal breastmilk expression outcomes: a scoping review. Int Breastfeed J. 2021 Mar 12;16(1):25. doi: 10.1186/s13006-021-00371-7.

Reference Type BACKGROUND
PMID: 33712049 (View on PubMed)

Casey JRR, Banks J, Braniff K, Buettner P, Heal C. The effects of expressing antenatal colostrum in women with diabetes in pregnancy: A retrospective cohort study. Aust N Z J Obstet Gynaecol. 2019 Dec;59(6):811-818. doi: 10.1111/ajo.12966. Epub 2019 Mar 19.

Reference Type BACKGROUND
PMID: 30891743 (View on PubMed)

Demirci JR, Glasser M, Fichner J, Caplan E, Himes KP. "It gave me so much confidence": First-time U.S. mothers' experiences with antenatal milk expression. Matern Child Nutr. 2019 Oct;15(4):e12824. doi: 10.1111/mcn.12824. Epub 2019 May 23.

Reference Type BACKGROUND
PMID: 30950165 (View on PubMed)

Demirci J, Schmella M, Glasser M, Bodnar L, Himes KP. Delayed Lactogenesis II and potential utility of antenatal milk expression in women developing late-onset preeclampsia: a case series. BMC Pregnancy Childbirth. 2018 Mar 15;18(1):68. doi: 10.1186/s12884-018-1693-5.

Reference Type BACKGROUND
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Soltani H, Scott AM. Antenatal breast expression in women with diabetes: outcomes from a retrospective cohort study. Int Breastfeed J. 2012 Dec 1;7(1):18. doi: 10.1186/1746-4358-7-18.

Reference Type BACKGROUND
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Bruun S, Wedderkopp N, Molgaard C, Kyhl HB, Zachariassen G, Husby S. Using text messaging to obtain weekly data on infant feeding in a Danish birth cohort resulted in high participation rates. Acta Paediatr. 2016 Jun;105(6):648-54. doi: 10.1111/apa.13382. Epub 2016 Apr 13.

Reference Type RESULT
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Simonsen MB, Bentzen SB, Moller S, Holm KG, Vinter CA, Zachariassen G. Safety of antenatal breastmilk expression from week 34 of pregnancy: a randomized controlled pilot study (The Express-MOM study). Matern Health Neonatol Perinatol. 2025 Jan 3;11(1):2. doi: 10.1186/s40748-024-00197-1.

Reference Type DERIVED
PMID: 39748396 (View on PubMed)

Bentzen SB, Simonsen MB, Zachariassen G, Vinter CA, Garne Holm K. Women's bodily experience of antenatal breastmilk expression from 34 weeks of gestation: Qualitative results from the Express-MOM study. Eur J Midwifery. 2024 Nov 1;8. doi: 10.18332/ejm/193601. eCollection 2024.

Reference Type DERIVED
PMID: 39493541 (View on PubMed)

Provided Documents

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Document Type: Study Protocol

View Document

Document Type: Statistical Analysis Plan

View Document

Other Identifiers

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OUH-HCA005

Identifier Type: -

Identifier Source: org_study_id

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