None listed
Conditions
Brief summary
From about the sixteenth week of pregnancy, breasts begin to produce the first milk, colostrum. Traditionally, antenatal colostrum expression (ACE) was performed as a means of preparing the breasts for breastfeeding after birth. More recently, ACE is performed to collect a supply of colostrum antenatally. Colostrum can be collected using a syringe, and safely stored in a freezer. The colostrum can then be defrosted and given to the baby. The stored colostrum can be used to treat hypoglycaemia in the infant after birth, or if breastfeeding issues occur. The use of ACE is controversial, as very few RCTs have been conducted in this area, with none in healthy women, and most using a small sample size . Some midwives and lactation consultants report advising healthy women to use hand expression during pregnancy, despite limited evidence to support the practice. Conversely, others do not encourage ACE due to a lack of evidence, or due to hospital policy. This study will investigate effects of ACE (from 37 wks gestation) on long term breastfeeding rates and also determine the feasibility of teaching pregnant women ACE using an online instructional video. If successful, this project will provide the platform for much needed research to determine the efficacy of teaching ACE in the general population, using an easy method that can readily be incorporated into routine antenatal practice.
Interventions
There are two intervention groups and one control group for this study.
The Video (VI) intervention group will receive a link to an online instructional video on antenatal colostrum expression (ACE), along with instruction to hand express 2-3 times daily from 37 weeks gestation via written information and phone call. They will be asked to keep an expressing diary and will be contacted weekly via phone call for compliance checks. Participants will have access to the video online to view at home
There are two intervention groups and one control group for this study. The Video (VI) intervention group will receive a link to an online instructional video on antenatal colostrum expression (ACE), along with instruction to hand express 2-3 times daily from 37 weeks gestation via written information and phone call. They will be asked to keep an expressing diary and will be contacted weekly via phone call for compliance checks. Participants will have access to the video online to view at home as often as they like. The instructional video runs for 16 mins and includes a lactation consultant giving information on ACE and how to safely collect and store colostrum with demonstrations by pregnant women. The Midwife (MW) intervention group will receive personal one-on-one instruction on ACE (approx. 15 mins) from a qualified midwife, along with instruction to hand express 2-3 times daily from 37 weeks gestation via written information and phone call. The MW group will also be asked to keep an expressing diary and will be contacted weekly via phone call until the birth for compliance checks. Participants are advised to take their stored colostrum to hospital for use after birth if required. As an optional part of the study, participants will have the opportunity to provide a postnatal colostrum sample for analysis.
Sponsors
Edith Cowan University
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Prevention
Masking
Blinded (masking used) (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Nulliparous women, singleton pregnancy, planning to breastfeed, and able to speak, read and write in English
Exclusion criteria
Relevant maternal or infant medical conditions including history of threatened/actual premature labour, cervical incompetence, cervical suture in situ, antepartum haemorrhage, placenta praevia and suspected fetal compromise, fetal anomaly, infant born <37 weeks. Diagnosis of gestational Diabetes Mellitus is an exclusion criteria for analysis between control and intervention groups.
Outcome results
None listed