09/07/2026
Effect of antenatal colostrum expression teaching on breastfeeding practices and birth outcomes: a retrospective case-control chart review
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 s*x.
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.
https://link.springer.com/article/10.1186/s12884-026-09298-5
