Authors (including presenting author) :
Sze PY(1), HO HL(1), Yip MY(1), Wong HMR(1), Li OCA(1), Wong D(1)
Affiliation :
(1)Obstetrics & Gynaecology, Pamela Youde Nethersole Eastern Hospital
Keyword 1: :
Breastfeeding
Keyword 3: :
Antenatal expression
Keyword 5: :
Hand expression
Keyword 6: :
Antenatal education
Introduction :
Breastfeeding, while optimal for infant nutrition, is frequently disrupted by delayed lactogenesis consequent to low confidence and early formula reliance, leading to suboptimal breastfeeding outcomes and premature cessation. Traditional antenatal education prioritizes theoretical knowledge over practical skill acquisition. Antenatal breastmilk expression (aBME) addresses this gap by developing practical hand-expression skills, facilitating colostrum collection, and building early breastfeeding confidence. This study evaluated a structured aBME program implemented in the Department of O&G at PYNEH to examine its impact on maternal breastfeeding self-efficacy, antenatal colostrum collection and breastfeeding outcomes across the first six months postpartum.
Objectives :
(1) To evaluate the impact of aBME on maternal breastfeeding self-efficacy (2) To examine the relationship between program engagement and successful colostrum collection, and postpartum feeding outcomes. (3) To evaluate the effectiveness of the aBME program in promoting breastfeeding.
Methodology :
Primiparous women participated in a 45-minute structured antenatal workshop (33-37 weeks) on hand expression and were advised to practice the technique daily from 37 weeks until delivery. Breastfeeding Self-Efficacy Scale–Short Form (BSES-SF) was administered pre- and post-intervention, followed by a survey assessing participant satisfaction with and perception of the aBME program. Engagement, colostrum collection, satisfaction, and breastfeeding modalities were recorded at discharge, 1-month, and 6-month postpartum.
Result & Outcome :
Among 73 participants recruited between June and July 2025, the aBME program significantly increased breastfeeding self-efficacy, elevating mean BSES-SF scores from 40.25±9.22 to 47.82±8.84 (p < 0.001, 95% CI: 5.68-9.47). A Spearman correlation revealed a strong positive association between program engagement and improvement in breastfeeding self-efficacy (r = 0.709, p < 0.001). The odds of successful colostrum collection increased by 8.6% (OR 1.086, p < 0.001). Clinically, the aBME group achieved significantly higher exclusive breastfeeding rates compared to the control group at discharge (45.2% vs. 21.9%), one month (68.5% vs. 23.7%), and six months postpartum (64.4% vs. 18.1%). Furthermore, infants in the aBME group were significantly less likely to experience >7% weight loss (4.1% [3/73] vs. 13.5% [29/215], p = 0.03, Fisher’s exact test). The aBME program demonstrated great behavioral and psychological benefits. By enhancing maternal confidence and readiness, aBME significantly improved early colostrum availability, breastfeeding initiation, and sustained exclusive breastfeeding up to six months. These findings support integrating aBME into routine antenatal education as an evidence-based strategy to strengthen breastfeeding outcomes.
