The Gestational Diabetes Antenatal Milk Expression (GAME) trial: effects on breastfeeding outcomes and maternal mental health-A randomised controlled trial.
Antenatal milk expression program nearly doubled exclusive breastfeeding at discharge in gestational diabetes
The Gestational Diabetes Antenatal Milk Expression (GAME) trial: effects on breastfeeding outcomes and maternal mental health-A randomised controlled trial.
Women with Gestational Diabetes Mellitus (Gestational Diabetes Mellitus) are at increased risk of delayed lactogenesis and suboptimal breastfeeding.
We aimed to evaluate the effects of a structured antenatal milk expression programme on breastfeeding and maternal psychosocial outcomes in women with Gestational Diabetes Mellitus.
We conducted a two-centre, parallel-group, assessor-blinded, randomised controlled trial at two public antenatal clinics in Hong Kong from May 10, 2023, to May 10, 2024.
more than double the odds of exclusive breastfeeding at discharge with antenatal milk expression
25.2%; aOR 1.37 [0.73-2.56]).
The intervention group demonstrated significantly higher odds of exclusive breastfeeding over time (adjusted odds ratio 2.43 [95% CI 1.17-5.04], p < 0.05).
Regarding secondary outcomes, the intervention group reported significantly lower maternal depressive symptoms at 8 weeks postpartum (mean difference -1.74 [95% CI -2.94 to -0.54], p = 0.004) and higher breastfeeding self-efficacy at 8 weeks postpartum (mean difference 3.30 [95% CI 0.12-6.48], p = 0.042).
The GAME programme significantly increased exclusive breastfeeding, improved breastfeeding self-efficacy, and reduced maternal depressive symptoms in women with Gestational Diabetes Mellitus, with no added perinatal risk.
Integrating structured antenatal milk expression into routine antenatal care could improve both infant feeding and maternal psychological well-being in this high-risk population.