The Effect of Prenatal Hand Expression on the Rate of Exclusive Breastfeeding to Two Months

Study Overview
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Brief Summary
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Despite recommendations by several health authorities, the rate of sustained exclusive breastfeeding for two months is less than fifty-five percent in Canada. The two most common reasons for early discontinuation are problems with milk supply and difficulty with technique. Antenatal hand expression (AHE) is a method used to assist with colostrum collection in low-risk pregnancies near term. This method has been shown to have several benefits, including increased milk supply at birth. This study aims to determine if the employment of antenatal hand expression in low-risk pregnancies near term affects the rate of sustained breastfeeding exclusively to two months.

Official Title
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The Effect of Prenatal Hand Expression on the Rate of Exclusive Breastfeeding to Two Months

Conditions
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Breastfeeding, Breastfeeding, Exclusive, Breast Milk Collection

Intervention / Treatment
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* Behavioral: Antenatal hand expression


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: inclusion to breastfeed no contraindications to vaginal delivery multiple gestation only if cleared for vaginal delivery Exclusion Criteria: intention to formula feed antenatal hand expression training provided by staff outside of study protocol practiced antenatal hand expression prior to 36 weeks gestation breech presentation history of preterm labour, preterm birth or threatened preterm labour history of (or current) cervical insufficiency any contraindication to vaginal delivery (ie. placenta or vasa previa, classical uterine scar, etc.) intrauterine growth restriction antepartum hemorrhage any contraindication to breastfeeding (eg. HIV) multiple gestation requiring Cesarean delivery
Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Antenatal hand expression - intention to exclusively breastfeed<br>Eligible participants in this group intend to exclusively breastfeed AND must have received standardized counselling on and practiced antenatal hand expression for a minimum of 10 days beginning no earlier than 36 weeks gestational age. | Behavioral: Antenatal hand expression<br>* Standardized counselling and provision of information/resources on the practice of antenatal hand expression to encourage milk let down and colostrum production/collection.<br>|
| No antenatal hand expression - intention to exclusively breastfeed<br>Eligible participants in this group intend to exclusively breastfeed but have NOT received any standardized counselling on antenatal hand expression and have not practiced antenatal hand expression OR have practiced antenatal hand expression but for less than 10 days. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Exclusive breastfeeding to two months | Participant-reported data on newborn dietary intake, collected by telephone questionnaire | This metric measured by questionnaire at two months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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antenatal, colostrum, hand expression, prenatal