# Effect of Antenatal Milk Expression on Breastfeeding Outcomes among Overweight and Obese Women

> **NIH NIH R01** · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · 2020 · $387,233

## Abstract

PROJECT SUMMARY/ABSTRACT
The purpose of this randomized controlled trial is to examine the impact of an antenatal milk expression (AME)
intervention versus an attention control condition on breastfeeding outcomes among a sample of nulliparous,
non-diabetic women with pre-pregnancy body mass indices ≥ 25. AME involves milk expression and collection
in the third pregnancy trimester and is theorized to address multiple barriers to breastfeeding among
overweight and obese women, including impaired breastfeeding self-efficacy, insufficient milk supply (critical-
period endocrine modulation of milk volume), and early formula supplementation in the context of a medically-
complex birth (availability of banked antenatal milk). Although AME is increasing in popularity outside the U.S.,
there is a lack of evidence to support its widespread adoption among women both with and without risk factors
for poor breastfeeding outcomes. In the proposed study, participants will be enrolled at 34-366/7 gestational
weeks and allocated into one of two study arms: 1) AME instruction delivered by remote, live International
Board Certified Lactation Consultants via an innovative app-based telelactation platform trialed in our previous
research; or 2) an attention control condition (video-based infant care education unrelated to infant feeding).
AME instruction or control group video education will occur in weekly study visits from 37 to 40 weeks
gestation, with women in the intervention group continuing AME 1-2 times per day at home. Specific aims are
to: 1) determine the effect of the AME intervention on short-term breastfeeding outcomes, including
breastfeeding self-efficacy and exclusivity, to two weeks postpartum; 2) to explore the sustained effect of the
AME intervention on longer-term breastfeeding duration and exclusivity over the first year postpartum; and 3)
to examine participants’ experiences with and perceptions of AME. Data for Aims 1 and 2 will be captured via
medical record review and in-person and remote survey completion at enrollment and postpartum follow-ups at
2 weeks, 6 weeks, 12 weeks, 6 months, and 12 months postpartum. For Aim 3, maternal perceptions about
and experiences with AME will be captured via in-depth interviews at 6 weeks postpartum. Using an intention-
to-treat approach, generalized linear mixed-effects modeling and Cox proportional hazards regression will be
used to examine the effect of treatment assignment (AME vs. control) on quantitative outcomes. Sensitivity
analyses will be conducted to determine receipt and “dose” of AME on outcomes. We will also explore the role
of maternal perception of milk supply and onset of lactogenesis II (copious milk production in the days following
birth) in post-hoc mediational analyses. This project leverages our study team’s ongoing research investigating
feasibility and preliminary efficacy of AME among normal weight and overweight/obese first-time mothers and
feasibility of telelactation-delivered b...

## Key facts

- **NIH application ID:** 10004136
- **Project number:** 5R01HD098186-02
- **Recipient organization:** UNIVERSITY OF PITTSBURGH AT PITTSBURGH
- **Principal Investigator:** Jill Radtke Demirci
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $387,233
- **Award type:** 5
- **Project period:** 2019-09-01 → 2024-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10004136

## Citation

> US National Institutes of Health, RePORTER application 10004136, Effect of Antenatal Milk Expression on Breastfeeding Outcomes among Overweight and Obese Women (5R01HD098186-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10004136. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*