Trial reportSingapore medical journal2019
Early initiation and regular breast milk expression reduces risk of lactogenesis II delay in at-risk Singaporean mothers in a randomised trial.
Trial report in Singapore medical journal, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 42 citations in OpenAlex.
- Risk factors for self-reported insufficient milk during the first 6 months of life: A systematic review.Maternal & child nutrition · 2022Pooled it
- Effects of postpartum hand expression on milk volume and breastfeeding outcomes: a systematic review and meta-analysis protocol.BMJ open · 2026Article
- Comparison of Milk Removal Efficiency and Maternal Perception Between a Hospital-Grade and Personal-Use Pump.Healthcare (Basel, Switzerland) · 2026Article
- Early Postpartum Milk-Expression and Expressed-Milk Feeding Practices in Relation to Breastfeeding Outcomes: A Systematic Review.Healthcare (Basel, Switzerland) · 2026Review
- Case Studies to Document Strategies Used by Mothers to Overcome Significant Maternal Morbidity Challenges to Successful Breastfeeding.Journal of human lactation : official journal of International Lactation Consultant Association · 2026Article
- Comparing Impacts of Donor Human Milk to Formula Supplementation on the Gut Microbiome of Full-Term Infants Born Via Cesarean Section: Protocol for a Pilot Randomized Controlled Trial.Journal of human lactation : official journal of International Lactation Consultant Association · 2025Article
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- Facilitators and barriers to establishing lactation among women with diabetes?Diabetic medicine : a journal of the British Diabetic Association · 2025Article
- Knowledge, attitude, and practice of breastfeeding among mothers attending King Abdulaziz University Hospital, Jeddah, Saudi Arabia.Journal of family medicine and primary care · 2025Article
- What social media analyses can tell us about Ghanaian women's concerns during pregnancy.Frontiers in digital health · 2025Article
- Does extremely early expression of colostrum after very preterm birth improve mother's own milk quantity? A cohort study.Archives of disease in childhood. Fetal and neonatal edition · 2024Article
- Expressed breast milk and maternal expression of breast milk for the prevention and treatment of neonatal hypoglycemia: a systematic review and meta-analysis.Maternal health, neonatology and perinatology · 2023Article
- Determinants of delayed onset of lactogenesis II among women who delivered via Cesarean section at a tertiary hospital in China: a prospective cohort study.International breastfeeding journal · 2022Article
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- A prospective cohort study on lactation status and breastfeeding challenges in mothers giving birth to preterm infants.International breastfeeding journal · 2022Article
- Review
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Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionLactogenesis II (LaII) failure can be prevented in at-risk mothers with simple proactive interventions. In a randomised trial, we investigated the efficacy of early and regular breast milk expression in establishing LaII, using an electric double-breast pump.
methodsMothers with uncomplicated singleton deliveries were randomised to intervention (n = 31) or control (n = 29) groups. The former commenced breast milk expression with an electric pump within one hour of delivery and maintained regular expression with direct breastfeeding. Control mothers directly breastfed without regular pump expression. Expressed milk volumes were analysed for citrate, lactose, sodium and protein.
resultsMedian time of LaII was Day 3 (interquartile range [IQR] 1 day) with intervention and on Day 4 (IQR 1 day) among controls (p = 0.03). Biochemical steady-state concentrations were achieved around early Day 4 (sodium, total protein) and Days 4-5 (citrate, lactose). Sodium, protein and lactose levels were similar in both groups over seven days, at 5.80 mM, 0.68 mM and -13.38 mM, respectively. Mean daily milk volume with intervention was 73.9 mL on Day 3 and 225.2 mL on Day 7, greater than controls (25.4 mL on Day 3 and 69.2 mL on Day 7; p < 0.2). Mean infant weights were similar on Day 8 at 3,477 g with intervention and 3,479 g among controls.
conclusionLaII is established by postnatal Day 3 with early initiation of regular breast milk expression, a useful intervention for mothers at risk of early-onset breastfeeding failure.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.