Evidence map›Paper›PMID 41888726›Full record

SynthesisBMC pregnancy and childbirth2026

The efficacy and the safety of antenatal breastmilk expression on breastfeeding outcomes: a systematic review and meta-analysis.

Feixia Wu, Rui Liu, Wenwen Tao, Feifei Zhu, Lingyun Zhang, Jinxia Pei, Haifang Zhou

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in BMC pregnancy and childbirth, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Feixia WuHangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, No. 453 Tiyuchang Road, Xihu District, Hangzhou City, 310000, Zhejiang Province, China.
Rui LiuHangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, No. 453 Tiyuchang Road, Xihu District, Hangzhou City, 310000, Zhejiang Province, China.
Wenwen TaoZhejiang Vocational College of Special Education, Hangzhou, Zhejiang Province, China.
Feifei ZhuHangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, No. 453 Tiyuchang Road, Xihu District, Hangzhou City, 310000, Zhejiang Province, China.
Lingyun ZhangHangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, No. 453 Tiyuchang Road, Xihu District, Hangzhou City, 310000, Zhejiang Province, China.
Jinxia PeiHangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, No. 453 Tiyuchang Road, Xihu District, Hangzhou City, 310000, Zhejiang Province, China.
Haifang ZhouHangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, No. 453 Tiyuchang Road, Xihu District, Hangzhou City, 310000, Zhejiang Province, China. 783206521@qq.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAntenatal breastmilk expression (ABE) has gained attention as a potential intervention to improve breastfeeding success, particularly among women at risk of delayed lactogenesis or breastfeeding difficulties. Breastfeeding is highly beneficial for maternal and infant health, yet global exclusive breastfeeding rates remain below WHO targets. Although emerging evidence suggests potential benefits, a comprehensive synthesis of recent randomized controlled trials (RCTs) is lacking. This systematic review aimed to evaluate the effectiveness and safety of ABE on breastfeeding outcomes.

methodsThis systematic review followed the Preferred Reporting Items for Systematic Review and Meta-Analysis Statement. PubMed, Web of Science, Scopus, Embase, CINAHL (via EBSCOhost), The Cochrane Library, WanFang Data, China National Knowledge Infrastructure (CNKI) were searched from the inception of the data bases to September 2024. Two authors independently reviewed the studies. Studies were included if they used randomized controlled trials to evaluate the effect of ABE on breastfeeding related outcomes. The Cochrane Risk of Bias Tool was used to assess quality. Meta-analyses were performed using RevMan version 5.4. Heterogeneity was assessed using the I² statistic, and certainty of evidence was assessed using the GRADE approach.

resultsThis systematic review included 10 randomized controlled trials involving 1672 participants. ABE significantly improved the initiation of lactation (MD = -6.23; 95% CI: -7.77 to -4.69; moderate certainty evidence. at < 72 h: OR = 4.06; 95% CI: 2.15–7.67; high certainty evidence), and the breastfeeding self-efficacy (MD = 8.51; 95% CI: 7.69–9.33; moderate certainty evidence), both statistically significant. Exclusive breastfeeding rates were significantly higher within 3 months postpartum (OR = 4.95; 95% CI: 2.65–9.25, I2 = 85%; moderate certainty evidence), but no significant difference was observed at ≥ 3 months (OR = 1.09; 95% CI: 0.83–1.44, P = 0.54; moderate certainty evidence). There was no difference in the risk of admission to Neonatal Intensive Care Unit (OR = 1.08; 95% CI: 0.74–1.57, P = 0.69), gestational age at birth (MD = -0.15; 95% CI: -0.29 to 0.00, P = 0.05), birthweight (MD = -0.04; 95% CI: -0.14 to 0.05, P = 0.35), and cesarean section delivery (OR = 1.10; 95% CI: 0.87–1.40, P = 0.42) among mothers with ABE compared to those who did not.

conclusionThe existing evidence supports the efficacy and safety of ABE interventions on promoting breastfeeding. ABE programs can be incorporated into antenatal breastfeeding education.

trial registrationThis review has been registered in the International Prospective Register of Systematic Reviews (PROSPERO) (ID: CRD42024534064).

Indexed as

Breast FeedingBreast Milk ExpressionPrenatal CareFemaleHumansInfant, NewbornLactationPregnancyRandomized Controlled Trials as TopicAntenatal breastmilk expressionBreastfeedingMeta-analysisSystematic review

Identifiers

PMID41888726
PMCPMC13147747

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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Registered trials

None linked

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.