Information and practices of antenatal colostrum expression: a cross-sectional study of pregnant women in Norway

BACKGROUND: Antenatal colostrum expression (ACE) may increase breastfeeding self-efficacy. Although interest in ACE is growing in Western countries, evidence from Norway is scarce. This study examined whether, and in which form, pregnant women receive information about ACE, and explored characteristics of women who practise ACE compared to those who do not. METHODS: We conducted a cross-sectional survey among women who gave birth after 37 + 0 weeks´ gestation in Norway between 1 October 2023 and 30 September 2024. Data were collected through an anonymous online questionnaire (23 October -20 November 2024) from 1640 women and analysed using descriptive statistics, Chi-square, Fisher's exact test and Mann-Whitney U-test. RESULTS: Two-thirds of the women received information about ACE before birth. One quarter received information from healthcare personnel, and twice as many from other sources. The information from healthcare personnel was mainly given by midwives, in oral form. Women who expressed antenatal colostrum were more likely to have heard about ACE before pregnancy (p < 0.001), to have received information from healthcare personnel (p < 0.001) and other sources (p < 0.001), and to have been advised by healthcare personnel to practise ACE (p < 0.001), compared to those who had not undertaken ACE. Expressing antenatal colostrum correlated with being younger (p < 0.001) and primiparous (p < 0.001). The primary reason for practising ACE was to avoid formula, while non-practice was most often attributed to lack of knowledge. CONCLUSIONS: Women who received information about ACE primarily obtained this information from other sources than healthcare personnel. Women should have access to evidence-based information about ACE, including potential benefits and disadvantages, to make informed decisions. This underscores the need for national guidelines and further research on ACE and its impact on breastfeeding outcomes.