Research Thursday: The DAME Study

November 4, 2021

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This, our first Research Thursday post, reviews the DAME Study, which was a scientific look at the safety of Antenatal Milk Expression (AME).

What is antenatal milk expression? When is the pregnant woman’s body capable of making colostrum?

• Milk production begins around the 16th week of pregnancy.

• Antenatal milk expression is when a woman uses hand expression to express colostrum. This colostrum is saved and used after the birth of the baby.

Is Antenatal Milk Expression (AME) safe?

• This is what the 2017 DAME study looked at.

• Here is the citation for the study: Advising women with diabetes in pregnancy to express breast milk in later pregnancy (Diabetes and Antenatal Milk Expressing [DAME]): a multicentre, unblinded, randomised controlled trial. Forster DA, Moorhead AM, Jacobs SE, Davis PG, Walker SP, McEgan KM, Opie GF, Donath SM, Gold L, McNamara C, Aylard A, East C, Ford R, Amir LH. Lancet. 2017;389(10085):2204-2213.

• As you can see from the title, DAME is short for “Diabetes and Antenatal Milk Expression.”

• Here is a link to the abstract in Pub Med Dame Study

• The researchers enrolled women with pre-existing or gestational diabetes. The study randomized 319 women to twice daily antenatal milk expression (AME) at 36 weeks and 316 women to standard care.

• They found the answer to be YES, antenatal milk expression is safe. The study found no increased risk of obstetric or neonatal adverse outcomes in the study group.

How exactly do you do AME, for how long do you it and how much should you expect to get?

• Use the same technique as postnatal hand expression. 

• For the DAME study, the women did AME twice a day, no more than 10 minutes each time, starting at 36 weeks

• Women should not expect large volumes --- the DAME study reported 2-5 ml per episode.

What do you put the colostrum in? Do you freeze it?

• Many women will fill syringes with colostrum and freeze it.

• The same storage guidelines as used for post-partum milk apply.

Will antenatal milk expression (AME) induce contractions?

• No. Recall that the Dame study found no increased risk of obstetric or neonatal adverse outcomes in the study group.