BACKGROUND:
The increasing prevalence of Gestational Diabetes Mellitus (GDM) presents a global health concern, particularly due to its association with obstetric complications and adverse maternal and neonatal outcomes. The Chinese population is disproportionately affected, with high GDM rates contributing to breastfeeding challenges and heightened risks of type 2 diabetes for both mothers and infants. In Hong Kong, exclusive breastfeeding rates remain low compared to international standards, despite efforts like the Baby-Friendly Hospital Initiative, which advocates for breastfeeding as a vital intervention for women with GDM. To address these challenges, the Gestational Diabetes and Antenatal Milk Expression (GAME) program was developed as a behavioural intervention to promote exclusive breastfeeding.

OBJECTIVES:
To examine the feasibility, acceptability, and effectiveness of antenatal milk expression (AME) among Hong Kong Chinese women with GDM.

METHODS:
A randomized controlled trial conducted between January 2022 and December 2023. A total of 246 participants were randomized into intervention and control groups, with 215 completing follow-up assessments.

RESULTS:
At 4 weeks postpartum, exclusive breastfeeding rates were significantly higher in the intervention group compared to the control group (adjusted difference = 0.17, 95% CI: 0.04 to 0.31, p = 0.014). At 8 weeks postpartum, depressive symptoms were significantly lower in the intervention group (adjusted difference = 1.41, 95% CI: 0.41 to 2.40, p = 0.006), with greater improvements observed in multiparous women and those undergoing elective caesarean sections.

CONCLUSIONS:
The GAME program demonstrated promise as a feasible and effective intervention, improving exclusive breastfeeding rates, enhancing breastfeeding self-efficacy, and reducing postpartum depressive symptoms. Scaling up the program could empower midwives to provide targeted breastfeeding support for Chinese women with GDM in Hong Kong. Further research is recommended to assess its long-term efficacy and applicability in broader populations.

KEY MESSAGE:
The GAME program implemented by midwife lactation consulant showed effectively improves exclusive breastfeeding rates and significantly reduce depressive symptom. Poster session 2 (Group A)