ArticleBMJ open2026
Effects of postpartum hand expression on milk volume and breastfeeding outcomes: a systematic review and meta-analysis protocol.
Article in BMJ open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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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
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Corrections and comments
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Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionHand expression is a manual method of milk expression that requires no equipment and is commonly used in the early postpartum period, particularly when direct breastfeeding is not possible or not effective. Randomised trials have reported mixed findings across different maternal-infant contexts. This review aims to synthesise randomised evidence on the effects of postpartum hand expression on expressed milk volume and breastfeeding outcomes. METHODS AND ANALYSIS: We will include individually randomised parallel-group controlled trials involving human postpartum women expressing breast milk in the early postpartum period. The intervention is postpartum hand expression; comparators will include electric or manual pump expression and usual care without structured hand-expression training. We will search PubMed, Embase, CINAHL, PsycINFO, Web of Science and CENTRAL from inception, without language or date restrictions and also search OpenGrey, ClinicalTrials.gov and WHO ICTRP, plus reference lists. Two reviewers will independently screen studies, extract data and assess risk of bias using the Risk of Bias tool for randomised trials, version 2. Eligible outcomes include expressed milk volume, breastfeeding outcomes, supplementation, time to onset of copious milk secretion and maternal outcomes. Where appropriate, we will conduct pairwise meta-analyses, calculating risk ratios for dichotomous outcomes and mean differences or standardised mean differences for continuous outcomes with 95% CIs. Heterogeneity will be assessed using χ² and I², with prespecified subgroup and sensitivity analyses. Certainty of evidence will be assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE). ETHICS AND DISSEMINATION: This study will be based on previous research findings, so that ethics approval is not required. Data searching commences in June 2026 and expects to complete in January, 2027. The findings will be disseminated through peer-reviewed journals and academic conferences. PROSPERO REGISTRATION NUMBER: CRD420261327070.
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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 Socratic graph.