Colostrum is the yellow, first milk women produce from about their 20th week of pregnancy. It is the ideal first food for your baby. Known as “liquid gold”, it’s full of immunoglobulins that provide the vital initial framework for your baby’s immune system.
Ideal circumstances would ensure all babies receive colostrum after birth. Being a labour and delivery nurse, I know health care professionals strive to help women achieve this, but there are situations that arise that can put your baby at risk for needing supplementation. Some examples of this are:
- An infant whose mother has gestational diabetes
- An infant who is born prematurely
- An infant who has been stressed during the birth process
- An infant whose mother has gestational hypertension
Other reasons women might need to consider supplementing are:
- Women who have had previous breast surgery
- Women who have experienced low milk supply with previous children
- Women who have breast hypoplasia (limited breast development)
- Women who have polycystic ovarian disease
One way to avoid having to give your baby formula after birth is to consider antenatal hand expression. What is this? It is expressing and storing your colostrum while still pregnant so you have extra colostrum available for your baby if he or she needs supplementation.
I recommend always checking with your health care provider prior to starting antenatal hand expression to make sure it is safe for your pregnancy. Some examples of reasons why it may not be safe are:
- If you have a history of preterm labour prior to 37 weeks gestation.
- If you have a history of a shortened cervix, or if you have had a suture in your cervix to prevent preterm labour.
- If you have a low lying placenta or placenta previa.
These are just a few examples. At your next prenatal appointment, discuss if you can start antenatal hand expression safely.
When can you start?
After discussing with your health care provider, most women can start at 36 weeks gestation. Start with around 5 minutes per breast each day but it is important to stop if you are having contractions at any time.
How do I hand express?
- Always wash your hands before starting. I suggest expressing after a warm shower or bath.
- Sit up, leaning slightly forward.
- Massage your breast from the base to the nipple. This will stimulate a “let down”.
- Gently press your pointer finger and your thumb towards your chest wall, press together, and hold for a few seconds. Your fingers should not touch or squeeze your nipple. Think “press, hold, release, repeat”.
- Collect colostrum into a syringe as you see it appear at the end of your nipple. Don’t be discouraged if you see none when you first start expressing, it can take time and practice.
- Use a clean syringe each time. Label with date and time. Your colostrum can be stored in the freezer for three months and the deep freeze for six months.
Expressing should not hurt!!
Add your frozen milk to your list of things to bring to the hospital. When you arrive, ask your nurse to put it in a freezer safe for breastmilk- you don’t want all your hard work and precious colostrum to go to waste!
I find hand expression at the end of pregnancy helps moms feel more comfortable with expressing and handling their breasts prior to their babe arriving. A new baby is a STEEP learning curve and learning to breastfeed is a process. Practice hand expressing prior to baby’s arrival and you will find the comfort level you already have with hand expression has a significant impact on your comfort level breastfeeding your baby, resulting in a less stressful journey to exclusive breastfeeding.
If you would like more information and hands on help learning how to hand express, please contact me as I provide a package that includes an in-home session where I will show you how, and the supplies you need to get you started!
Take care and let me know if I can help!
Carrie Bruno RN, IBCLC