Antenatal hand expressing?

What is antenatal hand expressing?

A technique using during late pregnancy to gently massage and collect or ‘harvest’ colostrum (colostrum is early breastmilk, your baby’s first complete food). Your body actually began production of colostrum at approx. 16 weeks of pregnancy in preparation for your baby’s arrival!

Some women, not all, are able to collect small quantities of colostrum in sterile containers and freeze it until their baby is born.

Who should do it?

You should check with your midwife or obstetrician before beginning antenatal expression. Antenatal hand expressing may not be safe in pregnancies complicated by threatened premature labour, placenta previa, previous caesarean section(s), or a range of other maternal, obstetric and fetal issues.

Why do it?

If you are able to collect a small amount of colostrum before birth it can help with:

• Facilitating the first feed in cases where mother and baby might be separated at birth due to an emergency or unforseen circumstances

• Babies born to mothers with gestational diabetes have a higher risk of low blood sugar levels initally (hypoglycaemia). The best way to help them adjust is early and frequent feeding as they may have an increased energy requirement during their first 24hours. Colostrum expressed in pregnancy may help avoid the need for additional supplements such as infant formula, if your baby has low blood sugars.

• Snacks for a sleepy, recovering baby in their first 24hours when they dont know if they’re hungry or just too tired! (you can also hand express after birth too!)

• ‘Desserts” for nights 2&3 - these are big nights with lots of breastfeeds, which is normal! Your baby has a big increase in their appetite during these days and it can be tiring to keep up! having a few extra snacks to give after breastfeeds can be helpful!

• Circumstances where baby is unable to breastfeed well or often. A few examples include: premature birth, low birth weight, complications at delivery, nipple anatomy/shape, tongue tie and diagnosed conditions such as cleft lip or palate.

When should I start?

Not before 36 weeks of pregnancy. This is because the hand expressing technique triggers oxytocin - our love hormone. Oxytocin is the same hormone responsible for labour. This means there is a small chance it may trigger the onset of labour, and before 36 weeks this would be premature labour.

You should check with your midwife or doctor to make sure it is safe to commence expressing.

If it is safe to do so and you are >36 weeks gestation you may like to begin by trying to hand express 1-2x a day for 10 minutes at a time. You can gradually increase this to several times a day on both breasts as you draw close to your due date. Expressing in a private, safe environment maybe following a warm shower or gentle massage may help to stimulate the flow of colostrum easier.

Will I actually see any colostrum?

There is no way to know until you try! The ‘containment’ of our colostrum during pregnancy is completely controlled by hormones. Our hormone levels vary between mothers. This means some mothers will hand express and see colostrum, others will not. No matter how hard they try.

There is NO correlation between the amount (or absence) of colostrum you may see in pregnancy to amount of colostrum or breastmilk you will produce after birth.

If you see no colostrum despite checking the technique is correct, trying several times - then that is perfectly normal and means your body just needs to wait until after birth. The birth of the placenta will trigger the release of your colostrum instead, so please dont be disheartened!

Try after birth instead :)

References

Australian Breastfeeding Association. 2019. Antenatal expression of colostrum. [online] Available at: <https://www.breastfeeding.asn.au/bfinfo/antenatal-expression-colostrum> [Accessed 8 February 2021].

Brisbane, J. and Giglia, R., 2016. Experiences of expressing and storing colostrum antenatally.

Casey, J., Banks, J., Braniff, K., Buettner, P. and Heal, C., 2014. The effects of expressing antenatal colostrum in women with diabetes in pregnancy: A retrospective cohort study.

Forster, D., Moorhead, A., Jacobs, S., Davis, P., Walker, S., McEgan, K., Opie, G., Donath, S., Gold, L., McNamara, C., Aylward, A., East, C., Ford, R. and Amir, L., 2017. Advising women with diabetes in pregnancy to express breastmilk in late pregnancy (Diabetes and Antenatal Milk Expressing [DAME]): a multicentre, unblinded, randomised controlled trial.