Antenatally expressing your milk

Why should I consider antenatal hand expression?

Towards the latter part of your pregnancy, you may choose to hand express some of your breastmilk. The breastmilk at this stage is called ‘colostrum’ and is packed full of immunological properties to support your baby’s health. It is designed for your baby to meet their needs and aids in the passing of the first stool, known as meconium.

Towards the latter part of your pregnancy, you may choose to hand express some of your breastmilk.

If you do experience challenges during the first few days of nursing, it might be helpful to know that you have a reserve built up that can be fed to your baby whilst you are establishing breastfeeding or chestfeeding should you need it. Of course, ideally, you may want to exclusively breastfeed and your colostrum reserve may end up being unused which is not a problem at all (1).

Knowing how to hand express is a useful tool as you may use it to express a few drops of milk onto your baby’s lips to encourage them to feed. If your breasts or chest feels engorged, hand expressing a little bit to take the ‘edge off’ can help to prevent blocked ducts or mastitis (2). Colostrum is also helpful in preventing allergies and diabetes and may be useful for parents who have medical conditions that can interfere with establishing breastfeeding (4). If challenges do occur, you can hand express your colostrum and know that you have frozen milk to add to any supplementation requirements.

Expressing your milk during this stage of your pregnancy will not impact on your milk supply (1). Usually, it is considered safe and appropriate to express your colostrum after you reach 36 weeks gestation. Before doing so, you should talk to your midwife in case there are any risk factors in your pregnancy. If you experience cramping when expressing your milk, stop and contact your healthcare professional (1 & 4).

How to express your colostrum

It is considered suitable to express colostrum two or three times a day (1) from 36 weeks gestation. It is likely to take less than five minutes each time (2). It is important to bear in mind that a breast pump is not recommended at this stage because colostrum is sticky and collected in very small amounts (1).

To express colostrum, hand expression is key.

• You should start with clean, washed hands and make sure that you are comfortable. Some parents choose to apply warmth to the breasts to increase milk flow.
• Breast massage can be useful in stimulating the breasts to release milk and cupping the breast with your hand to resemble a ‘C’ is what you are aiming for.
• Make sure there are a few centimetres space between your fingers and thumb, rhythmically and gently compress and release. This will draw colostrum out of the breast or chest in drops.
• The colostrum can be collected in a sterile syringe, bottle or container. This can be kept in the fridge and added to during the day. At the end of the day, you should label the container with the date and you can then put it into the freezer for up to six months (1). The milk collected during the day may be enough to make up a full feed in the first few days of life (2). 

The colostrum can be collected in a sterile syringe, bottle or container. 

After baby is born

If you need to use your colostrum, you can thaw your milk by running it under warm water from a tap or leaving it out at room temperature. Any defrosted colostrum must be used within a twenty-four-hour period. You may choose to take your frozen colostrum in a cooler bag with an icepack to hospital but it is a good idea to let the hospital know (1). 

Any defrosted colostrum must be used within a twenty-four-hour period.

You can watch a video about hand expression produced by UNICEF (3). 

References:

1. ABM (2021) Expressing your milk before your baby arrives. [Online] Available from: https://abm.me.uk/breastfeeding-information/antenatal-expression-colostrum/ [Accessed 31 October 2021]
2. LLL (2021) Antenatal expression of colostrum. [Online] Available from: https://www.laleche.org.uk/antenatal-expression-of-colostrum/ [Accessed 31 October 2021] 
3. UNICEF (2021) Hand expression video. [Online] Available from: https://www.unicef.org.uk/babyfriendly/baby-friendly-resources/breastfeeding-resources/hand-expression-video/ [Accessed 31 October 2021]
4. Pearson-Glaze (2021) Expressing colostrum antenatally. [Online] Available from: https://breastfeeding.support/expressing-colostrum-antenatally/ [Accessed 31 October 2021]