Antenatal colostrum harvesting with diabetes

Please check with your community midwife before commencing antenatal hand expressing. If your Midwife is happy for you to go ahead after 36 weeks, please get in touch with us on [email protected] if you would like a syringe pack sending out.

What is colostrum?

Colostrum is produced in your breasts from 16 weeks of pregnancy. It is the first milk that is produced for your babyís first feeds after birth (usually yellow in colour). Colostrum is easy for your baby to digest, helps to clear your babyís first poo (meconium), reduces jaundice, and is full of antibodies to help protect your baby from infection. Colostrum is initially produced in small quantities but is everything your baby needs in the first few days of life. At around 3-5 days after having your baby your breast milk will be changing to more mature milk, which is produced in larger volumes.

You may find you leak colostrum whilst you are pregnant, others don’t. Don’t worry if you haven’t noticed any leakage whilst you are pregnant it doesn’t mean you will not produce enough milk for your baby once they are born.

Why express while pregnant?

You may find it useful to practice and gather a store of colostrum before the birth of your baby. If you have had diabetes during your pregnancy your baby may experience low blood glucose (sugars) during the first 24 hours after their birth. To help to prevent this you will be encouraged to feed your baby frequently. If your babyís blood glucose (sugar) is low they may need a little extra milk. If you have expressed your breast milk before your baby is born this is given to your baby. This also reduces the chances of introducing any other foods other than breast milk. There could also be unforeseen circumstances, such as you or your baby being unwell or separated following your birth and by having the colostrum in advance it minimises the chance of any delay in giving your own milk to your baby.

Learning to hand express colostrum also has other benefits:

Being familiar with your breasts and how they work will give you confidence for after the birth.
You’ll understand how far your baby’s mouth needs to be on the breast when he latches on.
You’ll be able to express a small amount of colostrum if your baby needs encouragement to feed.
You’ll be able to express colostrum for your baby if they have difficulty feeding or are cared for in the neonatal intensive care or special care baby unit.
You’ll find it easier to recognise changes in your breasts. Being able to hand express will help you avoid problems with engorgement and mastitis.
You’ll always have a way to express your milk if needed.

How can I express my colostrum?

You can begin expressing by hand (more effective at capturing your milk than by using a pump) a few times a day from 36 weeks of pregnancy. It helps to be warm and relaxed – practice in the shower/bath or when watching a funny film or TV show when you first try.

Ensure your hands are washed then gently massage your breast to aid the flow for at least ten minutes.
Then cup your breast and place your thumb and finger about 2-3cm from the base of the nipple. Using your thumb and fingers in a C shape, apply gentle pressure, and build up a rhythm, pressing holding and releasing.
Repeat this again and again, avoiding sliding your fingers over your skin. Collect any colostrum (droplets at first) in to your sterile syringe.
When the flow slows, rotate your thumb and forefinger around the breast and repeat. If you do not see any colostrum, try widening, or narrowing, your thumb and forefinger and /or push back into your chest wall and then press hold and release as before.
The colostrum collected should be put into the freezer at the end of each day in a syringe with the cap on. Please wrap one of your named hospital labels around the syringe, and write the date and time you have expressed it. This will help ensure the right milk is identified for your baby in the hospital. Store in your freezer in a see-through bag, and label with your full name, date of birth. When coming into hospital for birth, please bring your syringes in an insulated cool bag with ice packs, and let the midwives know so it can be placed in our freezer.

The following links can be used to view a video guide on hand expressing:

http://youtu.be/4rc4SEfqtSE

https://www.unicef.org.uk/babyfriendly/baby-friendly-resources/breastfeeding-resources/hand-expression-video/ (UNICEF hand expression)

Hand expressing in pregnancy can be a great tool for you to prepare for breastfeeding. However, if you do not wish to express please rest assured that it is not vital to be successful at breastfeeding. Also, if you try hand expressing but do not obtain any colostrum this does not mean your body is not producing any, nor does it mean your body won’t be able to produce enough breast milk for your baby after birth. Initially when you start to express the first few times you may not see any colostrum but with perseverance your body will gradually respond by starting to produce a glisten on the nipple, followed by an increase in colostrum. If you have expressed every day for a week and not managed to express or seen any colostrum you are welcome to ask your midwife for advice.