Why should I express my milk antenatally?
Colostrum is produced from approximately the 16th week in pregnancy up until the first few days after the baby has been born, and is called the baby’s ‘first vaccine’ as it is extremely rich in antibodies, which helps your baby’s immune system to develop.
Colostrum is packed with proteins, vitamins, minerals and salt which help prevent dehydration. Colostrum helps to develop baby’s digestive system, which protects your baby from allergies.
Colostrum also has a ‘laxative’ effect and helps the baby to pass meconium which assists in reducing the risk of jaundice and helps to regulate your baby’s blood sugars.
Who can collect colostrum?
Most expectant mothers can express their colostrum from 36-37 weeks (please see below for when colostrum collecting is not recommended).
However, we would strongly recommend collecting colostrum if you have any of the following risk factors:
- Women with diabetes in pregnancy (pre-existing or gestational)
- Infants diagnosed during the antenatal period with cleft lip/palate or congenital conditions
- A strong family history of dairy intolerance or inflammatory bowel disease
- A baby who is not growing well or has a congenital condition
- Women with breast hypoplasia or had breast surgery
- Women with polycystic ovarian disease
- Women with multiple sclerosis
- Mothers who are having a planned Lower Segment Caesarean Section (Please discuss this with your Consultant if you have had a caesarean section before this pregnancy)
- Mothers who have high blood pressure or are taking beta blockers (ie: Labetalol).
- A raised BMI of 35 or over
- Previous difficulties with breastfeeding.
Who cannot express colostrum antenatally?
Those who:
- Have a history of threatened/actual premature labour
- Have placenta praevia, accrete, percreta, vasa praevia and/or a low lying placenta or the placental site is unknown in the absence of an ultrasound scan.
- Have a history of Antepartum haemorrhage
- Have had more than one previous Lower Segment Caesarean Section
- Have cervical incompetence or Cervical suture in situ
- Have a multiple Pregnancy (twins, triplets etc) – we advise that you discuss colostrum collecting with your Consultant.
- Are taking a medication that may be harmful for your baby to have through your breastmilk. Please contact the infant feeding team by email at dbth.infantfeedingteam@nhs.net if you are unsure.
- If you are unsure if you should not collect colostrum, please ask your Consultant or Midwife.
Colostrum collecting is unlikely to trigger labour but you may feel your womb going hard and then relaxing without pain, these are called Braxton-hicks contractions.
Do not worry about these, unless they begin to feel like period type cramps or mild labour contractions.
This is rare, but if it does happen, you should stop expressing immediately and rest.
If they do not stop and you think you are in early labour, you should telephone Triage on: 01302 642711 / 642712.
When can I start?
You can start from 36-37 weeks of pregnancy.
How often can I express?
We recommend you express up to 2 to 3 times a day, for approximately 5-10 minutes each session.
How much colostrum will I produce?
This will vary from mother to mother, from a few drops to a teaspoonful. Colostrum may be yellow/orange or clear in colour, and is thick and sticky.
It is very concentrated in nutrients and helps your baby to fight infections. This small amount is perfect for your new baby.
Do not expect to get great amounts of colostrum, you may only get a drop or two but don’t give in. Please do not worry that your supply will run out, you will continue to produce colostrum, the more you express, the more you will collect and every drop of liquid gold counts.
How should I collect my Colostrum?
Please ask your community midwife or midwife in Antenatal Clinic for a pack containing small syringes, and labels, which you can use to collect your colostrum.
You can express your colostrum 2 or 3 times each day into the same syringe, keeping the syringe in the back of the fridge between collections and using a new syringe every day.
Keep the syringe away from meat products, eggs or any uncooked food.
The syringes can then be labelled with your name, the date and time you expressed, and put into a clean re-sealable freezer bag or sterilised container with a lid.
How do I store my Colostrum?
We advise that you store your colostrum in the freezer, and then when you come into hospital in labour or for your Induction of labour, bring some of your frozen syringes into Hospital in a cool bag with an ice pack.
Defrosted colostrum cannot be refrozen.
Give these immediately to the Midwife on admission so that they can be stored correctly in our ward freezer.
How to give the Colostrum
Your midwife will discuss with you how to safely feed your expressed colostrum to your baby, alongside breastfeeding and expressing to stimulate milk production.
Any questions please contact your community midwife or email the Infant Feeding Team; dbth.infantfeedingteam@nhs.net
How do I express my Colostrum?
The best way to do this is by hand:
- Make sure you are relaxed and comfortable, a warm bath/shower can be useful when first trying
- Talk to your baby or touch your bump to feel connected to your baby.
- Have your syringe ready before you start
- Get comfortable and start with a gentle breast massage to stimulate oxytocin, which helps your milk to release. Stroke from the back of your breast towards your nipple for one or two minutes.
- Cup your breast with your thumb and fingers in a ‘C’ shape about 2-3 cm back from the base of your nipple. Squeeze your fingers and thumb together gently but firmly (should not be painful), hold for 2-3 seconds and release and then repeat in a rhythmic motion.
- It may take a while before you see any colostrum appear. If no colostrum appears after a few minutes simply move your fingers slightly forward or back and try again to find the right spot. Only expect a few drops at a time’ .
- When the drops stop, move your fingers around to try a different section of your breast and then swap to the other breast.
If you find this is not working for you, speak to your midwife and they will give you some tips or contact the infant feeding team at dbth.infantfeedingteam@nhs.net
Patient Advice & Liaison Service (PALS)
The team are available to help with any concerns, complaints or questions you may have about your experience at the Trust. Their office is in the Main Foyer (Gate 4) of Doncaster Royal Infirmary. Contact can be made either in person between the hours of 9am-3pm, by telephone or email.
The contact details are:
Telephone: 01302 642764/642767 or 0800 028 8059
Email: dbth.pals.dbh@nhs.net
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