Antenatal (pregnancy) hand expression involves expressing colostrum in the final few weeks of pregnancy. It can also be referred to as ‘colostrum harvesting’.
Mothers are normally advised to wait until around 36 weeks before starting antenatal expression. Mums who are having multiple births may sometimes be advised to start sooner as giving birth earlier is more likely.
For some mothers, it can be a useful tool that helps ensure their baby will start life without the need for formula supplementation. The importance of exclusive breastfeeding for all babies has been well-established by scientific research. Colostrum contains vital immunological properties and helps to colonise the baby’s gut with healthy bacteria that protect against allergy and disease. It also contains the perfect balance of proteins, fats and micronutrients needed for human babies as well as acting as a laxative to help the passing of the first tarry meconium (bowel motion).
Some babies may experience difficulties with feeding or maintaining their blood sugar levels during the first few days after birth and therefore may require supplementary feeds.
These include babies:
- Babies whose mother had diabetes in pregnancy or who has a history of diabetes.
- Babies with a cleft lip or palate.
- Babies with congenital conditions e.g. Down syndrome or cardiac complications.
- Babies diagnosed with intrauterine growth restriction (IUGR).
- Babies whose mother is taking beta blockers to control high blood pressure.
- Babies who are twins or triplets.
Women who have had previous breast surgery or problems may have concerns regarding their ability to breastfeed and should have the support of a midwife, lactation consultant or breast feeding counsellor. It is important for a mother to discuss her plans to express antenatally with her doctor or midwife. It may not be recommended if you’ve been at risk of preterm labour in previous pregnancies, have a cervical stitch or have placenta/vasa previa for example.
It is recommended to express by hand antenatally rather than use an electric or manual breast pump. Colostrum will be produced in quite small quantities (often drops) and can easily stick to the bottles or pump parts and be harder to collect. A pump at this stage is likely to be more uncomfortable than gentle hands. Try hand expressing for a few minutes, once or twice a day.