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Ask the midwife | The #1 question right now

A common topic of conversation that I am hearing a lot at the moment amongst pregnant women is about antenatal expressing of colostrum.

Colostrum is the fluid first produced by the breasts from about 20 weeks of pregnancy and during the first few days after birth. It is easily digested and the first milk the baby will get from the breasts. It is high in antibodies and anti-infective properties and has many health benefits.

Antenatal hand expressing is sometimes referred to as ‘colostrum harvesting’ and it is when colostrum is expressed by hand during the pregnancy to give the baby following the birth if it is required to reduce the need for formula. Giving colostrum rather than formula can assist with the success of exclusive breastfeeding and promotes good gut bacteria amongst other benefits.

There are a few reasons why women might consider antenatal hand expressing, usually when there is a higher chance that the baby would need extra fluid in the first few days after birth. These include:

• history of low milk supply or breast-feeding difficulties
• breast anomalies or babies with cleft palates which might make breastfeeding more difficulty
• diabetes

Baby’s whose mums have diabetes have a higher chance of developing a low blood sugar level after birth, increasing the need for extra feeds. If there is some stored colostrum which has been expressed antenatally helps to avoid the need for formula. A large study called the DAME Study demonstrated that it is safe for women with low risk pregnancies to express colostrum from 36 weeks’ gestation.

If you chose to hand express in pregnancy, it is recommended to express from 36 weeks and to talk to your caregiver to see if this is appropriate for your pregnancy. It is important to understand that not all women have expressible colostrum in pregnancy and that this is not indicative of milk supply when the baby is born.

It is recommended to express twice a day from 36 weeks for approximately 3-5mins per breast. Any colostrum can be stored in the freezer and taken with you to hospital in an insulated bag with a cold pack. You should stop expressing if you have any contractions or bleeding or reduced fetal movements and call your caregiver or hospital if this occurs

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