Antenatal Hand Expression

As midwives, we advise some women to hand express breast milk in the antenatal period. These women are those who are identified to have babies which may be at risk in the neonatal period, such as women with diabetes (babies at risk of low blood sugar levels), IUGR etc..

However, should we be advising ALL women to hand express and "harvest" their colostrum in the antenatal period? If so, why? If not, why not?

Also, when do you think that women should begin this?

I know a lot of women that do it routinely and I'm not sure why they do it, so I'm watching this thread with interest

I actually think it is a great idea and might help reduce the amount of women who think they can't produce any milk as it provides another opportunity to discuss supply and demand.

On the downside it is almost saying 'you will have problems' or 'your baby is likely to be sick and need this'

I'm thinking of doing my dissertation on this. I've recently heard quite a few popple i know who are having babies say that they're going to buy a supply of formula in "just in case".

I figure that encouraging them to express would be a great alternative. Plus it's arming them with a skill which is potentially very useful postnatally, without having to teach them whilst their baby sits next to them. I think that if they get the technique then it's something which could give women a lot of confidence.

However I have heard it argued that women could feel disheartened if they can't express anything, although hopefully if we tell women the kinds of volumes (teeny tiny amount) they should be seeing then this shouldn't be too much of an issue. Or that it could potentially induce early labour, so maybe the recommendation should be from 36-37 ish weeks?

Great thread.

I never even thought about it antenatally. Might make those first few days of breastfeeding a little easier...would it effect your production if you're effectively supplementing with previously expressed milk?

I guess it could do, but is there any need to give it immediately in the first week or so? it can be frozen for up to 6 months (i think!). I guess a two month old baby won't be bothered about a couple of drops of colostrum but it might be a good thing to have just in case?

I actually think that it could be a good idea to approach the idea with all women.

It could be approached with the view of it's an essential skill in breastfeeding, and will support her knowledge of infant feeding, her own body and her comfort with expressing when the baby arrives.

It could also be used as a supplemental first feed for women who are adamant that they do not wish to breastfeed for whatever reason - so that if the woman is not happy to put the baby to the breast, stored breastmilk could potentially be given as the first feed, which would then teach women about the volumes a newborn requires and the baby would also be given an important feed of colostrum, whether she decides to go on to forumla feed after that.

I don't think it needs to be approached as a "you may not be able to breastfeed, so must have a supply" or "your baby may be ill at birth and needs breastmilk", as this could undermine women, but if approached in the right way, it could be very empowering for women and beneficial to her and her baby.

I definatly think it's a good idea. Especially just to see that you are producing something. In those first few days it can seem your baby isn't getting anything. So if you've already expressed and can see what you're producing your mind would be more at ease.