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Antenatal expression of breast milk — why is it so important?

Article-Antenatal expression of breast milk — why is it so important?

Shutterstock Colostrum liquid gold
Colostrum is often referred to as "liquid gold" due to its concentrated nutritional content and immune-boosting properties.

Antenatal expression of breast milk, also known as colostrum harvesting or hand expression, is a practice gaining recognition among expectant mothers. This process involves manually expressing small amounts of colostrum (the nutrient-rich first milk produced by the mammary glands) before childbirth. While breastfeeding traditionally commences after delivery, antenatal expression offers a proactive approach to breastfeeding that comes with numerous benefits for both mothers and newborns.

Colostrum is often referred to as "liquid gold" due to its concentrated nutritional content and immune-boosting properties. Antenatal expression allows mothers to collect and store this valuable substance before labour, ensuring a readily available supply for the newborn during the crucial first few days of life. Colostrum is rich in antibodies, providing the baby with essential protection against infections and diseases. It comes in a few drops only and some parents may be concerned that will be not enough for the first days of life, but because of its rich amount of immunoglobulin and developmental factors, it covers the nutrition requirement for the newborn baby.

Related: The evolution of maternal immunisation

Antenatal expression can be especially beneficial for mothers to ensure a smooth start to the breastfeeding journey. By establishing a colostrum reserve, mothers can address potential issues such as latch difficulties or delayed milk production, providing a smoother start to breastfeeding and reducing stress for both the mother and the newborn.

Harvesting of colostrum is recommended for every mother, and it is essential for mothers with high-risk pregnancies or medical conditions that may necessitate early separation from the baby. Expressing and storing colostrum ensures that the newborn receives the crucial benefits of breast milk even if immediate breastfeeding is not feasible. This practice supports the bond between mother and baby, fostering a sense of closeness despite any temporary physical separation.

Aside from the baby benefits, antenatal expression of colostrum can also:
- Stimulate milk production: Regularly expressing small amounts of colostrum signals the body to prepare for breastfeeding, promoting the production of mature milk after childbirth. This can be particularly advantageous for mothers who may have concerns about low milk supply.
- Building maternal confidence: Engaging in antenatal expression empowers mothers by providing them with a hands-on approach to breastfeeding before the baby arrives. This proactive involvement fosters a sense of confidence and competence, making the transition to breastfeeding less daunting.

Understanding one's ability to express colostrum can boost maternal self-assurance and contribute to a positive breastfeeding experience.

There are only a few cases where antenatal expression cannot be performed. We need to remember that breast stimulation can induce early labour, therefore is not recommended before 36 weeks and in all the conditions where a woman is at risk of delivering her baby prematurely. Some particular cases like placenta previa are also a contraindication for colostrum collection. The advice is always to consult with a doctor, midwife, or lactation consultant prior to starting harvesting.

Related: Genomics aids non-invasive prenatal diagnosis

Practical tips for antenatal expression

  • See a doctor to check if you can harvest your colostrum.
  • Once you reach 36 weeks start to collect. Remember that at the beginning you might see only a few drops, the quantity will increase little by little. In case you do not see any colostrum and you are not able to collect please remember that this is not an indication of not having milk later. Some women experience dry breast during pregnancy, but they will have plenty of milk once the baby arrives.
  • Use hand expression technique – press, compress and release (see picture).
  • Expressing into a sterile container and label it with date and time. Colostrum can be kept six days in the fridge and six months in freezer.
  • On the day of delivery, don’t bring all the colostrum to the hospital but just one container — you might not need it at all and with the handling and variation of temperature it cannot be used for longer. In case more is needed, it can be always collected later.
  • Use a cool bag to transport colostrum from home to hospital.
  • In case you have any doubts or need further guidance, always consult with a healthcare professional or a lactation consultant for personalized advice and support.

Conclusion

Antenatal expression of breast milk is a proactive and empowering practice that offers a range of benefits for both mothers and newborns. From ensuring a readily available supply of colostrum to promoting maternal confidence, this approach contributes to a positive breastfeeding experience. As awareness grows, more expectant mothers may choose to incorporate antenatal expression into their prenatal preparations, unlocking the numerous advantages it brings to the early stages of motherhood.

Wendy Menghin is a Midwife Educator and Lactation Consultant, IBCLC/MHF. She will be speaking at the Obs&Gyn conference at Arab Health. 

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