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Expressing breast milk before birth!

As a Labour and Delivery nurse and a Mama Coach, I have had a lot of education on breastfeeding and what makes up breast milk, throughout my career. I understand the science behind breastfeeding and the benefits of it. I provide breastfeeding education and assist parents with the skills needed to breastfeed.

When I’m working on the ward and met my patient, one of the first questions I ask is how they plan on feeding their baby. Most people will have their mind made up but you will have a few that haven’t decided yet. At this moment, there is usually a lot going on and this may not be the best time to give them that breastfeeding education they need to make an informed decision.

Health Care Professionals agree on the importance of getting the baby to the breast within the first hour of life. If the parents have not made their decision regarding the feeding method, we may lose this really important window of opportunity.

I love teaching classes to expecting parents because breastfeeding education needs to be provided during pregnancy.

Breast Milk

According to the World Health Organization breast milk contains all the nutrients that a baby needs in the first 6 months of life. Breast milk provides protection against many different illnesses and infections for the baby.  Some of these include baby’s risk for asthma, ear infections, bowel infections, obesity, heart disease, diabetes, Sudden Infant Death Syndrome, and some childhood cancers.

Breastfeeding can also provide protection against breast and ovarian cancer for moms.  As well as lowering the risk of bone fractures later in life.

Breast milk is easily digestible and the composition of the milk changes with the baby’s needs.

Prenatal Breastfeeding Education

Breastfeeding often isn’t something that just “happens naturally”. Well, it happens naturally in the sense our bodies produce milk for the baby.  But, not natural for everyone when it comes to baby latching on and feeding well. Hand expression at the end of your pregnancy helps moms feel more comfortable with expressing and handling their breasts prior to the baby arriving. A new baby is a steep learning curve and learning to breastfeed is a process.

Practicing hand expression prior to baby’s arrival and you will find the comfort level you already have with hand expression has a significant impact on your comfort level breastfeeding your baby. It is normal for breastfeeding to be challenging and it takes time for both mom and baby to learn this skill. Don’t forget, your expected to learn this new skill right after the marathon of labour! Studies have shown the more comfortable the mom is with her breasts the better breastfeeding will go.

Antenatal Hand Expression

Antenatal hand expression is defined as the skill of expressing and storing of colostrum while still pregnant. Colostrum is the first milk your breasts produce during pregnancy and is high in protein and rich in antibodies.

Antenatal hand expression allows you have extra colostrum available for your baby if he or she needs supplementation.

Also, one of the first things the nurses on the Postpartum ward teach breastfeeding moms, you guessed it…how to do hand expression along with breastfeeding.  Studies have shown that hand expression works better to build milk supply in the first 24 hours than pumping.

I always recommended checking with your health care provider prior to starting hand expression to make sure it is safe for your pregnancy. Once you are of term gestation (37 weeks) and have had this discussion with your health care provider start around 5 minutes per breast each day.  Stop at any time if you are having contractions.

How do I hand express!?

-Always wash hands before starting.

-Sit up, lean slightly forward.

-Massage your breast from the base to the nipple.

-Gently press pointer finger and your thumb towards your chest wall, press together, and hold for a few seconds. Think of your hand making a “C” pressing back and in, holding, and release. Repeat as you work around the breast.

-Collect any colostrum into a syringe. Use a clean syringe every time.

-Label with date and time. Your colostrum can be stored in the freezer for 3 months and up to 6 months in the deep freeze.

Below is a video of how to hand express if your more of a visual learner!

Benefits for Gestational Diabetes

Recently, I attended an education day through the hospital where we were lucky enough to have a former co-worker, who now specializes in pediatric diabetes, come and do a presentation. She talked about the importance of moms with gestational diabetes (a condition in which a woman without diabetes develops high blood sugar levels during pregnancy) in their pregnancy to breastfeed their babies.

Babies born to mothers that were diabetic during pregnancy are used to higher sugar levels.  When they are born and are not in that environment anymore they are at risk for low blood sugars. Babies with low blood sugars need medical intervention, such as supplementation, to raise the blood sugar level back to normal.

Diabetes Canada states that between 3-20% of pregnant women develop gestational diabetes. As a nurse on the ward, I can tell you here in Manitoba we are probably at the higher end of this range.  We look after a lot of diabetic moms and their babies.

After hearing this presentation, everything just connected for me and got me thinking…what if these moms had education on antenatal hand expression during their pregnancy and were able to start collecting colostrum before their baby arrived!? They could store this milk in their freezer and bring it into the hospital. If their baby had a low blood sugar and needed supplementation they could give them this colostrum by cup feeding or with a syringe!

Colostrum is considered to be the ideal first food for your baby. Research shows breast milk stabilizes blood sugar levels more efficiently than formula. Colostrum is very high in calories, so babies don’t need much volume. This may be a game changer in the way of avoiding supplementation for some babies.

More Benefits…

Antenatal hand expression not only allows you to collect colostrum but encourages your milk supply to come in. This is another important benefit for moms with gestational diabetes as research shows that these moms milk supply will be delayed.  Breastfeeding has also been shown to protect the gestational diabetic mom from developing type 2 diabetes later in life.  Research shows women who breastfed were about half as likely to develop type 2 diabetes after gestational diabetes.

Babies of gestational diabetic moms will not be born with diabetes but will have a greater chance of developing type 2 diabetes later in life. Studies have found babies of moms with gestational diabetes were about 5 times more likely to develop type 2 diabetes in adolescence.  Whereas, babies of moms with type 2 diabetes were almost 7 times more likely.

As mentioned earlier, breast milk can provide protection against diabetes for infants by reducing their risk of obesity. Further research is needed, but it is suspected that breastfeeding provides much more protection than the current research shows.

Studies have found that babies of moms with diabetes who had breast milk were half as likely to get type 2 diabetes before the age of 18.  Breastfeeding has also been shown to delay the onset of diabetes in the infant that will go on to develop the condition later in life.

As well as gestational diabetic moms, antenatal hand expression can be beneficial for moms who are expecting multiples, deliver by caesarean section, have a history of milk supply issues, history of breast surgery, and/or high blood pressure during pregnancy. All of these can lead to delayed and or decreased milk supply and therefore higher chances of their babies needing supplementation.

Take Home Message

There needs to be more education around breastfeeding done in the community before moms come in to have their baby. Not just for the moms but for everyone…dads, grandparents, and other members of the community. Societal pressures are reality, we have come a long way but still there is a lot more work to be done in normalizing breastfeeding. Breastfeeding must be supported not only in the hospital but in the workplace, in the community, through our families. That is the only way we are going to see a rise in breastfeeding rates, compliance, and sustainability.

As a lactation counselor, a labour and delivery nurse, and a mom I feel passionate about breastfeeding and I am an advocate for breastfeeding. However, its important for me to add here that I am an even bigger advocate for maternal mental health.  I am well aware that societal pressures can work the other way as well. Fed.Is.Best. A mom needs to know that she needs to make a decision that is best for her situation. We need to support whatever feeding method is chosen, whether its breastfeeding, exclusively pumping, both breast milk and formula, or exclusively formula feeding. If you need help with your baby’s feedings, however they may look, I am here. If you want more information on prenatal classes or antenatal hand expression contact me here.  Please share this blog to get the importance of antenatal hand expression out there!

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