What is breastfeeding before birth? Antenatal hand expression (AHE) is collecting colostrum while you are still pregnant to jumpstart your breastfeeding journey. Giving your baby a little extra colostrum in the first few days of life gives them the best start!
Colostrum is “liquid gold”, which is rich in fats, sugars, and immune factors. It’s a baby milkshake! It gets the baby’s bowels working and colonizes the gut with beneficial bacteria and flora. Colostrum is made the first 3-5 days postpartum. Your colostrum is perfect for your baby- your body will change the composition of the milk to meet your baby’s needs. For instance, if you are exposed to a cold, your body will make immune factors to prevent the baby from getting that cold strain. Awesome right?!? Also, your body makes the right amount of colostrum for your baby. A Baby’s tummy is the size of a small grape and your body makes about a teaspoon of colostrum the first day.
Hand expression has many benefits for mom and baby! You will feel confident and comfortable handling your breasts when it comes time to feed your baby. Seeing is believing and you can ditch the worries about making enough milk. Best of all, you will know that you are doing your absolute best for your baby in the first days after birth. Babies get the benefit of starting their immune system and good gut health. Extra colostrum also helps reduce the risk of high weight loss and jaundice levels. Your colostrum is “mom made” versus formula being “man-made.” Perfect!
Babies may need supplementation for many reasons. Some of these reasons may not be apparent until after the birth, so being prepared can be helpful to make motherhood easier the first day. Examples are if mom is diagnosed with gestational diabetes, high blood pressure, or an infection. Another reason to supplement is to help ease any worries you may have about making enough supply the first few days. Along with breastfeeding on demand and hand expressing, you can give the baby a little top off after feeds.
Before getting started, you need to speak to your provider to see if AHE is a good fit for you. It is contraindicated if you are preterm (less than 37 weeks), you have a cerclage in place, a low-lying placenta, placenta previa or accreta, or any other risks for vaginal or uterine bleeding. Once your provider gives the okay and you are 37 weeks along, you can get started.
You’ll need a few supplies. A box each of 1ml and 3 ml oral syringes with caps are easily obtained online for about $10 a box. A medicine cup, label stickers (or a permanent marker), and a large freezer bag are the rest of the collection supplies. Before you go to the hospital, you’ll need a cooler and some ice packs. Put the cooler and milk on your list of things to bring to the hospital.
At first, you may not see colostrum, but don’t worry, it will come! This is mainly for stimulation at first and after a few times, you’ll strike gold (liquid gold that is!). You’ll start with 5 minutes per breast per day and gradually work up to 10 minutes per breast once or twice a day.
If at any time you start having contractions, please stop. This is not meant to induce labor. If you are scheduled for a cesarean section, stop immediately.
To start, take a warm shower for a few minutes if desired. Collect your supplies and wash your hands. Massage in a circular motion from under your arm pit, around the breast, and towards the nipple. This simulates a letdown. Make a large “C” with your hand and place it on the top and bottom sides of your breast where it meets the chest wall. Compress the top and bottom of the breast together and hold. Collect any drops of colostrum in the medicine cup as you go. Release and move your hand towards the middle of the breast, between the chest and areola. Compress, hold, release. Move your “C” hand to the left and right sides of the same breast and repeat. After 5 minutes, switch breasts. Don’t compress or squeeze the areola or nipple at any time, as this will cause discomfort and possibly tissue damage. Firm, yet gentle pressure is all that’s needed. Hand expression shouldn’t be painful.
After collecting your colostrum in the medicine cup, get a clean syringe. Suck the milk up into the syringe and put the cap on. Use a label sticker or a sharpie to label the date. Put in the freezer bag. The milk is good in the freezer for 3 months. Use a clean syringe every day and you may use the same syringe for 2 collections in the same day.
On the birth day, remember to bring the cooler, frozen milk syringes, and ice packs with you. The facility may have a breastmilk freezer where they can hold your milk after labeling it with your name and patient number. If they don’t have one, your support person can refill the cooler with ice to keep it frozen.
When you’re ready to thaw a syringe, run it under warm water. Roll it between your hands gently, but do not shake it. Squirt a little bit into the baby’s cheek and wait for him to swallow. Repeat until the syringe is empty.
Being prepared for the first day of your baby’s life will be a huge relief and help make your first steps into motherhood so much easier for you! You got this, Mama!