Antenatal expression of colostrum

[Gizmo]

Here's one for all you b/feeding afficionados: is it possible to stimulate antenatal production of colostrum using a breastpump?

DS2 is due in a week's time, and, because I had a dreadful time getting b/fing established with DS1, I would like to try and build a small 'cushion' of stored colostrum to cup feed DS2 in the event we hit difficulties with him.

But no sign of any colostrum at present, and I'm a bit wary of thrashing away with the breast pump without fully understanding any physiological side effects - can it stimulate contractions, for example.

Anyway, has anyone done it successfully? Any top tips for bringing milk on prior to the birth (rather than just bringing the birth on ). I know this has been done before, but I'm not turning it up in searches, so apologies if this is rather old hat...

Good luck Gizmo,

I thought the time to build up stores only happens after birth? and all the establishing that you need will be by the baby. You dont want to be sore and leaky even before all the fun and games of a newborn?

If you are relaxed and persevere you will be fine. Mine hurt like hell for the first 4 weeks because I wasn't latching her on correctly, a fab BF counsellor sorted me out, with support from HV. remember the baby has to learn as well! just relax now and it will be fine.xx

Awww, thanks Jaffacake. You're right, I should relax.

If it comes to it I guess I can afford to wait for a little while and pump postnatally. It's just that I 'm sure I will have a pretty low panic threshold this time around, so it would be better for me to be doing something to keep his energy levels up if he turns out to be a reluctant feeder like his bro.

why was it so hard to establish with first baby?

nipple stimulation can start contractions.

i saved a document in Word re expressing colostrum from MN once. if you want it, CAT me.

Good luck Gizmo

Do you have any breastfeeding friends - you could ask them to donate some milk?

Jaffacake: long and gory story involving slightly disinterested baby, postnatal care handling him very roughly and thus putting him off totally, 4/5 days of him fighting and refusing to feed, eventual readmission to NICU with dramatically awful jaundice and dehydration and shattered confidence on my part.

Upshot is that I want to be as relaxed as possible with this one and get him going with no pressure, and having an alternative feeding technique as a back up will help that.

Kiskidee, that's what I was afraid of re overuse of pump. I'll definitely CAT you about that doc.

Hey MP, that is a good idea. Just need to think of someone now...maybe if I offer to do the pumping for them.

No - on second thoughts, that's not going to work .

A South African midwife friend of mine mentioned to me about trying to hand express colostrum in the last couple of weeks of pregnancy. Apparantly it's quite common with some cultures there to help establish a supply. She managed to get a few drops out (she was six weeks ahead of me) but I tried with a pump with no luck.

I wanted to try it as I also had problems with DS1, but as it turned out my milk came in quicker anyway 2nd time around (3 days instead of 5) and they were both born by caesarian.

FWIW she recommended it after 37 weeks which is full term anyway just in case fiddling does start something!

I bet it was the bleedin' midwives getting cross when he cried at night and doing what they did to my poor dd, lunging her about and wrapping her up really tightly. she would cry when starving hungry, I would try and get her latched on, then she would cry harder in frustration, she could smell all that lovely milk but couldnt get at it. seriously I felt so useless and let the MWives bully me into positions etc.

the counsellor woman just spoke to me quietly, watched me try first and didnt snatch my baby away. I had to hold a big 'squodge' of breast and hum to dd to relax her. the counsellor said the whole aim of bf is for you BOTH TO ENJOY IT.
you cant enjoy it if some hulking great nurse is scowling at you, hands on hips, tutting.

you are in a better position as I guess they will leave you alone if you tell them its your second; and now you are equipped to recognise the signs of a baby not feeding properly---you are better equipped than hundreds of other mums.#

I get so cross reading the stories on here about how the mwives and crappy advice get in the way of mums who just want to feed, dammit!!!

sorry, rant over.

one of my friends babies had breast feeding trauma from rough postnatal handling---there is even a name for it. pigging ridiculous that crappy care results in a totally new 'trauma' that would otherwise ever exist.

oh good grief. rant totally over now.

Ah yes, JC, it does tend to bring on the rants, doesn't it?

I'm aiming to have this baby at home, partly so I can choose who will be able to give me breastfeeding 'support' this time. Needless to say, anyone picking up DS2 and ramming him onto my boob will be told where to get off in pretty short order!

Didn't think of just copy and pasting it earlier.

Expressing Colostrum during Pregnancy

Hypoglycaemia Policy
Most babies have no difficulty in adapting to life outside the womb. However, some babies have an increased chance of developing low blood sugar, sometimes called ?hypoglycaemia?. Babies at increased chance of low blood sugar are:
Babies born early or premature ? before 37 completed weeks of pregnancy
Babies, who are lighter in weight than expected for the number of weeks of pregnancy, sometimes called ?small for dates?.
Babies who need extra help to breathe at birth
A baby who is ill
Babies whose mothers had diabetes during pregnancy
Babies whose mothers have had to take medicine for blood pressure (betablockers).

If any of the above applies to you or your baby, then we will encourage you to feed your baby as soon as possible after birth and then to feed often, at least every 3 hours as this will help to prevent low blood sugar in your baby. Your expressed colostrum can also be given to your baby after breastfeeds. Your baby will be carefully monitored and we will check his/her blood sugar regularly.

Is there anything I can do during my pregnancy to prepare for this?
Sometimes as early as 28 weeks of pregnancy, women find that they leak colostrums. The midwives will offer to teach you a very simple technique for expressing colostrum and provide you with sterile equipment for collecting and safely storing it with labels for dating it.

How much colostrum will I be able to express?
Colostrum is present in the breasts from about sixteen weeks of pregnancy onwards. Some women leak colostrum and some don?t, both are normal. Don?t worry if you don?t leak colostrum, it is not an indication that you won?t have enough milk or a reflection on your ability to breastfeed. The amount of colostrum will vary from woman to woman. It can range from a few drops to as much as a teaspoonful or more.

When do I start?
A good time to start would be when you reach 36 weeks of pregnancy.

How often can I express?
A good time to have a first practice is when you are in the bath but you can express as often as you like.

How is it Done? In 4 Easy Steps!

1. Prepare ? gently stroke or use circular movements with your fingertips to massage your breasts, moving towards the nipple area. (It is not essential but sometimes a back massage can help. Ask someone to stand behind you with a fist either side of your spine, level with your breast and rub their fists up and down, gently and firmly).
2. Finding the place you need to press ? You need to find where your milk collecting ducts (sinuses) are in your breasts. The best way to do this is by feeling for them. They may feel like peas or peas in a pod or just a change in the texture inside your breasts. They are often found a few centimetres from the end of the nipple or where the darker tissue around the nipple area (areola) meets the skin of the breast.
3. Removing colostrum ? Place the flat your thumb above and the flat of your first finger below, in a ?C? shape, over the sinuses and gently press and release, building up to a rhythm. A few drops of colostrum may appear at the end of your nipple. When the drips stop move your thumb and finger around your breast to the next set of milk collecting sinuses, repeating this process of rhythmic press and release. You may need to swap hands to express colostrum from the other side of the same breast.
4. Collecting and storing colostrum ? You will be given a package containing equipment for collecting and storing your colostrum. There will be small sterile syringes with red caps, which you can use to collect the colostrum directly from your nipple. If you chose this way to collect colostrum, carefully replace the red cap and place the syringe at the back of the fridge. Alternatively, you may wish to use the small sterile gallipot for collecting colostrum, if so when finished re-cover the gallipot and place it in the back of the fridge. If you are expressing more than once in a day then use a new sterile syringe or gallipot at each expressing. At the end of the day, you can put all of the collected colostrum into one container (universal container) and store this in the freezer at minus 18 degrees C. When you are coming into hospital to have your baby put all of the collected colostrum into the plastic bags provided, pack the bag(s) with ice. Once at the hospital give the bag(s) to your midwife who will have it stored in the hospital freezer.

Hi Gizmo - good idea! might taker that one on board - but just beware that it can stimulate long painful contractions, maybe not what you're after with a homebirth (in the middle of a building site - you serious?) So you not getting any colostrum by gentle squeezing?

By 'postnatal trauma'/rough handling do you mean the whole 'ram 'em on and hope they stick' approach? I had that too - pretty certain it contributed to thoroughloy ruing me BF chances too.

good luck giz

xxxx
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let us know how it all goes

Yup, that's the one, LC. Sink plungers a go-go.

My building site is not getting much better, so much so that the midwife nearly fell into a large hole in the hall floor when she arrived this afternoon. Was not impressed, but she restrained herself from writing anything in my notes.

How's it going, btw? Owing to building works regularly cutting off internet access (plus requiring me to spend all my time on hands and knees tiling - grrrr) I've not been able to get onto Sept Antenatal thread much, so I shall have to go and catch up now.

Kiskidee, thanks so much for that. I shall read and digest, along with my dinner, which is just ready now...

Oooh you missed lots - loadsa babies! see you there

I know this is not in response to your initial thread but it is so reassuring to hear that it was not just me who had problems with breastfeeding in hospital. Looking back after reading this thread made me realise that it was the way the midwives handled me and ds1 that caused most of the problems (the excessive heat with no open window or air conditioning did not help either).

Good luck with your next one. You need to find someone to support you with starting off breastfeeding who is calm and helps you and the baby feel calm. At the hospital one of the midwives (unfortunately this was not until day 3 and ds1 had stopped pooing through lack of food) said for me to lie down and relax, she calmed him down by rocking him and also by putting a clean finger in his mouth, then she gently put him down next to me and calmly helped him latch on. It was like a miracle and once she had helped me a couple of times I then felt more confident in doing it myself. Once out of hospital I continued struggling with latching on but after 4 -6 weeks (like all the books said) things got easier. Unfortunately I still feel traumitised by the whole hospital experience but will hopefully feel more confident next time.

Good luck with breastfeeding this time - there are some great breastfeeding counsellors out there so get the right kind of support and keep asking different people until you find someone who is best for you and you new little one

Lori