Hand expressing colostrum during pregnancy - any experience?

[CorBlimeyTrousers]

I have gestational diabetes and have been advised to start expressing colostrum in late pregnancy and collect if possible to supplement the baby if he has problems with blood sugars (my first son had low blood sugars when born). I am booked for a caesarean in less than a week (when I will be 39 weeks).

I was given a leaflet by the midwife and have watched videos online. I have been trying to hand express for the past couple of days (couple of times a day) but haven't got any colostrum out. I am feeling very disheartened and this is also generalising to anxiety that it means I won't be able to breast feed either.

For history: I wanted to breast feed my son (who is nearly 5) but gave up early after he lost lots of weight and my confidence was shattered. I actually had a lot of milk and pumped for 4 weeks until I got mastitis. So my feelings are all mixed up with my 'failure' last time.

Any advice or experience please? Thank you.

OP, I don't have any personal experience of antenatal expressing (though, like you, lots of pumping experience, as I had a baby in NICU), but I just wanted to offer a little support.

The first thing that jumped out at me about your post is that you had lots of milk the first time round. In all likelihood, you'll have lots of milk again this time. What you can express now is no indication of how much colostrum and milk you'll produce after the birth. Some babies are just very, very hard to breastfeed and it sounds like that was the case for your son. This baby will be a different baby and you have much more experience than last time. I know you know that but sometimes it helps reading it written down.

Obviously, that's not really helping your with your problem right now. Can I ask whether you ever hand expressed at all with your son? How did that go? I think some women just don't produce colostrum antenatally, but I'm just trying to check that it's not a technical glitch with the hand expressing, if you know what I mean!

I also found this other mumsnet thread that might help!
Antenatal Expressing for Mothers with Gestational Diabetes

I am 28 weeks and have produced colostrum since about 23 I think. You might try relaxing, sitting somewhere comfy and without touching your nipple, applying gentle pressie on the outer edges of the areola. Observe the area, put very gentle pressure on the top, bottom and side by cupping fingers round the areola. Don't fiddle with the actual nipple. If a tiny glimmer of A bead forms there you go!!

Try hot flannels and doing it in a warm bath. Mine leak like crazy when they're hot this time round, not so much as a drop when I had DS (I even tried pumping to induce labour when I went 2 weeks over and still not a thing! )

I found I had to apply quite a lot of pressure to get something out, more pressure than you would normally would like to apply to yourself. I got my husband to do it, he's a bit more ruthless :-).

Yes, you definitely have to be pretty firm and kind of squeeze toward the nipple without actually pulling it. I have no idea whether the letdown reflex is involved when it's antenatal, but I found that massaging my breasts, rubbing the nipple, and standing under a hot shower before expressing all helped to trigger letdown. This all sounds kind of exciting but it was anything but!

by 'without actually pulling it', I mean that you kind of do pull on the nipple towards the end of the movement, but you definitely start on the areola, not on the nipple.

Thank you all. I've been pressing just back from the areola - midwife leaflet said where the breast tissue feels different and online video said an inch back. Maybe I should be closer. I remember having some colostrum leak in first pregnancy (only a little bit) and a month or so back I was able to express some colostrum from one breast as an experiment. I wonder if I'm tense and that's not helping. What also doesn't help is a 4 year old coming upstairs to see what I'm up to!

The other thread is helpful too thank you. There's an interesting post about the importance of maintaining good blood sugar control in the days before the birth so I can focus on that too. Should be easier this time around as have a planned casesaran booked whereas last time I went in for an induction which didn't work and I spent 3 nights on the labour ward where they didn't really have suitable food for me.

Massaging your breasts before expressing can help. I was taught to start outside of the areola and firmly push towards the nipple.

I started doing this last week (38 weeks, type 1 diabetic) and for the first few days produced nothing and felt very downhearted. I actually found this video really useful newborns.stanford.edu/Breastfeeding/HandExpression.html

Turns out I was being far, far too gentle with myself and since applying a lot more pressure and channelling images of milking animals (!) I'm now managing to get about 5ml a day. I find I need to press very hard (but it doesn't hurt, even though I thought that much pressure would iykwim) just on the edge of the areola, rather than the inch back I was advised my a midwife. Also, expressing after a hot bath or shower and massaging (kinda like kneading bread) around and about the breast before starting the 'milking' also helps.

Thanks Otters. That's the video I watched. I tried this afternoon and got the tiniest drop from left breast (too little to syringe although I tried) and still nothing from right. I have also downloaded some breastfeeding affirmations/meditation. Can't hurt anyway! When I expressed for my son I found imagining him and also picturing the milk flowing was helpful. But I don't have a baby yet to picture / look at.

I suppose I need to remember that I can control whether I try and what I do but I can't control the outcome. I wish I'd started earlier though.

Oh and 5ml a day sounds amazing to me! I might try milking animals visualisation!

Trust me, it takes a while to get that much! Usually two sessions of about an hour. I stick on some rubbish TV and squeeze away! I also find that it helps to keep switching breasts even if only one droplet has come out. I take the plunger entirely out of the syringe, put a stopper on the 'needle' end and kind of scoop/catch the individual drops into the end of the syringe. Good luck!

If you've got any videos/pics of your DS when he was a newborn, you could try looking at those while expressing. I started leaking milk when pregnant with dd2 while looking at video clips of dd1 as a tiny baby.

God, I just looked at that video that was linked earlier …

It's not as easy as on this video!

I don't know where they found these ladies, but they're very lucky producing so easily!

I'm getting about 4 mls in 10 mins, do it just thrice a week, as doing it for no particular reason except to have stock ups.

I take a nice warm bath, syringes and storage bags are in the bathroom indiv wrapped. Without dressing, sit on a seat in bathroom and begin. Press around edges of areola and every press yields one or two fat drops which I drop straight into syringe. Later presses yield 1-3 drops per squeeze. Don't do more than ten mins.