You all know I am a huge advocate for antenatal hand expression, (after 37 weeks and in consultation with your health care professional) but with encouragement comes the responsibility of educating when and how to use any milk collected in a way that supports breastfeeding postpartum.
Why should you express antenatally?
Before we get into the nitty gritty I want to explain why I am an advocate for hand expression in pregnancy. Firstly it is a skill that every breastfeeding mother should know, know how your body works and your sweet spots to get milk will serve you well for your whole feeding journey.If your baby isn't feeding well in the early days you can hand express to collect milk.
If you are feeling a little engorged and needing to relieve some pressure? You can hand express
If you are headed away from the baby and going to miss a feed? Relieve the pressure with hand expression
If you forgot your pump at work? Hand express!
Hand expression is a skill you will need but for most women touching their bodies especially their breasts is a foreign concept prior to having a baby. Once their baby arrives it's all on. However early postpartum is a HUGE time for learning and we often aren't in the best frame of mind to be learning new skills. Often exhausted, emotionally and mentally drained from the end of pregnancy, labour and then finally a beautiful newborn that wants to feed constantly.
Learning how to hand express in pregnancy allows you to have that skill onboard as you enter postpartum. You can hand express a small amount of milk to encourage your baby to latch if you are having difficulties. You are more familiar with how YOUR breasts work and how to get milk out. If you are experiencing a painful latch you are able to continue to stimulate your milk and provide your breastmilk for your baby until you are able to seek further lactation support. It reduces the need to top up with formula in early postpartum.
Further there is research suggesting that women who are able to hand express in the first hour postpartum have a higher milk supply at 6 weeks postpartum.
Hand expression in pregnancy is not about the milk you get, it is about LEARNING THE SKILL.
But what do you do with the colostrum you have collected?
You may never truly need to use the milk you collect - in the ideal situation you wouldn’t. The only milk you would need to give is what your baby is able to get from the breast after birth, however as we are all aware there are some situations that don't go the ideal way.
So when would you give expressed colostrum
- Separated at birth
- Gestational diabetes
- Traumatic birth where baby has used up energy stores
- Baby gets cold and burns through energy stores
- Latching difficulties
- Sleepy baby
- Baby requiring neonatal care
Reasons you wouldn't give expressed colostrum
- To give yourself a break
- To encourage baby to sleep longer
- To replace a feed (without expressing to replace)
- If your baby is feeding well and as expected
How can you give the milk but still support milk production postpartum?
Milk expressed in pregnancy is no indication of your milk supply after birth. Research shows us it will not bring in your supply any faster or increase your supply after birth. However hand expression after birth CAN impact your milk supply positively. First thing you feed the baby, following this if for whatever reason your baby is needing more than what they are receiving at the breast you can hand express to provide that milk for them.
If you are needing to give any of the milk that you have expressed in pregnancy it is important that you replace that milk with a hand expressing session. This way your body gets the memo that this milk was used and needed for your baby and your body can remake it. Supply and demand.
In simple terms
ANYTIME your baby receives milk that is not direct from the breast you need to stimulate your breasts and remove milk to support your body's milk production long term.
Hand expression is a fantastic skill to learn and learning in pregnancy provides a stress free environment to do so. Supporting you to enter the postpartum period with the confidence that you know how your body works and you CAN feed your baby whatever is thrown at you. You should always discuss with your health care provider prior to starting. Any milk that is collected is safe to give but if given should be replaced with another session of expressing when the milk is given to ensure it supports your milk supply.
You may never need to use the milk collected - you could save it for bonus milk at a later date - it’s RICH in antibodies. You could consider donating it to another mother and baby or use it for your baby's skin or nappy rash.