Is Pre-Birth Milk Expression Safe?
Women who are nearing the end of pregnancy may experience an unusual phenomenon. The first milk produced by their bodies, colostrum can leak out from the nipples. This early milk, which is high in antibodies, is crucial to newborns as it provides essential nutrients and immunity protection. Some hospitals in recent years have advised expecting mothers to collect colostrum at the end of pregnancy, especially if they suffer from certain medical conditions such as diabetes. With limited research, there are questions about this practice. Is it safe? What are the risks and benefits of the process?
What is Colostrum?
The breasts produce a thick yellowish liquid during pregnancy and soon after childbirth. The rich nutritional profile of colostrum and its immune-boosting properties are what make it so popularly known as “liquid Gold”. The colostrum contains antibodies, has a higher protein concentration and lower sugar than regular breast milk. It is therefore uniquely suited for newborns.
Colostrum Nutritional Composition
Colostrum contains not only antibodies but also essential vitamins, minerals and growth factors. Some of the key components are:
- Immunoglobulins : These antibodies – particularly IgA – help protect the mucous membranes of the baby in the respiratory and gastrointestinal tract.
- Lactoferrin: This protein binds to iron and makes it less accessible for bacteria that cause infection.
- Growth factors: These substances help to develop the gut and immune system of the infant.
The unique composition of colostrum makes it a valuable resource for newborns. It gives them the tools they need to fight infection and adapt to their environment.
Why do some women collect Colostrum?
Although the practice of collecting colostrum has been around for a long time, it is becoming more popular. For several reasons, many women, particularly those with diabetes during pregnancy, think about expressing colostrum before giving birth.
1. Managing Blood Sugar Levels
Hypoglycemia is more likely to occur in babies born to diabetic mothers. It happens because the babies are used to receiving glucose continuously from the placenta. This supply stops abruptly when they give birth. A small amount of colostrum can help to stabilize the baby’s sugar levels at this crucial time. Early feeding of colostrum may reduce the need to supplement formulas, which are not optimal for the developing gut of a baby.
2. Reduce Formula Supplementation
A mother who has already expressed colostrum may be able to feed her baby directly and reduce the need to supplement with formula. Formula can be harmful to the immature gut of a newborn and increase the risk for allergies or metabolic problems in later life. Mothers can help prevent these complications by giving their babies colostrum. This will also promote a healthier development.
3. Breastfeeding Challenges Previous
Early colostrum collection may be beneficial for women who have had low milk production in past pregnancies, or are aware of medical conditions that can complicate breastfeeding. Infants born prematurely or with congenital disorders may need extra support to achieve effective feeding. Colostrum can help ease some of the initial stress associated with feeding difficulties.
4. Psychological Preparedness
Colostrum collection can boost a mother’s self-confidence in her breastfeeding abilities. This is a great way to get familiar with your body and breastfeeding. It can reduce anxiety in the early postpartum phase.
The Collection Process
The majority of women are encouraged to collect colostrum at around 36 weeks. This technique is also known as antenatal expression or colostrum collection. How it works is as follows:
Hand Expression Technique
- Prepare Before you begin, wash your hands well. Choose a comfortable, quiet place to relax.
- Warm up: A warm compress on the breasts, or a warm shower will stimulate milk production. Warmth encourages relaxation and the let-down response.
- Gently Massage: Start with a gentle massage of the breast to stimulate your let-down reflex. Use your fingers and gently knead the breast.
- Cupping technique: Place your thumb over the nipple, and your fingers under it. Make a C shape. This is important for effective expression.
- Compress, Press, Release: Press gently back towards your chest, while compressing, and release. This motion should be repeated in rhythm to increase milk flow.
- Rotating Positions: Rotate your fingers around the breast to stimulate different areas. This will help ensure that all parts of the breast are stimulated to release colostrum.
- Colostrum Collection: Collect colostrum in sterile syringes and small containers as it begins to flow.
Storage Guidelines
- Colostrum in the fridge If not immediately used, store collected colostrum. Keep it at a temperature that prevents bacterial growth.
- Freezing At the end of he day, you can freeze the colostrum. Use a ziplock bag to protect the colostrum and label it with date and time. For long-term storage, freezing is an option.
- Thawing: If necessary, defrost the colostrum at room temperature or in warm water. Avoid using the microwave as it can destroy some of the colostrum’s beneficial properties.
Considerations and Risks
Although colostrum can be beneficial, some valid concerns exist about the safety of the practice. One of the biggest risks is that you could induce early labor. Consider these important factors:
Inducing Work
The stimulation of the nipples during hand expression may increase oxytocin, a hormone which is crucial for both labor contractions as well as milk letdown. Healthcare providers may warn women at high risk of preterm labour or who have previously had cesarean births to refrain from expressing colostrum.
Reduced Blood Flow
Experts express concern that nipple contractions and resulting nipple stimulation could reduce blood supply to the uterus. This is a particular concern for women who are experiencing a slow growth of their fetuses or have conditions like polyhydramnios, (excessive amniotic liquid), or macrosomia. If complications are likely to occur, health care providers may advise against expressing colostrum.
Individual Risk Factors
What is safe for one woman might not be the same for another. Women who have a history of preterm labour, surgical stitches or other complications, should discuss with their healthcare provider their plans to express colostrum. Using a personalized approach, any potential risks can be thoroughly assessed.
Research and Recommendations
The scientific evidence on the safety of colostrum is still limited. In a study in The Lancet, involving more than 600 women with diabetes, it was found that expressing the colostrum during low-risk pregnancy did not increase early births or neonatal care admissions. One in four women could not collect colostrum. This highlights the wide range of experiences among women.
Current Guidelines
According to the available evidence, it is generally recommended that women who are at low risk of pregnancy begin expressing colostrum between 36 and 38 weeks. But those with greater risk factors should consult their healthcare team for individualized advice. They can then weigh up the benefits and risks of their situation.
Seeking Professional Advice
Consult with a healthcare professional if you are considering expressing colostrum before giving birth. The healthcare professionals can give personalized advice based upon the individual’s medical history and conditions during pregnancy. This conversation will help to clarify potential risks and benefits, and determine if colostrum is appropriate.
Antenatal hand expression: Benefits
There are many compelling reasons for some women to choose to express their colostrum before giving birth, despite the risks. Here are some potential benefits.
1. Breastfeeding Confidence Enhanced
Women can feel better prepared to breastfeed if they express colostrum. This is a great way to get to know your body and learn how to handle breastfeeding challenges.
2. Nutritional Support for Newborns
Colostrum can be a lifesaver if colostrum is available to a baby who has difficulty in their first few days. This is especially true for babies who have medical conditions or are at risk of low blood sugar. Early colostrum feeding can reduce the need to use formula and mitigate associated risks.
3. Reduced Formula Use
By having colostrum on hand, mothers can reduce their reliance upon formula and avoid the risks associated with it, such as long-term allergies and adverse effects to an infant’s gut health. Exclusive breastfeeding is associated with numerous benefits including decreased risks of infection and improved development outcomes.
4. Empowerment
Women who are proactive in their breastfeeding journey find empowerment. Collecting colostrum is a great way for women to be proactive about their breastfeeding journey and take control of their choices. This feeling of control can reduce anxiety and promote a positive experience with breastfeeding.
How to safely express Colostrum
Here are some tips on how to safely and effectively express colostrum if you decide to go ahead.
Hand Expression Technique
- Prepare your Environment : Choose a quiet, comfortable place to relax. Before you begin, wash your hands thoroughly.
- Warm up: Take a warm bath or compress to stimulate milk flow. Warmth helps relax and aids the let-down response.
- Gentle Massage: Begin
With a gentle massage of the breasts, you can stimulate the reflex to let down.
- Cupping technique: Place your fingers and thumbs in a C-shape behind your nipple.
- Compress gently and release: Press your chest backwards, then release.
- Colostrum Collection: Collect colostrum in sterile syringes and small containers as it begins to flow.
Storage Guidelines
- Colostrum in the fridge. Store colostrum collected in the refrigerator, if it is not going to be used right away.
- Freezing At the end of the day, you can freeze the colostrum. Use a ziplock bag to protect the colostrum and label it with date and time.
- Thawing: If necessary, defrost the colostrum at room temperature or in warm water. Do not refreeze thawed or cooled colostrum.
Transporting Colostrum from the Hospital
Using an insulated bag with freezer packs, mothers can transport frozen colostrum from home to hospital when it’s time to deliver. To avoid any delays, it is important to inform hospital staff in advance about the stored colostrum and include this information in your birth plan. This can ensure that the feeding process in the hospital is smooth.
What to do after birth?
As soon as the baby is born, it’s important to get started with breastfeeding. If breastfeeding is going well, it’s ideal that the expressed colostrum remains unused. If challenges do arise, the colostrum can be an invaluable resource.
Setting up a Routine for Feeding
Establishing a feeding schedule is important in the first few days and hours after birth. Colostrum is a great way to meet the needs of newborns who need to be fed every two to three hours. The mother should be aware of their infant’s hunger signals, which can help guide the feeding schedule and ensure that they are getting enough.
Overcoming Initial Challenges
Some mothers have difficulty breastfeeding because of factors like a nipple problem, latch problems, or engorgement. If this is the case, colostrum that has been previously expressed can be used to address these issues. Lactation consultants and breastfeeding support groups are also helpful in overcoming initial obstacles.
Conclusion
It is up to the individual whether they decide to express colostrum or not. This decision will be influenced by their circumstances, medical histories, and personal preferences. There are benefits such as promoting breastfeeding and providing newborns with essential nutrients, but there are also potential risks.
Consult your healthcare provider to make an informed decision about collecting colostrum that is safe and healthy for both mother and child. Expectant mothers who are armed with information and guidance can navigate the complex terrain with confidence.
Understanding the nuances involved in expressing colostrum will empower women to make informed decisions for their families and themselves. The key to a successful breastfeeding journey is fostering an open dialogue with healthcare providers. Mothers can improve their readiness to breastfeed by taking a more informed approach. This will also help them lay the foundations for their baby’s health and well-being from the beginning.
