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Thread: Prenatal Expressing

  1. #1

    Default Prenatal Expressing

    Does anyone have any tips for expressing colostrum in pregnancy? Or any good videos which are about expressing colostrum specifically, rather than milk once breastfeeding is established?

    Also, some advice with regards to the best gestation to start? I'm almost 31 weeks, and there is colostrum there. But I don't want to start too early.

    Back story: My first baby never latched, and try as I might I could not get anything expressed on a hot, noisy, stressful ward. We ended up on formula.

    I've got lots of good advice and support this time, so I'm hopeful this baby will take to feeding with no issues and frozen colostrum won't be required. But for peace of mind, I'd like to get some in the freezer if I can. I'm having a planned c-section, which is another factor.

    So any help or advice appreciated.

  2. #2
    Join Date
    Mar 2007
    Posts
    1,110

    Default Re: Prenatal Expressing

    I had to be induced when PG with DD2 and I was still nursing DD1 so the LC recommended to express collostrum while PG. I was only able to express a few drops at a time, which was perfectly normal and enough as I was collecting it every time I could and every day. I used a syringe to collect and put it in a freezer bag and then freeze right away and I would add the next collection to the previous one.

    Fortunately, I never had to use it but it gave me a peace of mind that it was ready in case I needed it.

    I think the sooner you start collecting, the better.

    It looks like this time you are more than ready to make it work!!

    Good luck!

  3. #3
    Join Date
    May 2006
    Posts
    21,147

    Default Re: Prenatal Expressing

    It's generally advised that women avoid pumping in late pregnancy, because pumping can stimulate uterine contractions and induce labor. You don't want to do that at just 31 weeks! I think hand expression into a syringe would be ideal.

    I think that in your shoes, I would be trying to focus less on getting colostrum out and more on doing the things I could do to ensure a better nursing experience. Some things to consider:
    - Make sure your c-section is not performed before 39 weeks gestation, unless there's a good medical reason to have it done earlier. Babies born before 39 weeks are more likely to have problems- particularly breathing problems- which require a trip to the NICU, and that can derail breastfeeding.
    - Discuss what will happen to your baby after your c-section. Will baby stay with you the whole time? Will he/she be taken to the hurry, and if so, what happens to him/her there? Is formula supplementation or pacifier use routine?
    - Room in with baby during your hospital stay. You'll learn baby's nursing cues faster and you won't risk a "helpful" nurse slipping your baby formula or a paci.
    - Avoid artificial nipples if at all possible. They can interfere with a baby's desire and ability to latch. If supplementation is necessary, finger-feeding or syringe feeding can be used.
    - Find a good lactation consultant, preferably an IBCLC, and line up a consultation for soon after your baby is born.
    - Line up help for when you're back home! You are going to need to do nothing but recover and focus on nursing.
    - Consider a VBAC...? I don't want to sound like I'm pushing you, especially since I totally get that not all moms want VBACs and that VBACs aren't always the right or safe choice. But if a VBAC is a possibility for you, you might want to try for one. Faster recovery for you, somewhat better likelihood of nursing starting off on a good foot...
    Coolest thing my big girl said recently: "How can you tell the world is moving when you are standing on it?"
    Coolest thing my little girl sang recently: "I love dat one-two pupples!"

  4. #4
    Join Date
    Jun 2009
    Posts
    5,609

    Default Re: Prenatal Expressing

    There is no reason to think you will not be able to nurse this baby just fine, right? Every baby is different.

    Babies are NOT born hungry and even if you are separated for a few hours baby should not need supplements in the normal course of things, and whatever colustrum a mom normally has after birth is normally all baby needs in the first few days prior to milk becoming more abundant. Yes, I know, babies are given supplements in the hospital all the time but it is usually totally unnecesary and can be avoided by telling the staff no, unless medically neccesary-ie, ordered by a doctor who has examined the baby and gives you a specific and compelling reason why. (And even then, if you don't agree, you can seek a second opinion.)

    So I do not really see the need to express a lot of colustrum before hand and like mommal I would be concerned about over stimulation causing early labor. THAT would certainly make nursing more difficult. PLEASE, discuss this with a breastfeeding professional before trying to express prior to birth.

    I do know that after a baby is born, hand expression is reported to work better for expressing colustrum than pumping in many cases. There are videos online for hand expression, and see http://www.llli.org/docs/00000000000...expression.pdf

    As pp mentioned, do not expect to get a lot. Yes colustrum is in the breasts months prior to birth, but it is often not available prior to birth because birth triggers the hormones that allows let down of milk. Some moms leak prior to birth, but many do not. All normal. Even after birth, colustrum is still often very scant! This is good and by biological design. You don't want to be trying to nurse a brand newborn with breasts bursting with milk. The small amount of colustrum in the early days allows baby to learn to latch and nurse effectively (and makes baby compelled to nurse very frequently) while only taking in what his brand new digestive system can handle.

    I would add to mommals suggestions that you attend a LLL meeting or at least talk to any local Leaders before going into the hospital, so you know who is arround for that local, free support. Also I hope you have the book The Womanly Art of Breastfeeding (8th edition 2010) tons of great, very up to date info for nursing moms from before birth on.

  5. #5

    Default Re: Prenatal Expressing

    Thanks everyone for your advice.

    In response to some of the queries raised:

    No, there is no reason why this baby shouldn't nurse straight out. But then again, there was no logical reason why my last baby didn't ever latch on either! I can't help but feel that having a little bit of colostrum frozen will help take the worry away. My first baby wasn't supplemented randomly, it was down to the fact at 36hrs old she hadn't latched once. I still don't understand why she couldn't latch - she wasn't affected by any drugs, she wasn't tongue-tied. She was hungry. And would accept the breast in her mouth in the beginning, but made no latching attempt.

    I had no luck expressing colostrum once she was born. Mainly due to being on a stinking hot hospital ward, and feeling under enormous pressure to "perform".

    I do have a LLL meeting locally, and am due to meet with a IBCLC next week. She works at the hospital and is coming over to help me put an action plan together for delivery. I will discuss antenatal expressing with her.

    I'm in the UK, so rooming in is the norm here. My baby won't be away from me at all, barring any health issues, so we shouldn't have any issues with supplementation or pacifiers being given without our knowledge.

    I'm having a c-section due to previous birth trauma and a 3rd degree tear. Another "natural" delivery is not an option for me. The effect the c-section may have on feeding has been carefully considered, along with all the other risks.

    No amount of nipple stimulation budged my first baby! She was finally born at 41+5!! But I do appreciate the concern re: inducing labour. If I do decide to express, I will leave it a few more weeks. and I fully intend to hand express rather than pump, if that makes any difference.

  6. #6
    Join Date
    Jun 2009
    Posts
    5,609

    Default Re: Prenatal Expressing

    yes I totally get it, you had an unfortunate exp. with your first child, but it sounds like you have learned at least what may have contributed to the issue at least as far as not being able to express. Having talked to many moms who had problems nursing number 1 (and being a mom with that issue myself) I know we often fear things will be exactly the same the second time around and that is seldom the case. I had repeat c-sections and even so my experiences was like night and day with number two going just fine from the start. I had changed hospitals, which I think helped somewhat, but mostly I think I had educated myself and simply had more confidence that second time around.

    If you want some expressed colustrum available for peace of mind, I am not saying that does not make sense. I just thought you might want to consider waiting until closer to the time your baby will be term and/or discuss it with a IBCLC or your midwife or doctor and see what they think.

    The feeling pressured to perform thing is something I truly understand, and this may have led not only to your feelings of discomfort and stress that inhibited your ability to express but also to your baby's apparent lack of interest. This is a typical issue in hospitals around where I am in Northern California and it drives me batty.

    Have you heard of the biological nurturing research done by British midwife Suzanne Colson? She has made some fascinating discoveries about how best to get breastfeeding off to a good start. You might want to look at this info here: http://www.biologicalnurturing.com/ and http://www.llli.org/docs/00000000000...astfeeding.pdf

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