Re: Pros/Cons hand expressing colostrum during 3rd trimester
Expressing colostrum during pregnancy is not a terrible idea, but it's usually an unnecessary one.
If you decide to express some colostrum, make sure you go slow and stop if you feel any increase in contractions. Nipple stimulation is a good way to induce labor, and you absolutely don't want to have your baby preterm! Do not expect to get a large amount- a few ccs is probably as much as you can reasonably expect to express and/or collect.
Some expressed colostrum could be a good thing to have on hand if your baby has difficulty nursing after birth. But it's generally unnecessary because most babies are born able and willing to nurse, and can easily extract the colostrum they need.
Now, if your baby were to be born with low blood sugar, that could result in pressure from the hospital to supplement him/her with formula or sugar water. If you had colostrum on hand, that would be a better alternative to formula/sugar water. But again, most babies can extract plenty of colostrum just by nursing. And of course your want to avoid bottles of ANYTHING if possible, since bottles can mess up a baby's latch. If you run into a situation where you must supplement, using a syringe or finger feeder or something is going to be preferable to using a bottle.
How likely is it that your baby will have low blood sugar? Well, that depends on a) how well your GD is controlled and b) how your birth and the immediate postpartum period is managed. As long as your GD is under good control, and you can control it with diet alone, there's really no reason to think that your baby is more likely to have low blood sugar than a baby born to any other normoglycemic mom.
There are a few things that happen before/during/immediately after birth that can impact a baby's blood sugar. For example, induction of labor can lead to a more difficult birth, difficulties with nursing, increased likelihood of mama-baby separation, etc. Use of IV fluids during birth can be especially tricky for moms with GD, because the IV solution often contains glucose, which can cause mom's blood sugar and also baby's blood sugar to skyrocket. When baby is born, and disconnected from mom's blood supply, the baby's pancreas will pump out insulin, resulting in a rapid decline of sugar levels. So you want to avoid an IV if possible! Finally, in the immediate postpartum period it's important to prioritize baby nursing over any routine consideration. The weighing, measuring, eye ointment, footprints, bracelet, etc., that can all wait until after the baby has had a good chance to nurse. Sugar checks can be conducted on mom, while baby nurses or in between breasts.
Delayed cord clamping can increase the likelihood of jaundice which requires phototherapy. However, MOST babies who get delayed clamping either do not have jaundice or have minimal/normal jaundice, particularly if they are born at or near term, rather than early. IMO, if your first baby didn't get jaundiced, or didn't get all that jaundiced, then there's no reason to worry about delayed clamping.
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