Expressing your milk before the birth of your baby

Most expectant mothers can hand express milk in pregnancy. This should ONLY be done from 36 weeks onwards and ONLY after checking with your midwife.

Colostrum is the first milk you produce (from around 16 weeks) and will continue after the birth of your baby.

Your milk can help your baby grow and develop. Your milk can also help protect your baby against infection.

Learning to express your milk in pregnancy can be a really useful skill for lots of reasons.

It can help:

• get breastfeeding off to a good start
• boost your confidence when starting to breastfeed your baby
• ensure your baby receives your milk
• you to be more confident about your body

It can be especially useful for expectant mothers who are:

• expecting more than one baby
• having a planned caesarean section
• having induction of labour

Or expectant mothers who may have:

• diabetes
• any breast abnormalities
• previous breast surgery

Or expectant mothers who previously:

• experienced breastfeeding difficulties
• experienced low milk supply

Or expectant mothers whose baby may:

• be preterm
• be ill
• need extra care following birth

Babies of mothers with diabetes are at risk of developing hypoglycaemia (low blood glucose levels) in the first 48 hours following birth. Colostrum helps stabilise blood glucose levels. If colostrum is available because a mother has expressed her milk in pregnancy this can be given to baby to help avoid low blood sugar.

Studies show that breastfed babies are less likely to develop diabetes. Cow’s milk (the main ingredient of formula milk) is thought to be a possible trigger for diabetes in childhood.

Sometimes expectant mothers notice that their own blood glucose levels drop when they start to express colostrum. This is because more energy is being used. If this is happening please contact the Diabetic Specialist Midwife or the Consultant.

Colostrum is quite sticky, and appears only as drops; it is difficult to suck out with a pump so needs to be ‘expressed’ by hand.

How do I express my milk

1. Have a clean sterilised container/oral syringe to hand before you start.
2. Gently but firmly massage your breasts for a few minutes. Then roll nipples between finger and thumb for a few seconds.
3. Cup your breast and place your thumb and finger about 2-3 cm from the base of the nipple.
4. Using your thumb and the rest of your fingers in a C shape, gently compress this area – this shouldn’t hurt.
5. Release the pressure and then repeat again and again, building up a rhythm. Avoid sliding your fingers over the skin. Drops of colostrum will appear. Colostrum is quite sticky and tends to only come out as drops.
6. If colostrum does not flow, try moving your fingers slightly towards the nipple or further away, and try again.
7. When the flow slows down, move your fingers round to express a different section of your breast and repeat. Whenever the flow slows move your fingers around the breast and repeat again. Do this until you have expressed all the way round the breast.
8. Repeat steps 2-7 on the other breast.

Helpful hints

Try to AVOID sliding your fingers over your skin as this friction can make you sore. It helps to be warm, relaxed and comfortable. Try practising in the bath or shower.

Start expressing from 36 weeks, once daily. Increase each day until expressing up to a maximum of 3 times daily.

Important

Towards the end of your pregnancy you may start to feel your bump going hard and then softening, this is your womb tightening and relaxing. These are called Braxton Hicks contractions and are quite normal. This may also occur when you express.

Stop expressing if these contractions become painful. The contractions are likely to settle. If they don’t stop and you think labour may have started contact the Labour Ward for advice.

You will need to collect your milk in a sterile container. Staff may be able to provide you with small oral syringes.

Colostrum can be collected (in any 24 hour period), in the same syringe/container and kept in the fridge between expressing. These can be placed in a small plastic bag or plastic container. Label them with your name, and the date and time you expressed.

Colostrum can be stored in the fridge for up to 5 days at 4o C or lower (towards the back, never in the door).

Colostrum can be stored for 2 weeks in the ice compartment of a fridge or for up to 6 months in a freezer.

When you attend hospital for the birth of your baby, remember to bring in your chilled/frozen colostrum. Bring it in a cool bag with an ice pack. Let your midwife know so that it can then be stored to prevent it from defrosting too soon.

Further information If you have more questions please speak to your midwife or ring the hospital on 01709 820000 and ask to speak to the Diabetic Specialist Midwife (if diabetic) or Infant Feeding Coordinator.

Do you feel you need extra support?

Contact the Infant Feeding Team:
Telephone: 01709 423333
Email: rgh-tr.rotherhaminfantfeedingteam@nhs.net

Breast Buddies:
Breast Buddies are mums who have breastfed their babies and received training to support other mums to breastfeed. Find Breast Buddies on Facebook or for more information contact your local Children’s Centre. To find your nearest children’s centre contact Family Information Service on 0800 073 0230.

National Breastfeeding Support:
National Breastfeeding helpline - 0300 100 0212
National Childbirth Trust - 0300 330 0700
Breastfeeding Network - 0300 100 0210
Association of Breastfeeding Mothers - 0300 330 5453

Greenoaks Antenatal Clinic
Telephone: 01709 424347

Wharncliffe Ward
Telephone: 01709 424348

Labour Ward
Telephone: 01709 424491

Your local midwife and GP contact numbers will be on your handheld maternity notes.