For various reasons, some babies may require more fluids or nutrition in the early postnatal period than they can get directly from their mother. Your midwife or obstetrician could recommend antenatal expressing of colostrum, which will be frozen and used to feed your baby after birth, if required.
Let’s look at the benefits and the potential reasons you might be required to express colostrum whilst pregnant, whether it’s safe, and finally, the amount you would expect to express antenatally, according to the Australian Breastfeeding Association.
Antenatal expressing of colostrum is the hand expression and collection of colostrum during pregnancy. You might not be aware, but from about the 16th week of pregnancy, a woman’s breasts begin to make colostrum.
Australia’s National Health and Medical Research Council (NHMRC) and the World Health Organisation (WHO) recommends babies be exclusively breastfed for around the first six months of life, and then to continue breastfeeding alongside family foods for one year, or for as long as the mum and child would like to.
This also includes only receiving colostrum in the early days after birth. If there is a possibility that the baby will require more fluids/nutrition during this period than what she can provide herself, she might choose to be prepared with a supply of expressed colostrum rather giving her baby formula.
Remember to discuss this first with your midwife or obstetrician before proceeding. You may be advised to express if you have:
The results from a large study called the Diabetes and Antenatal Milk Expressing (DAME; read more here) showed that women with diabetes and a low-risk pregnancy can safely express breastmilk in late pregnancy without causing harm to their babies.
Antenatal expressing was not studied in, and may not be safe in, pregnancies with complications that can lead to uterine contractions. Complications can include (but are not limited to): a history of antepartum haemorrage or placenta praevia; previous classic, undocumented or multiple caesarean scars; any suspicion of fetal compromise or any abnormal tests of foetal wellbeing; or serious maternal, mental, medical, or obstretic issues.
There is a wide variation in the amount of colostrum different women express. The median amount mothers expressed in the study (mentioned above) was 5ml in total. There is no evidence to suggest that a woman who expresses a tiny amount of colostrum will go on to have a low milk supply, and the same goes for expressing larger amounts.
Apart from antenatal expressing, to further minimise the risk of early formula supplementation, you could create a breastfeeding plan to get breastfeeding off to the best possible start.