Author: JONES, RUTH (RJE) UHNM

Patient Information Leaflet

Expressing your milk before your baby arrives

Please speak to a member of staff if you need this leaflet in large print, braille, audio or another language

Introduction
This leaflet is intended to provide you with general information and advice regarding expressing your milk before your baby arrives.
It is not meant to replace the discussion between you and your Doctor/Midwife but may act as a starting point for discussion.
If after reading it you have any concerns or require further explanation, please discuss this with a member of the Midwifery Team .
Antenatal expressing of colostrum
Colostrum (your first milk) provides vital nutrients that helps to fight infection and prevent allergy.
Antenatal expressing of colostrum means expressing during the final few weeks of your pregnancy.
This has been shown to be useful in helping mothers to feel more confident about breastfeeding as well as providing colostrum before your baby arrives. It also reduces the need to give formula to a breast fed baby.
Scientific studies indicate that exclusive breastfeeding give your baby the healthiest start in life.

Pregnant women produce colostrum from around 16 weeks, as the body prepares for the baby.
Colostrum is present even if you do not leak any.
It is safe to express the colostrum by using your hand from around 36 to 37 weeks of pregnancy.
The benefits of expressing your colostrum
Mothers who have expressed milk before their baby arrives have said that it gives them confidence to know how their bodies work and they felt better prepared to hand express once their baby arrived.
It also reduces the need to give formula.
Reasons for antenatal expressing include:
Reduction of type 2 diabetes in later life for ladies who suffer with gestational diabetes, and a reduction in occurrence of diabetes in the baby’s lifetime.
If your baby has a cleft palate and is unable to feed normally.
If you have a history of previous breast surgery.
Low confidence with breastfeeding.
Multiple births (twins, etc).
A baby who we know is going to be born preterm.
A baby who will need surgery.
A baby who will require additional care.

How to hand express
Your Midwives or Support Worker will talk you through how to hand express and provide special syringes for you to use.
Warmth and having a shower or bath will help.
Wash your hands and have a syringe ready (this is available from your Midwife).
Gently massage both breasts, from the back forward, particularly around the nipple and areola area (the darker skin around your nipple).
Make a “C” shape with your thumb and finger.

Place your thumb on top of your breast and your finger below the nipple, approx. 2-3cm away from the base of the nipple. This is where your milk ducts are.
Gently compress both fingers together without sliding them along the skin.
Try to keep to a rhythm like your baby would if she/he was suckling.
Move your fingers around the breast. It can take a few minutes before you will see any beads of colostrum. Every drop is precious.
Repeat twice on both breasts.
Express for approx. 5-10 minutes in total, twice a day.
If you find you get more practice contractions (Braxton Hicks), then stop expressing and talk to your Midwife.

Breast pumps are not suitable for antenatal expressing.
Visit unicef.org.uk/BabyFriendly
and search for Hand-expression.
The amount of colostrum collected varies greatly between mothers but it does start to increase as you continue.
If you are unable to get any colostrum do not worry as this will not reflect your supply once baby arrives.
Storing your colostrum
Any colostrum you collect should be refrigerated and then frozen within 24 hours.
You can use the same syringe twice, but store the colostrum in the syringe between uses in the refrigerator and always freeze within 24 hours. So, if you express in the morning, place the syringe containing colostrum in the fridge and then use the same syringe in the evening and then freeze it.
Place the syringes in a zip lock bag and freeze at -18oC and label clearly with:
Your name
Your Hospital number
The date and time the colostrum was expressed.

Bringing the colostrum into hospital
To transport your frozen colostrum, place the syringes in a cool bag with freezer blocks.
Hand this to your Midwife when you arrive in Hospital. There is a designated freezer on the Maternity Unit.
If the birth is imminent we can place it in the fridge, otherwise, we will keep it frozen until needed.
Defrosting
Please remind staff that you have antenatal colostrum.
If we need the colostrum quickly, we can defrost it using gentle warming. The colostrum then needs to be used straight away.
It can also be defrosted slowly in the fridge but then must be used with 24 hours..

Contact Numbers
If you have any questions please contact your Midwife or The Infant Feeding Team during office hours (8.00 am to 4.00 pm) Tel: 01782 672212
An answer machine facility is available.

Author: F Garrington, Lead Infant Feeding Co-ordinator
Approved: April 2021
Review date: April 2024

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