Antental Expressing
Expectant mothers with diabetes face unique challenges, and one crucial aspect of their prenatal care can be overlooked: antenatal expressing of colostrum. This practice holds significant importance in ensure the well-being of both mother and the newborn, especially in the context of insulin resistance and its impact on lactogenesis - or milk creation.
Understanding insulin resistance and lactogenesis
Insulin plays a critical role in the synthesis of mil. Diabetes in pregnancy is caused by insulin resistance in the antenatal periods and it is well established that this resistance can affect lactogenesis (or milk creation).
While attached to the placenta, your baby is relying on you for its nutrition through the umbilical cord. But once born, it will need an adequate supply of colostrum and milk as it starts to metabolise food through the gut and maintain its glucose levels for the first time in its life.
Antenatal colostrum expressing becomes a valuable tool in mitigating potential difficulties in establishing breastfeeding postpartum and preventing hypoglycemia in the newborn.
Importance of glucose monitoring for newborns
Newborns of mothers with diabetes may experience fluctuations in blood glucose levels as they start oral feeding for the first time, emphasising the need for diligent glucose monitoring in the first 24 hours of life. Antenatal colostrum expression ensures that mothers can provide their infants with a small reserve of colostrum and reduce the chances of the baby having artificial feeds from early on.
If formula is needed to kee your baby's glucose levels stable, it is not the end of the world, however the volume of formula given can cause your baby to start wanting larger volumes of milk and it can take time for your supply to match this quantity. Research shows us that women with diabetes who express colostrum in the antenatal period are less likely to need to give formula to their babies within the first 24 hours of their life.
Antenatal colostrum expression
Expressing colostrum before birth allows mothers to store this nutrient-rich early milk, providing a readily available source of nourishment for the newborn. It also helps you become familiar with your breasts and how to express in the event your baby takes time to learn to latch correctly.
Make sure to ask your maternity care provider for an expressing kit around 34-36 weeks of pregnancy.
Benefits of antenatal colostrum expressing
Blood glucose stability - by having colostrum readily available, newborns can receive small, controlled feeds that help stabilise their blood glucose levels until breast milk is in ready supply.
Early nutrient intake - colostrum is rich in antibodies and essential nutrients, providing a powerful immune boos and optimal nourishment during the critical first hours of life.
Breastfeeding success - antenatal expressing promotes the initiation of breastfeeding, helping mothers and infants establish a successful breastfeeding relationship.
Antenatal colostrum expressing stands as a practical and empowering strategy for expectant families with gestational diabetes. Here is a simple guide on the technique of hand expressing, storage and how to transport your stored gold when you welcome your new baby.
Hand expressing
Wash hands - start with clean hands to ensure hygienic expressing. Doing after a shower sometimes help as it opens up milk ducts in the breast and can make the process easier.
Find a comfortable position - sit comfortably with good back support.
Massage breasts - gently massage your breasts to stimulate colostrum flow.
Express over a clean container - use a clean, sterile container or syringe to collect the colostrum. Cup your breast with your hand, forming a "C" shape.
Thumb and finger placement - place your thumb above your nipple and your fingers below, a few centimeters away. Avoid placing fingers directly on the areola.
Compress and release - press your thumb and fingers together, compressing the milk ducts, and then release. Repeat this rhythmically, gradually working your way around the breast.
Express drops into the container or syringe - aim to express the colostrum in drops initially. As you become more proficient, you can express larger amounts. Keep in mind that colostrum is usually thick and sticky and comes in a variety of colours. It can even be red or green. Don't stress, this is a normal variance.
Switch sides - after a few minutes (no more than 10), switch to the other breast and repeat the process.
It can take a while to get the technique right and often it can take a few tries before you can collect any, so keep trying if it doesn't happy on the first try!
Storage of colostrum
Use sterilised containers - choose small, sterilised containers or syringes with tight lids to store colostrum. This helps prevent contamination.
Label containers - clearly label each container with your name, date and time of expression.
Storage in small portions - store colostrum in small portions (around 1-3mls) to minimise waste during feeds.
Refrigeration or freezing - if using colostrum within 48hrs, refrigerate it. For longer storage, freeze it. Ensure the container is airtight to prevent freezer burn.
Thawing colostrum - when ready to use, thaw colostrum by placing in the refrigerator or holding it under warm running water. Do not use a microwave.
Transporting colostrum
When transporting to your place of birth make sure you take it in a cool bag with ice bricks. The goal is to get it back into the freezer ASAP. If the colostrum thaws it will need to be used within 24hrs, so one tip is to only take in a small supply if you have a large collection going by the time you have your bub.
Happy Expressing!!
