Prenatal Hand Expression and Collection
Prenatal hand expression and colostrum collection seems to be a hot topic on “pregnant social media”. Most of my prenatal clients come to me with some background knowledge about colostrum collection and a desire to learn more.
If this were a lactation visit and we were looking at each other, I would flap my hands in the air and talk about how our hands were the original pumps. I truly believe every lactating person needs to have the skill of hand expression in their repertoire. The health of lactating breasts is dependent on the removal of milk and at times, our hands are the best tools available to ensure milk removal. “Low tech and high touch” is the heart of hand expression and I find pregnancy the perfect low-key time to begin practicing the essential skill of hand expression.
Prenatal Hand Expression Logistics
I recommend beginning to get to know your new pregnant breasts in the shower. The shower is a perfect time to develop your hands-on touch and your hand expression skills. In the shower, there is no pressure to collect colostrum or to even to actually express colostrum. Shower goals are to feel comfortable touching your breasts, learning the level of pressure that is comfortable without bruising or leaving your breasts feeling tender, and to develop your hand expression techniques.
Once you are feeling more confident from your shower experimentation, I suggest moving your hand expression trials to dry land. At this juncture, we celebrate every drop and every bead of moisture. As you develop your touch and technique, you will likely begin to observe drops of clear or yellow colostrum on your nipples.
If your goal is to save colostrum to freeze for future use, this is time to get out a clean spoon or a clean tiny cup (like a shot glass) to collect your drops of colostrum. This might require a second set of hands so don’t be shy to ask for your partner’s help to hold a spoon near your nipple and gently collect the drops of colostrum.
The next step is to pull out the 1mm syringes you have already ordered from Amazon or a medical supply company. These tiny capped syringes are low price and buying in bulk (usually about $10 for pack of 100 syringes) will ensure you have more than enough for your colostrum collection and extras to pass to a pregnant friend any that you don’t use. Just slurp up our expressed colostrum into your tiny syringe, cap it and put it in a Ziploc bag to safely store in your freezer.
My favorite hand expression online resources for learning this important skill:
Prenatal Hand Expression FAQ’s
When should I begin prenatal hand expression?
I typically recommend practicing hand expression around weeks 35-38 of pregnancy.
Will prenatal hand expression make labor begin?
Hand expression is far gentler than nursing a toddler through your pregnancy and that is a normal event that rarely triggers labor for most women. If hand expression triggers any twinges, contractions or uncomfy feelings, I suggest to stop hand expression because babies need to cook for every possible day!
How often should I practice prenatal hand expression?
Your breasts are yours! How often do you want to practice? Once a day, twice a day, once a week, just one time and never again. The choice is yours!
Will I express all of my colostrum and my baby won’t get any after birth?
No! Your body has been internally producing colostrum since around 16 weeks of pregnancy. During pregnancy, the hormone progesterone is very high because it is busy growing your baby. As soon as your placenta is born, your milk making hormone, prolactin, kicks in to begin the shift from colostrum to mature milk. It is impossible to express all of your colostrum!
What if I’m not able to hand express colostrum? Does that mean I won’t make milk for my baby?
No! I suspect if you are unable to hand express any colostrum at all, your technique probably isn’t quite right
What do I do with the colostrum I collect in my freezer?
I suggest bringing your bag of frozen colostrum syringes to the hospital or birth center for your baby’s birth (even easier for a homebirth!). My philosophy is that the more colostrum your baby can drink in the very earliest days after birth, the bettter! If your baby is latching and drinking colostrum straight from the tap, you can still give your baby tiny syringes of colostrum in between feeds. If latching is a struggle, you will need to protect your milk supply through hand expression and pumping (a different topic for a different post) but you can also give your baby some of your expressed colostrum. Talk to your L&D nurses and your midwife for their suggestions!
