Antenatal Milk Expression
Before your baby is born you might consider expressing milk antenatally. Before I begin this blog, please know that I’m not a trained breastfeeding supporter and as always my experience should never replace advice from an IBCLC (lactation consultant). I recommend you speak to a midwife about this before beginning but if you’re reading this blog you may already have reasons for choosing to do antenatal milk expression (known as AME), and questions about the practical aspects. In this blog I’ll try to give you some tips but choosing to do it should remain your choice.
Some of the reasons for choosing to express your milk antenatally might include diabetes or gestational diabetes (to help baby’s blood sugars after birth), and recanalisation/recanalization for parents nursing after surgery (BFAR, breast reconstruction, mastectomy or breast augmentation). You might be reading this and wonder why someone would choose to nurse their baby after a mastectomy or chestfeed after top surgery. But feeding from a human nipple (regardless of if/how much milk our bodies produce) helps you to bond with your baby, helps their oral development, baby’s social and linguistic skills later in life just to name a few. If you’re nursing your baby at your chest you might want to see if you can produce a little bit of milk despite being told you won’t be able to: you might be surprised. Perhaps you’re not expecting but wondering if you can make some milk, wanting to breastfeed an adopted newborn or baby born with a surrogate or gestating partner, or help feed wetnurse or donate to your best friend or to donate to an adult with an illness like cancer.
You might be planning to feed your baby by exclusively pumping; maybe for a bottle or cup or for your partner to use with a supply line nursing aid. If you’re not sure about feeding your baby you might want to have a small supply of colostrum to help them in their first few days before introducing formula. Whatever the reasons then antenatal milk expression can be great if you can master it! It can lead to confidence in expressing and pumping and faith in our bodies.
Why Do People Advise Against AME?
One of the age old ways to encourage and speed up labour to start has been to stimulate your nipples to produce oxytocin. It’s therefore often believed that nipple stimulation can start the birthing process when your body isn’t ready- this is why I’m advising you to check with your care provider before beginning – because in a healthy pregnancy most doctors give the ok to sexual activity and nipple stimulation (this link gives some in-depth advice) but there may be reasons for you not to. There really isn’t a lot of peer-reviewed research apart from this questionnaire which looked at pregnancies where the participants were nursing older babies. Mostly we know from hundreds and thousands of anectotal observations that it’s perfectly healthy and normal to nurse an older child while we’re gestating and that babies don’t tend to come until they’re ready. You should have seen me during my induction with Ayla, doing antenatal milk expression every two hours but she just wasn’t ready; in the end she was born by caesarean section four days later.
Antenatal Milk Expression
Don’t worry about supplies before you begin. The tiny beads of milk you’ll get at first aren’t big enough to collect and you might find it frustrating. One way to start is in a nice hot shower. Make the room warm and steamy and start to gently massage your underarms and down towards your nipples. Use the time to look for lumps and abnormalities too! Then start to circle the nipple with your fingers and gently squeeze behind the dark parts, the areolae, it will start to produce oxytocin. When you’re dry you could try the same and see if you get a little bead of liquid. It might look clear, opaque creamy white or somewhere in between and it’s all normal. As you keep doing this over a few days the beads might get bigger. That’s when you can think about collecting a little.
You can ask your midwife for little 1ml syringes buy them here. You just open the little pack and with clean hands express a few drops, sucking it up with the syringe a little at a time. Put it back in the pack and you can freeze it just as it is.
If you start to fill a few of these at a time you can move on to 10ml syringes or the 50ml pots that fit onto a wide range of breastpumps including the ones in UK hospitals.
As you start to produce more milk you might like to try a breastpump or even start off with one. I recommend the Spectra 3 Electric Breast Pump which is what I used after Bastian was born and I loved it. It’s half the price of the hospital grade ones but personally I couldn’t see a difference. You can get it with a little kit that converts it from a single to a double pump and if you have a larger chest you can get the larger flanges, which made it a bit more comfy. Personally I don’t think you need to take your own pump if you’re going into hospital because once you’re comfortable with pumping they’re quite similar but let me know if you disagree! The reason I chose Spectra is that they sell their bottles in an ethical way; not violating the international code on infant feeding marketing.
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