Pregnancy Questions

Women’s breasts begin producing colostrum from around 16 weeks of pregnancy, some may see it leaking out while they are pregnancy and others may not see it until their baby is born. You may notice a yellow mark on your bra or some leaking in the shower. Colostrum is known as ‘liquid gold’, it’s full of protein, anti-bodies and nutrients. It tends to be much thicker than mature milk and golden in colour. It is all that your baby needs in the first few days of life.

Expressing colostrum before birth is generally not required, however, if you wish to express colostrum before birth, consult your healthcare provider before expressing during pregnancy. You can start collecting colostrum from 37 weeks so that you have some stored for when your baby is born. The best way to do this is by hand expressing. Talk to your health care professional before you start so that they can give you guidance. 

Breastfeeding women all have different amount of breast milk available at any given time, their baby is unique and will have different needs to others. Keeping hydrated and eating a healthy balanced diet is important to keep your supply up. Every time you sit down to feed baby, bring some water and a snack.  Some foods, herbs and medications can increase milk supply. You should consult a lactation consultant or your healthcare provider before taking any of these.

Something to remember- size doesn’t matter. Small breasts have the ability to produce just as much as large breasts- ever heard the saying “quality not quantity?”

If you are having any problems with your supply talk to your midwife or health care provider- take note of the number of times you are feeding your baby in a 24 hour period and how many wet and dirty nappies your baby is having in the same time period.

Antenatal (pregnancy) hand expression involves expressing colostrum in the final few weeks of pregnancy. It can also be referred to as ‘colostrum harvesting’.

Mothers are normally advised to wait until around 36 weeks before starting antenatal expression. Mums who are having multiple births may sometimes be advised to start sooner as giving birth earlier is more likely.

For some mothers, it can be a useful tool that helps ensure their baby will start life without the need for formula supplementation. The importance of exclusive breastfeeding for all babies has been well-established by scientific research. Colostrum contains vital immunological properties and helps to colonise the baby’s gut with healthy bacteria that protect against allergy and disease. It also contains the perfect balance of proteins, fats and micronutrients needed for human babies as well as acting as a laxative to help the passing of the first tarry meconium (bowel motion).

Some babies may experience difficulties with feeding or maintaining their blood sugar levels during the first few days after birth and therefore may require supplementary feeds.

These include babies:

• Babies whose mother had diabetes in pregnancy or who has a history of diabetes.
• Babies with a cleft lip or palate.
• Babies with congenital conditions e.g. Down syndrome or cardiac complications.
• Babies diagnosed with intrauterine growth restriction (IUGR).
• Babies whose mother is taking beta blockers to control high blood pressure.
• Babies who are twins or triplets.

Women who have had previous breast surgery or problems may have concerns regarding their ability to breastfeed and should have the support of a midwife, lactation consultant or breast feeding counsellor. It is important for a mother to discuss her plans to express antenatally with her doctor or midwife. It may not be recommended if you’ve been at risk of preterm labour in previous pregnancies, have a cervical stitch or have placenta/vasa previa for example.

It is recommended to express by hand antenatally rather than use an electric or manual breast pump. Colostrum will be produced in quite small quantities (often drops) and can easily stick to the bottles or pump parts and be harder to collect. A pump at this stage is likely to be more uncomfortable than gentle hands. Try hand expressing for a few minutes, once or twice a day.

When you’re breastfeeding twins it’s important that you are in a comfortable position whilst also having access to plenty of water and perhaps some snacks at hand. You can feed one at a time or both together- known as tandem feeding. If you’re tandem feeding, it’s important to get a good latch with one twin and before you latch the second- a lot of mothers find that the football hold works best for positioning. One baby will tend to show hunger cues first, start by feeding this baby before she gets to the point of crying. In the early days you will need someone to help to pass you the other twin, but soon enough you’ll become an expert in managing not only breastfeeding but life with two babies.

Ideally your baby will remain skin to skin with you from the moment of birth until they have their first feed (and beyond). This will help increase the chances of a successful feeding journey. If you’re unable to provide your baby with skin to skin contact then your support person should be encouraged/helped to do this for you.  Babies start to show signs of wanting to feed soon after birth, however they can be subtle and easily missed. Your midwife will support you to learn these signs and encourage you to offer baby the breast.

If you have made the choice to bottle feed your baby, either with expressed breastmilk (EBM) or formula your midwife will also support you in becoming familiar with preparing bottles and the practices surrounding each feed (cleaning, sterilising, storage). It is best to ask your hospital/ birth centre if they supply bottles and formula (most do).