Can I start collecting colostrum before baby is born?

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Hand expression is the most effective tool for emptying colostrum from the breast when baby is sleepy or not efficient at the breast in the first 3-5 days after delivery. When baby isn’t latching immediately after birth, many hospital lactation consultants will have the mom start  pumping. This is a great way to stimulate the breast, but many get discouraged from not seeing much colostrum come out with those first few pumps. 

Colostrum is a thick, nutrient dense first milk. It starts in a small amount and moves slow to help baby learn how to practice sucking, swallowing and breathing  without getting overwhelmed by a faster flow. Colostrum has been in the breast since 10-14 weeks gestation so it is ready for whenever baby is born, even if baby is born premature. 

You can actually start practicing hand expression while you’re still pregnant. It is a phenomenal skill to practice in case you need to hand express after baby is born. It will also give you the confidence that you have milk and do not need to wait for “milk to come in” To start, you’ll want to gently prime the breast. Using your fingers like combs or in gentle strokes, massage the breast from back to front. The colostrum is made at the back. These gentle strokes and massages encourages the milk to move from the back of the breast, down the breast ductal system to the nipple at the front. You can also gently shake the breast to help stimulate the movement of milk. After a less than a minute of massage you’re ready to express your milk. There are multiple ways to hand express, and I will show you several different ways. You’ll want to practice different techniques until you find what works for you and your body. Some people can hand express with either hand, and some will find they need to use their dominant hand. There is no one right or wrong way, it is what works for you and your body.  To start, take your hand in a C or U position. The breast is a circle, so either position is fine, and you’ll want to experiment with both until you find the sweet spot on your own breast that works for you to start seeing your colostrum come. You want your finger and thumb opposite of each other on the areola not too close to the nipple. You’ll bring your hand back into the breast and compress your fingers together, trying to make them meet behind the areola and nipple area. Compress and release. You may have to do this gentle compresss and release for a minute or two before you start to see the glistening drops of colostrum from the nipple. If you don’t see anything after a few compresses, go back to gentle massage. You can switch breasts often.  Be mindful to bring your fingers together  from equal points cross from each other on the circle of the areola. If you are asymmetrical, you won’t see any movement.  

Usually the first time you try, you may see only a drop or two from each side. You cannot run out of colostrum or have colostrum change to mature milk until your placenta is birthed. As long as you are a low risk pregnancy and not on bed or pelvic rest, it is considered safe to hand express. This should not hurt. If you feel any pain or discomfort, stop and find a local IBCLC lactation consultant to help you practice. If you have questions about antenatal hand expression, make sure to ask your IBCLC lactation consultant during your prenatal breastfeeding consultation. 

HERE'S HOW TO COLLECT COLOSTRUM BEFORE BABY ARRIVES

Breast pumps only use suction, so if you use some compressions on the breast with your hands to start moving the milk to fill the ducts, it might flow easier when pumping. Using the pump to stimulate your hormones and then ending with lots of hand expression will actually help you see milk move. Don’t get discouraged if you don’t see any colostrum the first few times you pump after birth. Pumps are not as efficient as your hands or your baby once they’re awake and alert.

Pregnancy and breastfeeding

If you’re still breastfeeding and become pregnant, your mature breastmilk will transition back to colostrum around the end of the first trimester in preparation for whenever the new baby is born. By 4 months gestation, the placenta is large enough to suppress most milk production. Your body will prioritize your fetus over your nursling in terms of milk and produce the appropriate milk for the more vulnerable child. Colostrum is a high protein, laxative milk to help newborns poop out meconium. It is saltier in taste and thicker in consistency. Many older babies don’t care if it tastes different, but some will and may wean themselves. The supply is not likely to be able to support an infant 10 months old and younger. But if the older infant (11+ months) or toddler is eating solids and drinking other liquids, those babies may not care if they are getting milk or “dry nursing” until the next baby comes. Some choose to supplement younger babies with donor milk or may transition to formula until the new baby arrives and then continue to tandem feed with their own breastmilk again. 

Pregnancy hormones can make breasts and nipples more sensitive and uncomfortable. And these sensations often will make one want to wean or experience a nursing aversion. Toddlers may still aggressively want to nurse and it’s ok to put boundaries on your nursing. 

The typical things recommended to increase supply (additional feeding/pumping, herbs and supplements, etc.) are not appropriate and are ineffective since the placenta will continue to increase in size. Hormones supported by the placenta are what impact milk production and there’s not much you can do to combat the hormone shift as it’s needed to support the pregnancy. 

Breastfeeding and Weight Loss

You were probably told breastfeeding would be this incredible biological postpartum weight loss plan. While that may be true for about 1/3 of people, most of us hold on to our weight regardless of how much boob juice we make. When you breastfeed, fat cells stored in your body during pregnancy and calories from your diet fuel milk production. Your body burns about 20 calories for each ounce of milk you make. Which is why you need an extra 300-500 calories a day. After an immediate postpartum weight loss of about 15#, it tends to be gradual — about 1–2 pounds a month for the first six months after childbirth and more slowly after that point. It often takes 6-9 months to lose pregnancy weight.

Why are you not losing the baby weight?

🧁 I don’t know about you, but I was hungrier breastfeeding than pregnant. You’re still eating for two only your second party is bigger now than when they were in your belly. Breastfeeding cravings are real. 

🧁 Lactation cookies? Let’s be honest, a cookie is still a cookie whether or not it helps with your supply. Eating lots of bars, cookies, power drinks and teas with sugar or honey are not going to help with weight. 

😵‍💫Stress: Research has also found that elevated cortisol levels (the stress hormone) have been associated with weight retention in the first 12 months postpartum

😴 Lack of sleep:  Research shows when we don’t get consistent sleep, our hunger hormone (ghrelin) gets triggered and our satiety hormone (leptin) dips, increasing appetite. Scientists at the University of California also found that sleep-deprived people tend to reach for higher-calories foods compared to those who are well-rested.

🩸Hormones: Prolactin, your milk making hormone, is also sometimes called the “fat-storing hormone”. High levels of prolactin can result in weight gain. And they are at their highest while breastfeeding. While more research on prolactin is needed, we hypothesize that our bodies undergo metabolic adaptations to hold onto excess fat as “insurance” for baby. Meaning, if you were to find yourself in a famine, you body has what it needs for baby.

🔑Remember: there is waaaay too much pressure to “bounce back” after having a baby. Your body is epic and lovely and just pushed a tiny human being out. Your body is going through so many changes and there are physiological things at play that can be beyond your control. Trust your body. Trust your baby. Love your body. 

Sudden breast milk supply drop

Breastfeeding going well and all of a sudden you feel like your milk is gone? Go pee on a stick. A drastic drop in milk supply when breastfeeding has been going well can be a sign of pregnancy, even if your period hasn’t come back yet. Research shows it is safe to continue breastfeeding while pregnant and does not increase the risk of miscarriage. So there no reason to wean unless you’re a high risk pregnancy (if you are told by your health care provider that you can’t have sex, you shouldn’t breastfeed. If it’s safe to have sex, it’s safe to continue breastfeeding.) If so you are not alone—far from it.

Key points to remember when breastfeeding and pregnant:

• Milk will shift from mature milk back to colostrum around 14-20 weeks of your pregnancy to prepare for the birth. Babies under 6 months may not get enough milk from the breast alone while toddler eating solids may do fine. Monitor weight gain for babies under 1 year

• Colostrum is saltier than mature milk. Some nurslings are fine with the taste shift and others may self wean

• Aim for a total of about 600 to 800 extra calories — 300 for the fetus and 300 to 500 for milk production.

• Nipples may become extremely tender during pregnancy, especially at the beginning, due to hormone changes

• Breastfeeding aversion while pregnant is normal (feelings of stress or anxiety or wanting to stop breastfeeding)

• If your toddler always nurses to sleep, you may want to find other sleep routines to make putting older one to sleep easier when you have the new baby.

• As your belly grows, you may need to experiment with new breastfeeding positions.

You are what you eat, and so is your baby

Did you know that not only do the volumes of milk produced by the left and right breast differ, the milk made in the left breast can also taste different than that made in the right… during the same feeding!!

What you eat used to change the flavor of your amniotic fluid, exposing baby when they were a fetus to the profile of your diet, preparing them for the flavors they would later experience in your breast milk. Eating a wide variety in your diet while you’re pregnant and breastfeeding exposes your little one to a wide variety of flavors, getting them used to the spices, herbs and tastes of food they will be given when they start table food eaten by your family. The more of a particular food you eat, research says, the better the chance your baby will also like to eat that food.

Eating allergenic foods during pregnancy also protects baby from food allergies, especially if you continue to eat them while breastfeeding suggests new research. So far, there is no evidence that avoiding certain foods while breastfeeding helps prevent baby from developing allergies or asthma. The exception to that might be eczema: avoiding certain foods may reduce the risk of eczema. Allergy studies are challenging because of many factors, including food introduction, genetics, and maternal diet. Most studies conclude that exclusive breastfeeding (even as little as one month) lessens how often some allergies occur. Evidence also suggests that exclusive breastfeeding during the first four months may offer protection against certain types of allergic diseases including cow’s milk allergy and atopic dermatitis. So while oatmeal 24/7 may help increase your milk supply, switch it up for baby’s sake (and yours!!)