Midnight Baby Support

The first milk your body makes for your babies first feeds is called colostrum. It is sometimes  referred to as liquid gold because it has some amazing properties that are essential for baby's first few feeds. The main quality is the transfer of antibodies which help to protect baby against illnesses and infections, and it also helps baby's immune  system to develop. It also helps your baby's digestive system to develop and can prevent allergies. It encourages baby to pass their first bowel movement , which is a sticky black tar substance called meconium.

The amount of colostrum produced is small as it is a very concentrated form of milk and as baby's tummy is approximately the size of a marble they don't need much to feel full.

You can consider hand expressing off some colostrum after week 37 of pregnancy and storing it in syringes in  your fridge or freezer and these can betaken into hospital around the time your baby's is due to be born. This is known as Colostrum Harvesting or Antenatal colostrum banking.

You cannot hand express before 37 weeks pregnant as their is a risk of it initiating labour. Collecting colostrum and storing till until the time of birth will help you if you have any problems with the baby's first feeds , or your ability to feed initially straight after birth. Colostrum will ensure that your baby's blood sugar is stable, You m ay need to consider this if  your baby :-

• is large or small for their gestational age
• is a twin or triplet
• has a cleft lip or palate
• has Down’s syndrome or a heart complication
• are taking beta blockers to control high blood pressure
• have developed pre-eclampsia during pregnancy
• are diabetic or have developed diabetes during pregnancy
• have polycystic ovary syndrome (PCOS)
• have breast hypoplasia (a condition in which the breast doesn’t fully develop) or you have had breast surgery
• have a raised body mass index (BMI)
• plan to give birth by Caesarean section
• Plan for mum to have general anaesthetic at birth.

Colostrum collection can also be beneficial for your baby :

• If your baby needs extra feeds, you will be able to use your colostrum instead of formula milk if you have collected sufficient quantity in advance.
• Your baby has to go to SCBU(Special care baby unit) initially after birth if born early or baby is not fully developed at birth.
• If You are going to be separated from baby while you or baby have emergency surgery shortly after you've given birth.

If you would like to collect and store your colostrum, you can start hand expressing for a few minutes once a day when you are  37 weeks pregnant+. Gradually build up to gently expressing for about five to ten minutes at a time, two to five times a day, and then as often as necessary in the first few days after you give birth. If your baby is premature or unwell, you will be encouraged to start expressing within two to three hours of giving birth.

You can collect your colostrum while you’re pregnant by hand expressing in the same way that you will express milk when your baby is born. While you’re pregnant you should only use your hands for expressing. You are advised not use a breast pump until after you have given birth.

Hand Expressing Colostrum :-

• To collect your colostrum, you will need a clean, sterilized syringe and a clean, sterilized larger container. Have these items ready before you start.
• Make yourself comfortable and try to relax. 
• Heat/ warmth when expressing by hand will help, so try expressing in the shower or bath at first. You can gently massage your breasts with a warm flannel.
• Use your hand to cup one of your breasts. Your hand should be in a ‘C’ shape around the nipple with four fingers under the breast and the thumb at the top. Your thumb and fingers should be about 2-3cm away from the base area around the nipple.
• Use your thumb and index finger to gently squeeze. Release the pressure and then repeat to create a rhythm. This shouldn’t hurt. Avoid sliding your fingers over your skin as this may cause discomfort. If the colostrum doesn’t flow, try moving your fingers slightly towards the nipple or further away, finding the spot that works best for you. You could also try gently massaging your breast.
• Collect your colostrum with the sterilised syringe and if necessary decant to the larger sterilised container. Colostrum is very concentrated and will come out of your breast drop by drop. At first, only a few drops will come out at each session, but with practice and time, you should get more.
• When the drops slow down, move your fingers round to try a different section of your breast and repeat.
• Repeat the process for your second breast.

Storing your colostrum

• Label the syringe or container with your name and the date and time you expressed the colostrum.
• Put the syringe or container in a clean re-sealable bag and place it in your freezer at a temperature of -18°C.
• If your expressing immediately before going into hospital, you can store your milk in the back of the fridge at a temperature of 2-4°C for up to 24 hours before you freeze it.
• Colostrum/Breast milk that has been frozen can be defrosted in the fridge. It must be used within 24 hours.

You can express and freeze your colostrum at home and bring it into hospital when you have your baby.

To bring your colostrum into hospital you will need:

•  re-sealable food bags
• Small syringes storing upto 5 mls max
• a small cool bag
• two large ice blocks

When you go into hospital to have your baby, put a few of your (labelled) frozen syringes into a re-sealable food bag. Place this inside the cool bag between the two ice blocks.

Tell your midwife that you have colostrum with you when you arrive. It will be labelled with the date and time it was removed from your freezer and stored in the hospital fridge or freezer. This will be documented in your notes.

If you are in hospital during the later weeks of your pregnancy, discuss colostrum collection with your midwife. You will be given syringes so that you can harvest your colostrum and store it in the hospital freezer.