Expressing Colostrum Antenatally – Breastfeeding Support haldol side effects

Other names used for expressing colostrum before birth include antenatal haldol side effects expression, harvesting colostrum and antenatal banking of colostrum. The technique involves hand expressing and collecting drops of colostrum haldol side effects during late pregnancy. Colostrum is particularly valuable to a newborn baby, it is low in volume but each drop is rich haldol side effects in antibodies and concentrated nutrition. Is antenatal expression safe?

Several NHS (national health service) foundation trusts in the UK advocate antenatal expression (referenced below), and breastfeeding charities offer information on the subject 1 2. However, in the literature, there are mixed opinions about the safety of harvesting colostrum haldol side effects in pregnancy. The main safety issue is that nipple stimulation releases oxytocin, a hormone that causes the uterus to contract in labour. There is a concern therefore that antenatal expression could potentially haldol side effects trigger premature labour resulting in complications from an early birth. Those who advocate antenatal expression usually recommend doing so after haldol side effects 37 weeks gestation—as long as there are no risk factors present for haldol side effects premature birth (see below), and as long as the mother’s health care professional has no concerns. What does research say?

A recent study, known as the DAME study (diabetes and antenatal milk expressing), looked at the safety of antenatal expression amongst over 600 haldol side effects women with diabetes in pregnancy and found: excerpt from advising women with diabetes in pregnancy to express haldol side effects breastmilk in late pregnancy (diabetes and antenatal milk expressing [DAME]): a multicentre, unblinded, randomised controlled trial, forster et al, the lancet, 2017

Previous to this study however, several authors and researchers expressed concerns about the safety of haldol side effects expressing colostrum in pregnancy. Lawrence and lawrence 3 say antenatal expression is a controversial haldol side effects procedure which could cause premature labour and occasionally antenatal mastitis, and risks outweigh benefits. Soltani and scott 4 found a higher rate of admission haldol side effects of babies to the special care baby unit (SCBU) when mothers expressed antenatally. And several other studies concluded that more research was needed haldol side effects before deciding whether antenatal expression was safe 5 6 7.

Feldman and singh explain why oxytocin release from antenatal expression haldol side effects would be unlikely to cause labour contractions in the early haldol side effects antenatal period—because there are considerably fewer sites for oxytocin to be haldol side effects absorbed by the uterus (oxytocin receptors) before a mother’s due date. This may also be why intravenous oxytocin used to induce haldol side effects labour will not always work if the uterus isn’t ready. Another hormone, progesterone, also has a tight control on when birth will start, and the amount of nipple stimulation needed to trigger labour haldol side effects is thought to be much higher than that involved in haldol side effects antenatal expression 8 9. Breastfeeding through pregnancy

Nipple stimulation due to a mother continuing to breastfeed a haldol side effects sibling during late pregnancy is not thought to trigger premature haldol side effects labour in a normal, low risk pregnancy 10 11 and is likely to be haldol side effects at a higher frequency than antenatal expression. For more reading see can you get pregnant while breastfeeding? When can breast or nipple stimulation trigger labour?

Rebecca dekker discusses the research regarding breast or nipple stimulation haldol side effects triggering labour in natural labor induction series: breast stimulation. Dekker concludes that nipple stimulation can help induce labour at haldol side effects term, and can also help ripen the cervix, reduce cesareans and reduce postpartum haemorrhage. She shares that although several large randomised trials have not haldol side effects found any adverse effects, there have been case studies where nipple stimulation has caused haldol side effects uterine hyperstimulation which could be harmful to the foetus, so caution and monitoring are advised. Recommendations are to only stimulate one breast at a time, have rest intervals and mothers with high risk pregnancies are haldol side effects not advised to use nipple stimulation to trigger labour. What are the benefits of antenatal expression?

• increase a mother’s confidence in hand expressing 14. Even if the drops of colostrum are not saved, once the technique of hand expression is learned, a mother can start hand expressing straight after the birth haldol side effects if her baby isn’t able to latch immediately.

• colostrum protects against allergies. Colostrum helps the digestive system develop normally, introduces friendly bacteria to colonate the gut and avoids exposure haldol side effects to cows’ milk formula which can trigger cows’ milk protein allergy in susceptible children, particularly those with a family intolerance to dairy 18.

Antenatal expression of colostrum is often suggested for mothers with haldol side effects diabetes or gestational diabetes however there are other situations where haldol side effects it may be useful too. Mid essex hospital services summarise who might find it useful haldol side effects in their patient information leaflet: excerpt from antenatal expression of colostrum, information for mothers-to-be, mid essex hospital services NHS trust (pdf), 2016

University hospital southampton also include multiple births, babies diagnosed to have down’s syndrome or a heart complication, mothers with preeclampsia or a high body mass index (BMI) and babies who are expected to be large for gestational haldol side effects age 19. Royal berkshire NHS include mothers who have any medical condition haldol side effects where challenges are anticipated, if a mother will be having an early induction of haldol side effects labour or has a history of metabolic disorders 20. When is antenatal expression not recommended?

Antenatal expression of colostrum is not usually recommended before 36-37 weeks gestation, nor if you previously had a premature baby, have cervical incompetence or a cervical stitch in place, are at risk of premature birth or have had any haldol side effects vaginal bleeding or premature rupture of membranes during pregnancy 21 haldol side effects 22. When can I express colostrum?

Colostrum is produced in the breast quite early in pregnancy, some mothers may notice they leak small amounts from the haldol side effects second trimester 23. However, it is usually recommended to begin harvesting colostrum much closer haldol side effects to baby’s due date—from around 37 weeks gestation. Mothers are advised to discuss their start date with their haldol side effects health care professionals in case they have any risk factors haldol side effects that mean antenatal expression should be avoided (see above). If a mother notices cramping pains during expressing, she should stop expressing and rest and discuss this with haldol side effects her health care professional 24 25. How do I express colostrum?

Hand expressing rather than pumping is the best way to haldol side effects collect colostrum as there will only be drops to collect haldol side effects at first and colostrum is thicker and stickier than mature haldol side effects breast milk. Labour is also more likely to be induced with high haldol side effects frequency pumping than gentle hand expression (singh, 2009) and pumping is not recommended ( UHS, 2017). The drops of expressed colostrum can be collected with a haldol side effects blunt ended sterile syringe or expressed onto a spoon or haldol side effects into a small cup and then drawn into a syringe haldol side effects for storage (cox, 2006).

Information varies considerably from once a day 26 to at haldol side effects least four times a day 27. Mothers in the DAME study expressed twice per day. Your own NHS trust may have their own recommendations. University hospital southampton says: excerpt from harvesting colostrum for your baby, university hospital southampton NHS foundation trust, 2017

If you would like to harvest your colostrum, you can start hand expressing for a few minutes once haldol side effects a day when you are 36 to 37 weeks pregnant. Gradually build up to gently expressing for about five to haldol side effects ten minutes at a time, two to five times a day, and then as often as necessary in the first few haldol side effects days after you give birth.

The small syringes used to collect colostrum can be frozen haldol side effects with the colostrum inside and thawed later as needed. After the birth, the syringe can be used to drip the colostrum into haldol side effects baby’s mouth. Maternity hospitals may be able to provide sterile syringes, or medical suppliers online provide individually wrapped small sterile syringes haldol side effects with or without caps e.G. 1ml, 2.5ml or 5ml. Mid essex hospital services recommend the following storage times: excerpt from antenatal expression of colostrum, information for mothers-to-be, mid essex hospital services NHS trust (pdf), 2016

Some babies born to diabetic mothers can have low blood haldol side effects sugar levels due to high levels of insulin still circulating haldol side effects in their bodies 28. If baby’s blood sugar levels drop too low this is known haldol side effects as neonatal hypoglycaemia and can be dangerous for your baby. Breastfeeding as much as possible after birth is a good haldol side effects way to raise baby’s blood sugar levels and prevent hypoglycaemia. Because some diabetic mothers find their milk comes in later haldol side effects than usual 29 and others find their baby isn’t ready to breastfeed, harvesting colostrum antenatally can ensure a supplement is available as haldol side effects needed. There are benefits for the mother too. Breastfeeding can help protect a mother with gestational diabetes from haldol side effects developing diabetes in later life and reduce the insulin a haldol side effects diabetic mother needs 30. Blood glucose monitoring in the newborn

• the british association of perinatal medicine’s identification and management of neonatal hypoglycaemia in the full haldol side effects term infant, framework for practice, 2017. This document includes clinical signs and operational thresholds to guide haldol side effects interventions, and the recommended care for “at risk” infants born at term.

Expressing colostrum before birth is known as antenatal expression. It involves expressing and storing drops of colostrum during late haldol side effects pregnancy. Having some stored colostrum after birth is a particular advantage haldol side effects to any baby likely to be born needing mothers’ milk quickly, for example babies born to diabetic mothers because they might haldol side effects have low blood sugar. Because nipple and breast stimulation in pregnancy could potentially start haldol side effects labour, historically there has been mixed advice about the safety and haldol side effects advisability of antenatal expression for fear of premature birth. However, many national health foundation trusts and breastfeeding charities have promoted haldol side effects this practice for low risk mothers for many years. A recent study looking at antenatal expression in diabetic women haldol side effects has helped provide more guidance on safety. Most organisations suggest antenatal expression be started after 36–37 weeks gestation. Harvesting colostrum is not recommended for high risk pregnancies, and there are a number of cautions to be aware haldol side effects of.

This article offers general information regarding antenatal expression of colostrum haldol side effects and it should not be construed as medical advice. Always discuss whether antenatal expression is appropriate for you with haldol side effects your own medical professionals who can advise you based on haldol side effects your medical history.

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