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Hand expressing in pregnancy and colostrum harvesting—preparation for successful breastfeeding?

02 April 2015
13 min read
Volume 23 · Issue 4

Abstract

Colostrum harvesting is a process involving antenatal expressing and storing of colostrum. Its benefits include quicker establishment of ‘full lactation’ (Singh, 2009), increased confidence in hand expressing (Brisbane and Giglia, 2013), and reduced stress over breast milk supply in the immediate postpartum period (Cox, 2006). Despite its advantages, the use of colostrum harvesting remains limited, with only a small selection of UK Trusts currently utilising this process. In the past, there have been concerns over the safety of antenatal expressing and its potential to initiate premature labour (Soltani and Scott, 2012). A more recent critical review of the literature found that the substantial benefits of early feeding of colostrum outweigh the lack of evidence associated with the risk of preterm labour (Chapman et al, 2013; East et al, 2014). This article discusses the advantages of antenatal hand expressing and colostrum harvesting in view of the best available evidence.

Breastfeeding initiation rates in the UK have risen; in 2010, 81% of mothers chose to breastfeed their babies at birth, compared with 76% in 2005. However, breastfeeding is often short-lived as 24% of women breastfeed exclusively at 6 weeks postpartum in England (22% in Scotland; 17% in Wales; and 13% in Northern Ireland), 17% at 3 months and 1% at 6 months in the UK (UNICEF, 2014a).

It is important to find out why many women stop breastfeeding within weeks, despite such high initial breastfeeding rates. This article explores antenatal education and preparation for breastfeeding in the hope of finding solutions to overcome some of the postnatal breastfeeding problems experienced by women. The benefits of colostrum harvesting and extra support for diabetic women are discussed, using the best available evidence, as is the teaching of hand expressing during pregnancy. The inclusion of education in hand-expressing in routine antenatal care could improve women's experiences of breastfeeding and increase rates of breastfeeding continuation.

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