By Jill Wilson, IBCLC

Antenatal Hand Expression is when colostrum is expressed and collected from the breasts during the last month of pregnancy.  While antenatal hand expression is well known among lactation professionals, recently, it has become a  popular topic among social media influencers.

Colostrum is the nutrient dense fluid that babies receive in the first 3-4 days following birth. Often called, “liquid gold”, colostrum is packed with nutrients and immune boosting properties. Colostrum that is collected prior to delivery can be frozen in syringes or special vials. Stored colostrum can be brought to the hospital and given to a baby after birth.

When it Might Be Beneficial

There are instances where antennal hand expression may be helpful, such as those babies who are at risk for hypoglycemia and might require supplementation for low blood sugars.  Other instances where it may be recommended include:

• Pregnancy complicated by diabetes (pre-existing or gestational)
• Pregnancy notable for use of a beta blocker medication (Labetalol, Procardia).
• Babies who are diagnosed antenatally to have a medical condition that requires a transfer to the NICU following birth
• Babies who are known in pregnancy to be small or large for gestational age
• Babies who have a cleft lip/palate or other congenital anomalies where direct breastfeeding may be challenging or not possible
• Multiples
• Prior history of  breastfeeding challenges
• Prior history of  breast surgery or injury (early breast stimulation and colostrum removal may help breast milk production)
• Factors associated with cesarean births

Safety of Antenatal Hand Expression 

Experts agree that in most cases, antenatal hand expression is safe to begin in the 36^th week of pregnancy. Expectant parents who have a high risk pregnancy, or history of premature labor, should consult with their medical provider. Potential risks should be identified. With evidence-based information and shared decision making, parents will know if antenatal hand expression is right for them. If deemed safe, breastfeeding medicine clinicians recommend to hand express twice a day for about 10 minutes.

If you’re curious whether antenatal hand expression may be right for you, seek guidance from your midwife or OB and follow up with a board certified lactation consultant should you have questions about how to hand express your milk. These professionals can give you clear information. Advice given by social media influencers can be misleading, with more of an emphasis on gathering “likes” rather than providing accurate information.