Prenatal manual pumping.

This article covers all the basics of hand pumping before birth. We'll discuss the potential benefits, such as collecting colostrum for your baby and familiarizing you with the process. We'll also address potential drawbacks , including stress or anxiety if you express little milk, and myths like the idea that prenatal pumping will speed up labor. You'll also find prenatal pumping instructions and the supplies you need to have at home for safe and effective pumping.

Can hand pumping induce labor?

Some people believe that nipple stimulation can help bring on labor sooner. This idea stemmed from older, small studies that suggested that hand pumping during pregnancy could lead to earlier deliveries or more neonatal unit admissions. This made healthcare providers cautious about recommending prenatal pumping.

However, a large and reliable study, the DAME study, has investigated these concerns. This study involved 635 pregnant women with diabetes. Half of them were instructed to manually express milk from 36 weeks, while the other half did not. The result? Women who expressed milk before birth did not give birth earlier than women who did not, and there was no increase in neonatal admissions or other risks to the baby.

Source: Diabetes and Antenatal Milk Expression: the DAME trial . This study is a randomized controlled trial (RCT), meaning the evidence is strong. The conclusion? Prenatal hand pumping does not speed up labor.

What do other studies say about nipple stimulation and contractions?

There is some evidence that intensive nipple stimulation such as breast massage or prolonged stimulation can influence the onset of labor.

A Cochrane review of six studies found that intensive nipple stimulation reduced the number of women who had not given birth after 72 hours Source: Breast stimulation for cervical ripening and induction of labour | Cochrane .

Studies show that for women around their due date, intense breast massage can increase the chance of spontaneous labor Source: Cervical Ripening and Induction of Labor | AAFP .

The key difference is that these studies involved women who actively wanted to induce labor, while manual pumping in the final weeks of pregnancy is much gentler and more gentle.

What do medical guidelines say about manual pumping during pregnancy?

Because there was a long lack of clear evidence, healthcare providers were reluctant to recommend manual pumping. But thanks to the DAME study and other studies, prenatal pumping is now recommended in some cases.

Guidelines advise :

• Start from 37 weeks (not earlier).

• Always consult a midwife or gynaecologist first.

• Especially useful for women with gestational diabetes, as colostrum can help prevent low blood sugar in the baby Source: Study finds breast milk expressing in pregnancy safe | The Royal Women's Hospital .

Many hospitals and healthcare institutions now have protocols for hand pumping during pregnancy. This means that healthcare providers provide guidance and equipment, such as syringes for collecting colostrum. Source: Antenatal Expressing | South Eastern Sydney Local Health District .

When is manual pumping during pregnancy not safe?

Manual pumping is not recommended for women at increased risk of preterm birth. This applies, for example, to women with:

1. Premature birth in a previous pregnancy.

2. Placenta praevia (placenta lying too low).

3. High blood pressure or other pregnancy complicationsSource: Prenatal pumping – Mamma Minds .

If you have any doubts about this, always consult your healthcare provider.

What do midwives and lactation consultants notice?

Many healthcare providers see women unjustifiably worried about inducing labor through pumping. They explain that:

• Oxytocin , the hormone released during nipple stimulation, can induce labor, but the amount released during hand pumping is small.

• For example, during an orgasm, much more oxytocin is released than during manual pumping. Yet, this usually doesn't lead to labor.

• In a healthy pregnancy close to your due date, hand pumping alone is unlikely to release enough oxytocin to induce labor Source: Colostrum - La Leche League USA .

Some women experience hard contractions or mild cramping while pumping, similar to Braxton-Hicks contractions. This is normal. However, stop immediately and consult your midwife if you experience regular or painful contractions.

Conclusion: Is manual pumping safe during pregnancy?

• Yes , if you are healthy and your pregnancy is without complications.

• No , if you are at risk of premature birth or have other pregnancy problems.

  
  

Current scientific evidence shows that:

1. Prenatal hand pumping from 36 weeks is safe during a normal pregnancy.

2. It does not cause premature labor according to the DAME study.

3. It has advantages for mothers who want to collect colostrum for their baby.

4. Healthcare providers and lactation consultants see it as a useful preparation for breastfeeding.

Benefits of prenatal hand pumping

For some women, prenatal hand pumping can be valuable. By practicing pumping before birth, you become familiar with your breasts, the manual process, and collecting colostrum.

Some benefits that are often mentioned:

• Getting familiar with the process: You'll learn how your breasts respond to stimulation and how to pump effectively. This can reduce stress if pumping becomes necessary after delivery.

• Colostrum in stock: Having a small supply of colostrum can be useful if your baby needs some extra nutrition after birth, for example if blood sugar is low or if latching on is still difficult.

• More confidence: By practicing the steps beforehand, some women feel more confident about breastfeeding after giving birth.

• Possible support for starting breastfeeding: For women with diabetes or a planned cesarean section, prenatal pumping can help to get breastfeeding established more quickly.

Possible disadvantages of prenatal manual pumping

While hand pumping before birth can be helpful in some cases, it's also important to understand the potential drawbacks. Some (expectant) mothers experience anxiety or uncertainty when they're unable to express much or any milk. This is understandable, but this stress can make it difficult to start breastfeeding after birth.

Furthermore, the amount of milk expressed prenatally says nothing about future milk production or the mother's ability to breastfeed.

Prenatal hand pumping is often unnecessary. Most women will only express a few milliliters of colostrum, while a newborn baby typically drinks 7 to 10 ml per feeding. In practice, the collected milk quickly runs out, making you wonder if it's worth the effort.

My advice is therefore: don't try to collect as much milk as possible. Use prenatal pumping primarily to become familiar with the procedure. This way you will have gained experience in case extra stimulation or milk is needed for your baby after birth, without this leading to unnecessary stress or pressure.

Prenatal pumping instructions

If you'd like to start pumping before the baby is born, I recommend purchasing colostrum collectors . They are suitable for both heating and freezing.

You can express twice a day before delivery (no earlier than 37 weeks), for 5 to 10 minutes per breast. The goal is to collect small amounts of colostrum and get used to hand pumping without overstimulating your breasts.

After giving birth, you can hand express milk five times a day for the first three days. You can also use this fresh milk to feed your baby. The goal here is to collect colostrum for supplemental feeding and to provide additional breast stimulation.

Supplies:

• Clean glass or BPA-free plastic syringes for collecting colostrum.

• A towel to catch any leaks.

• A quiet and comfortable place to pump.

• Clean hands.

  
  

Steps:

1. Relax: Make sure you're in a relaxed environment. Warm your breasts with a warm cloth or take a warm shower to stimulate milk flow. Lean forward slightly to let gravity help.

2. Massage: Gently massage your breasts using circular motions, starting from the outside towards the nipple. This helps open the milk ducts.

3. Hand position: Place your thumb on top and your fingers on the bottom of your areola (the dark area around your nipple), about 2-3 cm away from the nipple.

4. Press and Squeeze: Gently push back toward your chest wall and then squeeze toward your nipple. This is a rhythmic motion—press, squeeze, and release—that you repeat.

5. Collecting Colostrum: The colostrum, which is often thick, yellow, and sticky, will appear in small amounts. Collect this in the syringes or containers. If nothing comes out, that's not a problem and completely normal. It may take a few sessions before you collect a good amount of colostrum. Stay calm and give yourself and your breasts time to adjust to the process.

6. Switch Breasts: Pump for about 5-10 minutes on each breast, alternating between them. Start with a few minutes on one side, then switch to the other, and continue alternating. If you want to collect more colostrum, you can return to the first breast after the second breast.

   
   

Store the collected colostrum in syringes and freeze them. Label the syringes with the collection date. After birth, you can thaw the colostrum and give it to your baby.

Whether prenatal hand pumping is right for you depends entirely on your situation, body, and feelings. For some women, it provides peace of mind and confidence, while for others, it can be stressful or cause uncertainty.

It's important to remember that the amount of milk you express before birth doesn't necessarily predict your milk production after delivery. Even without prenatal pumping, you can get off to an excellent start to breastfeeding.

So, consider hand pumping as a tool, not a requirement or a predictor of success. Always consult with your midwife or lactation consultant about what's right for you and trust that your body knows what to do.