Antenatal Hand Expressing

Information for Parents 

Antenatal hand expressing is a simple, evidence-based way to prepare for feeding your baby and to support their wellbeing around the time of birth. This guide explains what antenatal hand expressing is, why it may be recommended, how it supports your baby’s blood sugar levels, and what happens if a baby develops low blood glucose after birth. 

At Central Health London, antenatal hand expressing is often discussed as part of personalized pregnancy and antenatal care, particularly for families whose babies may need additional feeding support in the early hours of life. 

What Is Antenatal Hand Expressing? 

Antenatal hand expressing involves gently collecting small amounts of colostrum, the first milk your body produces, during pregnancy. It is usually recommended from 36 weeks onwards, unless your midwife or doctor advises otherwise. 

Colostrum is a thick, concentrated milk that is rich in energy, proteins and antibodies. Even very small quantities can be extremely valuable for newborns. 

Any colostrum you express can be frozen and brought into hospital, where it can be given to your baby after birth if needed. 

Why Is Antenatal Hand Expressing Recommended? 

Some babies have a higher chance of developing low blood sugar (hypoglycaemia) around the time of birth. This may include babies who: 

• Are born to parents with diabetes, including gestational diabetes 

• Are born early, or are small or large for their gestational age 

• Experience stress during labour or birth 

Having your own expressed colostrum available can: 

• Help support your baby’s blood glucose levels 

• Reduce the need for formula supplementation 

• Support early feeding while breastfeeding is being established 

This approach aligns closely with best practice in postnatal care and early feeding support. 

How Does Antenatal Hand Expressing Help With Blood Sugar? 

Colostrum plays an important role in early newborn adaptation. It: 

• Is high in energy and easy to digest 

• Helps stabilise blood glucose levels 

• Supports your baby’s immune system 

Offering colostrum early and frequently after birth, either directly at the breast or as expressed milk, helps maintain blood glucose within a healthy range. 

When and How to Start Hand Expressing 

Unless advised otherwise by your care team: 

• Start from 36 weeks of pregnancy 

• Use hand expressing, rather than a pump 

• Aim for 1 to 2 times per day 

• Collect drops of colostrum into a sterile syringe 

Your midwife or infant feeding specialist can demonstrate how to hand express safely and comfortably as part of your ongoing antenatal support. 

Important Care After Birth to Reduce the Risk of Low Blood Sugar 

1. Skin-to-Skin Contact 

Place your baby skin-to-skin on your chest as soon as possible after birth and keep them there for as long as you can, especially in the first hours. 

Skin-to-skin contact helps to: 

• Keep your baby warm 

• Regulate blood sugar levels 

• Encourage early feeding cues 

  
  

2. Keep Your Baby Warm 

• Dry your baby thoroughly after birth 

• Use skin-to-skin contact and blankets 

• A hat may be used if advised 

Keeping your baby warm reduces energy use and supports stable blood glucose levels. 

3. Feed Early and Often 

• Offer the first feed as soon as possible after birth 

• Feed frequently, at least every 2 to 3 hours, or more often if your baby shows feeding cues 

• Colostrum, either at the breast or expressed, is ideal in the early hours 

Early feeding is a key part of supporting your baby’s transition and is reinforced through professional breastfeeding support. 

 

What Happens If My Baby’s Blood Glucose Is Low? 

Hearing that your baby’s blood glucose needs checking can feel worrying. Low blood sugar is relatively common in some babies and is usually temporary and easily treated, particularly when identified early. 

Blood Glucose Monitoring 

If your baby is known to have an increased chance of low blood sugar, staff may check their blood glucose using a small heel-prick test. This is quick and helps ensure your baby is adapting well after birth. 

If the Blood Glucose Is Slightly Low 

In most cases, simple measures are enough. Your baby will usually be: 

• Kept skin-to-skin with you 

• Encouraged to feed at the breast or with expressed colostrum 

• Offered your expressed colostrum if available 

Blood glucose will then be checked again to confirm improvement. Many babies respond well to feeding and warmth alone. 

If the Blood Glucose Remains Low 

If levels remain lower than expected, staff may: 

• Offer additional feeds 

• Recommend supplementation if needed, using expressed breast milk first or formula if required 

• Monitor your baby more closely for a short period 

These steps help ensure your baby has enough energy while adjusting to life outside the womb. 

If the Blood Glucose Is Very Low or Does Not Improve 

Occasionally, babies need extra support. This may involve a short stay in the neonatal unit for closer monitoring. Treatment may include: 

• Regular feeds 

• Tube feeding 

• Intravenous glucose 

This support is usually temporary. You will be kept informed, involved in decisions, and supported to continue breastfeeding and maintaining contact with your baby wherever possible, including with input from our paediatric team. 

 

Reassurance for Parents 

Most babies who experience low blood sugar respond well to early feeding and warmth. Antenatal hand expressing, skin-to-skin contact, keeping your baby warm, and feeding early and often are all effective ways to support your baby’s transition after birth. 

If you have concerns or questions at any stage, please speak to your midwife, neonatal team or infant feeding specialist. 

Further Support 

Support is available from: 

• Your community midwife 

• Infant feeding team 

• Neonatal staff, if involved 

You are encouraged to ask for help at any time. If you would like personalised antenatal or postnatal guidance, you can speak to our team at Central Health London.