Pregnancy encyclopedia: Expressing breast milk to Group B streptococcus

Expressing breast milk

Sometimes it is necessary to manually express your breast milk: when you miss a feeding, when your baby has a bottle instead of breastfeeding, or when your breasts become engorged. Whether you're expressing manually or with a pump, remember to express each breast until the flow of milk slows down.

• Wash your hands well.
• Wash the breast pump equipment that contacts the breast, milk, or collection containers in a dishwasher or by hand in hot, soapy water. Rinse with cold water and air dry on a clean towel. Check with your hospital or health care provider for any other instructions.
• Try to pump when your baby would normally breastfeed. Your milk supply is usually most plentiful in the morning.
• Before pumping, relax and get comfortably seated. Massage your breasts to help your milk let down.
• Pump your breasts according to the breast pump maker's instructions.

Expressing breast milk manually

• Help your milk let down by massaging or stroking your breasts.
• With your right hand on your right breast, position your thumb above the nipple and your first two fingers below the nipple. Keep your fingers about 1 inch to 11/2 inch from the nipple -- not from the areola, since areola size varies from woman to woman. Your hand should form the letter "C" with your thumb pad at 12 o'clock and your finger pads at 6 o'clock in line with the nipple. In this position, your fingers are above the milk reservoirs in your breast. Do not cup your breast.
• Push straight into the chest wall. Avoid spreading your fingers apart. For large breasts, first lift, then push (illustration a) .
• Roll your thumb and fingers forward about 1 inch at the same time. This rolling motion compresses and empties milk reservoirs without injuring sensitive breast tissue (illustrations b and c).
• Repeat rhythmically. Position fingers, push in, roll out. Position fingers, push in, roll out.
• When those reservoirs are emptied, rotate your thumb and fingers to milk other reservoirs (your thumb at 11 o'clock and your fingers at 4 o'clock).

Then switch to your left hand to cover the remaining reservoirs (your thumb at 1 o'clock and your fingers at 8 o'clock, and then your thumb at 3 o'clock and your fingers at 9 o'clock). Express each breast for about 5 to 7 minutes. Then massage or stroke your breasts again. Begin expressing again, for about 3 to 5 minutes. Massage or stroke your breasts again. Then express for about 2 to 3 minutes.

During manual expression, do not:

• squeeze your breasts -- it can cause bruising
• slide your hand over the breast down to the nipple -- it can cause painful skin burns
• pull the nipple out -- it can cause tissue damage

Fallopian tubes

Two Fallopian tubes, one on either side of your uterus, carry eggs from your ovaries down your uterus.

Gestational diabetes

There are two types of diabetes which are lifelong diseases. They are type 1 and type 2 diabetes. However, it is possible to develop "gestational diabetes," which only occurs during pregnancy.

During digestion, many foods are converted to a sugar called glucose, which is your body's fuel. Your body produces a hormone called insulin to convert glucose to energy. If you have gestational diabetes, your body has trouble producing and/or using insulin. The extra hormones produced during pregnancy can make it difficult for the insulin in your body to work properly, causing diabetes -- but only until your pregnancy is over.

Gestational diabetes affects about 4 percent of pregnant women. Most women are tested between 24 and 28 weeks of pregnancy to see if they are at risk for developing gestational diabetes (see "Glucose screen.")

You may be at increased risk of developing gestational diabetes if you:

• have a history of gestational diabetes during previous pregnancies
• are a member of an ethnic group that is at risk for gestational diabetes
• have given birth to a very large baby
• had abnormal glucose in the past
• have a history of stillbirth
• are carrying twins or triplets

For your baby, untreated gestational diabetes can cause:

• higher birth weight
• low blood glucose at birth
• breathing problems
• jaundice

You can prevent these complications. If you are diagnosed with gestational diabetes, your health care provider will make sure you learn to modify your diet and to test your blood glucose to help normalize your blood sugar.

Glucose

A simple form of sugar that comes from many foods you eat. It is your body's main source of fuel (also known as "blood sugar").

Glucose screen (or one-hour glucose test)

This one-hour screening test measures your current risk for developing gestational diabetes.

• There is no special preparation for this test.
• You are given a sweet drink at your health care provider's office.
• You sit quietly for an hour without eating or drinking.
• Blood is drawn from your arm and tested.
• A negative test means that you are currently not at risk for developing gestational diabetes.
• A positive result means that you may be at risk for developing gestational diabetes. Your health care provider will recommend a three-hour glucose tolerance test.

Glucose tolerance test

This three-hour test determines if you have gestational diabetes.

• It is important to eat normally for 2 to 3 days before the test.
• Do not eat or drink for 8 hours before the test. (Small sips of water are OK.)
• When you arrive at the clinic, your blood will be drawn.
• You will be spending three hours at the clinic sitting quietly (bring a book).
• You'll be given a sweetened beverage to drink, and during the next 3 hours, 3 to 4 blood samples will be taken.
• You cannot eat, drink, smoke or walk around during the test (bring a snack to eat when the test is over).

If you have two or more test results that are elevated, you have gestational diabetes. Your health care provider will review your test results and make recommendations for treatment. Most often, you'll be referred to a diabetes center so you can learn what dietary changes you must make and learn how to monitor your blood glucose.

Group B streptococcus (GBS)

Group B streptococcus is part of the normal bacteria on the skin of 15 percent of American women. It does not cause illness in adults, but it can cause devastating illness in newborns. If you have GBS, you can pass it onto your baby during or after birth.

If your water breaks or you go into labor before 37 weeks, you will be tested with a swab of the vaginal opening and rectum for this bacterium and you will be treated. You may also be offered this test routinely at 36 weeks to determine if you should receive antibiotics during labor. Discuss this with your health care provider.


 

First published: 10/04/2002
Last updated: 10/04/2002

Reviewed by: Allina Patient Education, experts