The Gestie Podcast
Colostrum expression comes up when you're pregnant with gestational diabetes - but it's not always explained in a way that actually makes sense. This episode, we're covering all of it. I'm joined by Katie Irwin, an endorsed midwife and IBCLC from Flourish Lactation. We talk about why babies born after a GDM pregnancy are at higher risk of low blood sugars after birth, how expressed colostrum is actually used in those first hours, and what the DAME study - a high quality Australian randomised controlled trial - really found about safety and the amounts you can realistically expect. We also get into the emotional side of it, how to actually do it (technique, storage, getting it to the hospital), and why your birth partner has one of the most important jobs in all of this. Find Katie at flourishlactation.com.au [http://flourishlactation.com.au] or on Instagram @flourishlactation [https://www.instagram.com/flourishlactation]. Full shownotes: https://heygestie.com/blogs/podcast/colostrum-expression-for-gestational-diabetes [https://heygestie.com/blogs/podcast/colostrum-expression-for-gestational-diabetes] Chapters 00:00 Introduction 00:51 What is colostrum - and when does your body start making it? 01:29 How colostrum differs from transitional and mature milk 03:00 Benefits of antenatal expressing for mum 04:30 Why nine months of birth prep and zero breastfeeding prep is so common 05:18 Why antenatal expressing is specifically recommended with GDM 06:52 How expressed colostrum is actually used after birth 08:17 How baby's blood sugars are monitored after birth - the heel prick explained 10:14 What happens if colostrum isn't available - all the alternatives 11:43 Questions you can ask before any intervention in hospital 12:43 The DAME study - what it set out to prove and what it found 14:41 The surprising findings about how little most women actually express 16:33 No correlation between antenatal amounts and breastfeeding outcomes 19:32 The follow-up qualitative study - the emotional experience of antenatal expressing 21:57 What it feels like when nothing comes out (and why you might be pushing too hard) 22:35 How to decide whether antenatal expressing is right for you 23:54 When it's safe to start - and who should check with their care provider first 25:00 Step-by-step hand expression technique 26:58 What to actually expect (hint - nothing shoots out) 28:19 How to store colostrum and combine sessions 29:38 Getting your colostrum safely to the hospital 31:48 Why it should be on your birth plan - and your partner's job 32:40 When mum and baby are separated - a real example 36:06 How long to persist if nothing is coming out 36:15 Reframing the experience as skill-building, not output 37:43 Hand expression as a long-term skill beyond the newborn phase 39:21 Can women without GDM express colostrum too? 40:34 Using colostrum even when blood sugars are fine 41:20 Using colostrum to wake a sleepy or jaundiced baby 42:21 How to connect with Katie - telehealth, bulk-billed clinic, mastitis consults
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