Antenatal expression, or colostrum harvesting, involves manually expressing the first milk, colostrum, during the final weeks of pregnancy and storing it for the newborn. Colostrum is a thick, concentrated fluid produced from around the sixteenth week of pregnancy, rich in immunological factors and nutrients. While often safe for low-risk pregnancies, it is important to confirm with a healthcare provider before beginning this process. The goal is to have a supply available should the newborn require supplemental feeding after delivery.
Assessing Safety and When to Begin
The primary safety consideration for antenatal expression relates to the release of oxytocin, a hormone triggered by nipple stimulation. Oxytocin is responsible for the milk ejection reflex, but it is also the hormone that causes uterine contractions. While the small amount of oxytocin released during gentle hand expression is generally not enough to induce labor in a low-risk pregnancy, the potential connection requires caution.
For this reason, healthcare professionals typically advise that colostrum harvesting should not begin before 36 to 37 completed weeks of gestation. If, while expressing, a person experiences painful or regular uterine contractions, or any vaginal bleeding, they should immediately stop the activity and contact their care provider for advice.
Certain medical conditions or pregnancy complications mean that antenatal expression is not recommended. Contraindications often include a history of preterm labor, a diagnosis of placenta previa, an incompetent cervix, or a cervical suture insertion. Any high-risk pregnancy, including those involving significant bleeding or medically advised bed rest, also rules out this practice. Medical clearance is necessary to confirm that proceeding with colostrum harvesting is safe for the individual and the pregnancy.
Advantages of Harvesting Colostrum Before Delivery
Having a banked supply of colostrum is advantageous when a newborn may need supplemental feeding shortly after birth. Colostrum is perfectly balanced for a newborn’s stomach, offering a concentrated source of calories, proteins, and infection-fighting antibodies. This is particularly beneficial for infants at risk of developing low blood sugar levels, such as those born to mothers with pre-existing or gestational diabetes. The banked colostrum can be used to quickly stabilize the baby’s blood glucose.
A stored supply is also helpful for newborns who may have difficulty latching or feeding effectively immediately after birth. This includes babies diagnosed with conditions like a cleft lip or palate, Down syndrome, or those who are small for gestational age or have intrauterine growth restriction. Providing the baby’s own mother’s milk avoids the need for formula supplementation, which is important for gut health and immune protection.
Maternal factors can also make antenatal expression prudent, such as when a delayed onset of mature milk production is anticipated. This might occur following a planned cesarean section or a significant blood loss during delivery. If separation between parent and baby is expected—for instance, if the newborn requires immediate care in the Neonatal Intensive Care Unit (NICU)—the available colostrum ensures the baby receives this early nutrition. The process of expressing also serves as a practical benefit, allowing the parent to gain confidence and familiarity with hand expression techniques before the demands of a newborn.
Practical Steps for Expressing and Storing Colostrum
The preferred method for antenatal collection is manual expression, rather than using an electric pump. Colostrum is produced in very small volumes, and its thick, sticky nature makes it difficult to collect efficiently with a pump, which can also provide stronger stimulation. To begin, gentle breast massage for a few minutes can help encourage the milk to flow, followed by positioning the thumb and forefinger in a “C” shape a few centimeters back from the nipple.
Use a rhythmic, gentle compression of the breast tissue toward the chest wall, avoiding any painful pinching or sliding of the fingers on the skin. The small droplets of colostrum that appear should be collected directly into a sterile collection device, such as a 1 milliliter or 3 milliliter oral syringe. It is normal to only collect small amounts, and the expression session should last about three to five minutes per breast, one to three times per day.
Once collected, the syringe must be labeled immediately with the date and time of expression. If expressing multiple times in one day, the syringe can be stored in the refrigerator between sessions, but all colostrum collected within a 24-hour period should be frozen together at the end of the day.
Storage Guidelines
- Frozen colostrum can be stored in a standard freezer for up to six months.
- It must be transported to the hospital in an insulated cooler with ice packs to maintain its frozen state.
- Once thawed, the colostrum should be used within 24 hours.
- Never refreeze thawed colostrum.