Colostrum, often called “liquid gold,” marks the body’s first step in providing nutrition after childbirth. This thick, sticky fluid, which can range in color from clear to deep yellow, is a concentrated source of protection for the newborn. Colostrum is uniquely composed of high concentrations of immunologic factors, such as antibodies like Immunoglobulin A (IgA) and white blood cells, which help coat and protect the baby’s immature digestive tract. Expressing or pumping colostrum after birth is not only possible but is a widely supported and often necessary medical action. Colostrum also contains growth factors and is significantly higher in protein and lower in fat and sugar than mature milk, making it the perfect first food for a tiny stomach.
Situations Requiring Postpartum Colostrum Pumping
While direct nursing is ideal, expressing colostrum postpartum becomes necessary in several circumstances to ensure the newborn receives its benefits. One common reason is the temporary separation of mother and infant, such as when a baby requires specialized care in the Neonatal Intensive Care Unit (NICU) due to prematurity or illness. Expressing milk during this time is essential both to provide the baby with colostrum and to stimulate the mother’s body to establish a full milk supply.
Newborn health concerns often necessitate supplementation with expressed colostrum. Babies born to mothers with diabetes may experience low blood sugar (hypoglycemia), requiring small, frequent feeds of colostrum to regulate glucose levels. Additionally, if an infant has a congenital condition like a cleft lip or palate, or a poor sucking reflex, direct feeding may be ineffective or impossible.
Expressing also maintains the mother’s long-term milk production when the baby is unable to feed directly or adequately. If a newborn is excessively sleepy, struggling to latch, or if the mother is experiencing severe engorgement, removing the colostrum is important.
Collection Techniques and Volume Expectations
Due to colostrum’s viscosity and the very small amounts produced in the first 24 to 72 hours, manual expression (hand expressing) is often the most effective collection method. This technique involves using the hands to gently massage and compress the breast to express drops of colostrum directly into a collection container. Hand expression is superior to electric pumping in the early days because the thick, sticky nature of colostrum can easily adhere to and be lost within the pump parts.
To perform manual expression, a mother should first warm her breasts with a compress and massage them to encourage milk flow. Placing the thumb above the nipple and the fingers below in a ‘C’ shape, she then presses back toward the chest wall before gently compressing the fingers and thumb together. The position of the fingers should be rotated around the areola to ensure all milk ducts are drained.
While a pump can be used, particularly to stimulate milk production, a low-suction setting is recommended, often combined with “hands-on pumping,” which integrates manual expression with the pump. It is important to set realistic expectations regarding volume, as the newborn’s stomach capacity is very small. Mothers typically produce only a few milliliters of colostrum per feeding in the first days, which is entirely normal and sufficient for the baby.
Handling, Storage, and Feeding Guidelines
Once collected, colostrum must be handled with care to preserve its properties and ensure safety. Given the small volumes, colostrum is typically collected and stored in clean, sterile 1 mL or 3 mL oral syringes, which minimize waste and allow for easy administration. Each container must be clearly labeled with the date and time of expression to track its freshness.
For short-term use, fresh colostrum should be refrigerated promptly (ideally within one hour of collection) and can be stored at 4°C for up to 48 hours. For longer storage, colostrum should be frozen, where it can be kept for up to six months in a standard freezer or up to twelve months in a deep freezer (at or below -20°C). Adding subsequent small amounts of freshly expressed colostrum to an already frozen container is possible, provided the new milk quantity is small enough not to thaw the existing frozen milk.
When preparing to feed, frozen colostrum should be thawed gradually, either overnight in the refrigerator or by placing the container in a warm water bath (not exceeding 40°C). Thawed colostrum must never be microwaved, as this destroys beneficial components and creates unsafe hot spots. Once thawed, the colostrum should be used within 24 hours and should not be refrozen. Methods of feeding include administering it directly from the syringe, or using a small medicine cup or specialized feeding tool.