Colostrum is the first milk produced during pregnancy, often beginning around the 16th week of gestation and continuing for a few days after birth. This initial fluid is dense with nutrients, containing a high concentration of antibodies, growth factors, and immune components compared to mature milk, earning it the nickname “liquid gold.” Colostrum stabilizes a newborn’s blood sugar and provides a protective coating for the infant’s digestive system. Colostrum can be collected and saved for later use, but the expression process differs significantly from pumping mature breast milk.
Colostrum Collection Methods
Hand expression is widely considered the preferred initial method for collecting colostrum, especially in the antenatal period or immediately postpartum. The primary reason is that colostrum is produced in very small volumes, often just a few drops or milliliters at a time, and it has a thick, sticky consistency. This nature makes it difficult for a mechanical pump to effectively draw out and collect.
A traditional breast pump, whether electric or manual, can cause a substantial amount of the fluid to adhere to the pump parts, tubing, and collection bottle. Hand expression allows the user to collect the concentrated drops directly onto a sterile spoon or into a small syringe, maximizing the amount saved for the baby. Hand expression also stimulates the breast gently, which is often more comfortable than using a pump when milk volume is low.
Breast pumps can be used for colostrum collection, particularly after the first few days postpartum when the volume increases. If a pump is necessary, it should be set to the lowest suction level to avoid discomfort and tissue damage. Using a hospital-grade or high-quality personal pump with a gentle, slow cycle is recommended, though its effectiveness remains limited compared to hand expression. For mothers of premature babies, combining hand expression with pumping increases overall milk output and caloric content.
Timing and Safety of Antenatal Expression
The practice of collecting colostrum before birth, known as antenatal colostrum expression (ACE), should begin after 36 to 37 weeks of gestation. This timing reduces the potential for complications associated with stimulating the breasts earlier in the pregnancy. Consulting a healthcare provider before starting is mandatory.
The most significant safety consideration for ACE is the risk of inducing preterm labor. Nipple stimulation releases oxytocin, a hormone that naturally causes the uterus to contract. While the stimulation from expression is usually not enough to cause labor in a low-risk pregnancy, it is a precaution that must be taken seriously. If any uterine cramping or painful contractions are felt during expression, the activity must be stopped immediately, and a healthcare provider should be contacted.
Antenatal expression should not be attempted in high-risk pregnancies or those with specific medical contraindications. These conditions include a history of threatened or premature labor, a cervical suture, placenta previa, or incompetent cervix. Expression is medically indicated in several scenarios where a baby may need supplementary feeding shortly after birth. This often includes mothers with pre-existing or gestational diabetes, as their newborns are at increased risk of low blood sugar levels. Having a reserve of colostrum ensures the infant receives the protective fluid instead of formula if they have difficulty latching or need extra nutrition due to conditions like a cleft palate.
Storage and Administration Guidelines
Once colostrum has been collected, proper handling is necessary to maintain its quality for the newborn. The small, concentrated amounts are best stored in sterile, small-volume containers, such as 1-milliliter or 2-milliliter syringes, which allow for accurate dosing. Colostrum collected over a single day can be combined into one syringe, provided the fresh addition has been chilled to the same temperature as the refrigerated colostrum already inside.
Freshly expressed colostrum should be refrigerated promptly, ideally within one hour of collection, and can be stored for up to 48 hours before freezing. Colostrum can be kept in a standard freezer for up to six months or in a deep freezer for up to twelve months. When transporting frozen colostrum, it must be kept in a cooler with ice packs to ensure it remains frozen until it reaches its destination.
To thaw, frozen colostrum can be moved to the refrigerator to thaw slowly overnight, or placed in lukewarm water for faster use. Thawed colostrum must be used within 24 hours if refrigerated and should not be refrozen. Avoid using a microwave to warm the milk, as this destroys immunological components and creates a risk of uneven heating. The small volumes are administered to the newborn using the storage syringe, a small cup, or a soft-tipped spoon to ensure precise delivery and avoid introducing a bottle nipple early.