Antenatal colostrum harvesting (ACH) is the process of gently hand-expressing and collecting colostrum, or “first milk,” during the final weeks of pregnancy. This milk is nutritionally dense and rich in immune factors, providing the ideal initial food for a newborn. The practice allows expectant parents to store colostrum for supplemental feeding if the baby needs it after birth. This guide provides direction on safe collection amounts and procedures.
When Antenatal Colostrum Collection is Recommended
Collecting colostrum before birth is beneficial when the newborn may struggle with early feeding or maintaining stable blood sugar levels. This applies to pregnancies complicated by pre-existing or gestational diabetes, as the baby is at a higher risk of neonatal hypoglycemia. Having a supply of colostrum ready can stabilize blood sugar and potentially reduce the need for formula supplementation.
The practice is also helpful for parents expecting a planned cesarean section, which can sometimes delay the onset of mature milk production. Other indications include a known risk of premature birth, a history of low milk supply, or prior breast surgery. Colostrum collection is also recommended when the infant has a known condition that may impair feeding, such as a cleft lip or palate, cardiac issues, or intrauterine growth restriction.
Recommended Collection Volumes and Daily Limits
The amount of colostrum collected before birth is typically very small. Parents should focus on the quality of the collection process rather than the quantity. Colostrum is a highly concentrated food, and a newborn’s stomach is initially the size of a marble, meaning only tiny amounts are necessary for a full feed. Most mothers initially collect just a few drops, which may amount to only 0.1 to 0.5 milliliters (mL) per expression session.
It is recommended to start with short, gentle sessions, expressing for about three to five minutes on each breast, two to three times a day. Storing the colostrum in small, individual portions, such as 1 mL or 2 mL syringes, is advisable, as an average newborn feed in the first days is only about 5 to 15 mL. The volume collected antenatally is not an indicator of a person’s potential milk supply after the baby is born.
Step-by-Step Guide to Safe Harvesting and Storage
Antenatal colostrum harvesting should begin around 36 to 37 weeks of gestation in low-risk pregnancies. This timing minimizes the risk of uterine stimulation while allowing time to collect a small supply. Hand expression is the preferred method, as the small, sticky volume of colostrum is often lost or wasted if a breast pump is used.
The process begins with washing hands thoroughly and sitting in a warm, relaxed position. Gently massage the breast first, then place the thumb and forefinger approximately two to three centimeters from the base of the nipple. Press the fingers gently back toward the chest wall, then compress them together in a rhythmic motion, releasing the pressure in between to allow the milk ducts to refill.
The resulting drops should be collected directly into sterile 1 mL or 2 mL syringes, often provided by a healthcare provider. The same syringe can be used to add more colostrum within a 24-hour period, provided it is capped and stored in the refrigerator between sessions. After 24 hours, the syringe must be labeled immediately with the date and time of the first expression, placed in a zip-lock bag, and moved to the freezer. Colostrum can be safely stored in a standard freezer at -18°C or lower for up to six months.
When Should Harvesting Be Avoided?
Antenatal colostrum collection should be avoided in certain high-risk pregnancies. Nipple stimulation releases the hormone oxytocin, which can cause uterine contractions. Always consult with a doctor or midwife before beginning, as they can assess individual risk factors.
The practice is generally not advised for those with specific complications. Conditions that usually preclude harvesting include:
- A history of threatened or actual premature labor in the current or previous pregnancies.
- Cervical incompetence or a cervical suture (cerclage) in place.
- A diagnosis of placenta previa.
- Unexplained vaginal bleeding during the pregnancy.
If a person is cleared to express but experiences any uterine tightening, cramping, or painful contractions while harvesting, they must stop immediately and rest.