Colostrum is the initial milk produced by the breasts, typically starting around 16 weeks of pregnancy and continuing for the first few days after birth. This thick, often yellowish, fluid is rich in antibodies and protective substances that support a newborn’s immunity and aid in digestion. Antenatal colostrum expression refers to the practice of hand-expressing and collecting this early milk before the baby is born. This stored colostrum can then be given to the newborn if needed after delivery.
Understanding Antenatal Colostrum Expression
Expressing colostrum before birth is beneficial, particularly for babies who may face feeding challenges or need extra milk after delivery. Babies born to mothers with gestational or pre-existing diabetes may experience low blood sugar, and pre-expressed colostrum can help stabilize their blood glucose. Babies diagnosed with conditions like cleft lip or palate, or certain cardiac conditions, may also struggle with initial breastfeeding, making a stored supply valuable.
It also helps if a baby is anticipated to be born early, is small for gestational age, or if a planned cesarean section or induced birth is scheduled. Having colostrum available can prevent formula supplementation, supporting a healthy gut microbiome. For mothers, this practice builds confidence in hand expression and offers reassurance with a backup milk supply. This familiarity can contribute to a smoother breastfeeding journey.
When and How Often to Express
For low-risk pregnancies, healthcare providers generally advise starting antenatal colostrum expression no earlier than 36 weeks, with some suggesting around 37 weeks. It is recommended to express two to three times each day. Each session should last approximately three to five minutes per breast, totaling about 10 minutes. Consistency is more important than the volume collected, especially initially, as colostrum is produced in small amounts. The amount collected can vary widely, from a few drops to a teaspoon.
Safe Practices and Important Considerations
Hand expression is the recommended method for colostrum collection, as pumps are impractical for the small volumes produced. Before starting, wash hands thoroughly. A warm compress or expressing after a warm bath or shower can help stimulate milk flow.
To hand express, position the thumb and fingers in a “C” shape a few centimeters back from the nipple, then gently press back towards the chest and compress rhythmically. Avoid sliding fingers over the skin or pinching the nipple, as expression should not cause pain. Rotate finger positions around the areola to stimulate different areas of the breast.
If any painful contractions or vaginal bleeding occur, expression should be stopped immediately, and a healthcare provider should be contacted.
Antenatal expression is not advised for all pregnant individuals. Contraindications include a history of threatened or actual premature labor, a cervical suture, a short cervix, or placenta previa. It is also not recommended with any bleeding during the current pregnancy. Always consult with a doctor or midwife before beginning antenatal colostrum expression to ensure it is a safe option.
Storing Your Expressed Colostrum
Collect expressed colostrum in sterile 1ml or 2.5ml syringes, or clean, food-grade containers. Label them clearly with the date, time, your name, and potentially a hospital number. If collecting multiple times in one day, the same syringe can be used, stored in the refrigerator between expressions.
Once daily collection is complete, or after 24 to 48 hours in the refrigerator, freeze the colostrum. Place labeled syringes or containers in a sealed plastic bag to prevent contamination and freezer burn. Colostrum can be stored in a home freezer at 0°F (-18°C) or lower for up to six months, though three to four months is recommended for optimal quality. When transporting to the hospital, frozen colostrum should be kept in a cool bag with ice packs to prevent thawing.