Colostrum, often described as “liquid gold,” is the first milk produced by the mammary glands. This thick fluid begins to form as early as the second trimester of pregnancy and is available for the first few days after birth. It is dense with antibodies, proteins, and growth factors that help build a newborn’s immune system and stabilize blood sugar levels. Colostrum expression is the process of manually or mechanically removing this first milk before or immediately after delivery to ensure the baby receives these benefits.
Reasons for Colostrum Expression
The decision to express colostrum prepares for potential feeding challenges that may arise in the first few days of a baby’s life. Having a store of this nutrient-rich fluid can prevent the need for formula supplementation if a baby struggles to latch or requires additional feeds. This practice is particularly beneficial for mothers with diabetes, as their newborns are at an increased risk of low blood sugar levels shortly after birth.
Expression is also recommended if separation of the mother and infant is anticipated, such as when the baby is admitted to the Neonatal Intensive Care Unit (NICU). Preparing a supply ensures that infants with congenital conditions, such as a cleft lip or palate, or those born prematurely, can still receive the immunological and nutritional advantages of colostrum. Learning the skill of hand expression before delivery can also increase a mother’s confidence in feeding and milk management.
Antenatal Expression: When to Start and Safety Guidelines
Antenatal expression, or collecting colostrum before birth, is generally advised to begin around 36 to 37 weeks of gestation. This timing is chosen to minimize the theoretical risk that nipple stimulation could cause uterine contractions and trigger premature labor. Hand expression is the recommended method at this stage, as the small volume of colostrum is often difficult to collect with a pump.
A common recommendation is to express for short durations, typically 5 to 10 minutes total, two to three times per day. It is important to rotate the position of the fingers around the areola during expression to stimulate milk ducts evenly. While any amount collected is beneficial, seeing only a few drops or no colostrum initially does not predict the ability to produce a full milk supply later.
Antenatal expression is not advised for all pregnant individuals. Absolute contraindications include a history of threatened or actual preterm labor, a diagnosed short cervix, or the presence of placenta previa. If painful contractions or vaginal bleeding occur while expressing, stop immediately and contact a healthcare provider. Expectant parents should always consult with their doctor or midwife before beginning this practice.
Postpartum Expression: Determining Frequency
After the baby is born, the frequency of expression shifts from preparation to supply establishment, especially if the infant is not directly feeding. The goal is to mimic the natural feeding pattern of a newborn by expressing milk frequently to stimulate hormonal responses. Mothers are advised to express a minimum of 8 to 10 times in a 24-hour period.
This high frequency signals the body to build a full milk supply and should include at least one expression session overnight. Starting expression within the first six hours after birth is encouraged, as this early stimulation helps set the foundation for long-term milk production. In the immediate postpartum period, hand expression is often the most effective way to remove the small, concentrated amounts of colostrum.
Once the milk volume begins to increase, usually between day two and six postpartum, a hospital-grade electric breast pump may be introduced, often combined with hand expression afterward to fully empty the breast. Each session should last 15 to 20 minutes, or until the flow of milk has stopped for a few minutes. Maintaining this consistent frequency, rather than focusing on the small volume of colostrum, drives the transition to mature milk production.
Handling and Storing Expressed Colostrum
Proper management of expressed colostrum is necessary to maintain its high immunological and nutritional quality. The small amounts collected are best managed using clean, sterile syringes without needles, which allow for easy collection and simple administration to the baby. For larger volumes, small, food-grade containers or specialized breast milk storage bags can be used.
Every collection container must be clearly labeled with the date and time of expression to ensure the milk is used within its safe storage window. Freshly expressed colostrum can be kept at room temperature for up to four hours, or refrigerated for a maximum of four days at 4°C. For longer storage, colostrum should be frozen promptly. Frozen colostrum should be thawed slowly in the refrigerator or quickly under warm running water, but never in a microwave, which can destroy its beneficial components.