Antenatal colostrum harvesting is the practice of collecting small amounts of the first milk from the breast before the baby’s birth. This initial milk is rich in antibodies, nutrients, and immune factors perfectly suited for a newborn’s first days of life. Collecting colostrum ahead of time provides a valuable reserve to ensure the newborn receives this beneficial substance, especially if immediate nursing is challenging. This proactive approach is gaining acceptance among healthcare providers and is generally considered safe when performed under the correct conditions and timing. The process involves hand expression rather than using an electric breast pump.
Establishing the Safe Starting Point
The primary consideration when beginning this practice is the potential risk of stimulating uterine contractions. Nipple stimulation triggers the release of oxytocin, a hormone that facilitates the milk ejection reflex and plays a role in initiating labor. For a person with a low-risk, uncomplicated pregnancy, medical professionals agree that antenatal colostrum collection should not begin before 36 to 37 weeks of gestation.
This timing balances the desire to build a reserve of colostrum with minimizing the chance of an early delivery. By 37 weeks, a pregnancy is considered full-term, meaning the risk of prematurity complications is significantly reduced if contractions occur. Starting earlier than this recommended window is generally discouraged unless specifically advised by an obstetrician.
If a person begins expressing and notices any signs of uterine cramping or discomfort, they should stop immediately and contact their care provider. Although nipple stimulation is not a reliable method for induction, caution is warranted. Practicing hand expression for just a few minutes a day from 36 or 37 weeks allows a person to become familiar with the technique without excessive stimulation.
Specific Circumstances Warranting Antenatal Collection
While any person may choose to harvest colostrum, the practice is particularly beneficial for those with specific maternal or infant risk factors. Maternal diabetes, whether pre-existing or gestational, is a common justification. Babies born to diabetic mothers are at an increased risk of hypoglycemia (low blood sugar) immediately following birth, and a colostrum supply helps stabilize blood glucose levels without formula.
Infant conditions that may interfere with immediate and effective feeding are another strong reason to collect colostrum early. These include anatomical challenges like a cleft lip or palate, or congenital conditions such as Down syndrome or cardiac issues. A stored supply is also beneficial for planned interventions, such as an elective cesarean section or medical induction, which can delay the onset of a robust milk supply or cause temporary separation.
Additionally, expression may be encouraged for those who:
- Have a history of low milk supply.
- Have had previous breast surgery.
- Are carrying multiple babies.
- Need to gain confidence and stimulate milk ducts ahead of time.
Technique and Proper Colostrum Storage
Antenatal colostrum collection must be performed using hand expression, as the thick, sticky nature of the first milk is not efficiently removed by pumps. Hand expression is gentler, provides better control over the small volumes collected, and is typically measured in drops or milliliters. To encourage milk flow, a person can apply warmth to the breast for a few minutes, such as with a warm washcloth or during a shower.
The technique involves forming a “C” shape with the thumb and forefinger a few centimeters behind the nipple and areola. Use gentle, rhythmic compression toward the chest wall, rolling the fingers forward without sliding them over the skin to release the colostrum. Sessions should start short (once a day for five to ten minutes) and can be gradually increased to two or three times daily for up to 15 minutes as the due date approaches.
The expressed colostrum should be collected directly into sterile, small-volume containers, such as 1-milliliter or 2-milliliter syringes, often provided by a healthcare provider. Label each syringe with the date and time of collection before immediately freezing it at -18°C or lower, where it can be stored for up to six months. For transport to the hospital, the frozen syringes must be placed in a cool bag with ice packs to maintain the temperature.
Critical Safety Warnings and Contraindications
While antenatal colostrum harvesting is safe for most low-risk pregnancies, nipple stimulation is strictly contraindicated in specific medical situations. The release of oxytocin poses a risk of premature labor in certain high-risk pregnancies. It is imperative to consult with an obstetrician or midwife before beginning, especially if there are any known complications.
Contraindications that absolutely preclude antenatal expression include:
- A history of threatened or actual preterm labor in the current or previous pregnancies.
- Placenta previa (when the placenta covers the cervix).
- A cervical stitch (cerclage).
- Any experience of vaginal bleeding or premature rupture of membranes during the current pregnancy.
- The presence of multiples (twins or triplets), where provider clearance is mandatory.