Antenatal expression, also known as colostrum harvesting, is the practice of gently collecting the first milk, or colostrum, from the breasts during the final stage of pregnancy. This thick, yellowish fluid is produced from around the sixteenth week of gestation. This preparatory step ensures a supply of this nutrient and antibody-rich substance is available for the baby immediately after birth, especially if initial feeding challenges arise.
Recommended Timing and Medical Clearance
The standard recommendation for beginning antenatal expression is to wait until around 36 or 37 completed weeks of gestation. This late start is a safety measure, as nipple stimulation can lead to the release of oxytocin, a hormone that causes uterine contractions. Waiting until late in the third trimester helps mitigate the theoretical risk of triggering premature labor.
It is necessary to consult with a healthcare provider, such as an obstetrician or midwife, before starting any expression regimen. Certain high-risk conditions make antenatal expression inadvisable due to the potential for uterine stimulation. Contraindications include a history of premature labor, placenta previa, an incompetent cervix, or carrying multiples. If you experience contractions or vaginal bleeding while expressing, stop immediately and seek medical advice.
Specific Benefits of Antenatal Colostrum Collection
The primary motivation for colostrum harvesting is medical preparedness, ensuring the newborn has access to essential nutrients when needed. Babies born to mothers with pre-existing or gestational diabetes are prone to experiencing hypoglycemia, or low blood sugar, shortly after birth. A pre-collected supply of colostrum can be administered instead of formula or glucose to stabilize their blood sugar levels.
Colostrum is also helpful for infants who may struggle with feeding, such as those with a cleft lip or palate, or those who are premature or have congenital conditions. If a baby needs to be separated from the mother for medical reasons, a stored supply ensures they receive the benefits of human milk without delay. Colostrum is packed with antibodies and helps the baby pass meconium, which reduces the risk of jaundice.
The practice also serves to build maternal confidence and provide valuable practice for the feeding process. Learning the technique of hand expression before the baby arrives can be reassuring and may improve the continuation of breastfeeding later on.
Step-by-Step Harvesting Techniques
Hand expression is the preferred method for collecting colostrum because the initial volume is small and the fluid is thick and sticky. Colostrum is not easily removed by a mechanical pump, which can lead to waste. Before beginning, wash your hands thoroughly and find a relaxed position, which aids in milk release.
Begin by gently massaging the breast, stroking from the base toward the nipple to stimulate milk flow. Next, form a “C” shape with your thumb and forefinger and place them a couple of centimeters away from the base of the nipple. Press gently inward toward the chest wall, then compress the thumb and finger together, and release. This should be a rhythmic action, not a painful squeeze or slide on the skin.
Repeat this compress-and-release motion, rotating the position of your hand around the areola to stimulate all milk ducts. Sessions should be short, typically lasting three to five minutes on each breast, one to three times per day. The equipment needed is simple: a sterile syringe, usually 1 to 5 milliliters in size, to collect the tiny drops of colostrum as they appear.
Storage and Administration Protocols
Once colostrum is collected, safe storage is crucial. Any colostrum collected during the same session or day can be combined into a single sterile syringe. Each syringe must be clearly labeled with the date and time of the first expression.
Freshly expressed colostrum can be stored in the back of the refrigerator, where it is coldest, for up to 72 hours. For longer storage, the syringes should be placed in a sealed plastic bag and moved to the freezer. Colostrum can be stored in a deep freezer for up to six months.
When needed, the frozen colostrum should be thawed, ideally by placing the syringe in the refrigerator or under warm running water. Thawed colostrum should never be re-frozen and must be used within 24 hours. The colostrum is typically administered to the newborn via the syringe or a small, clean spoon, which allows for precise feeding of the small volume without introducing a bottle.