Colostrum is the initial milk produced by the mammary glands. This nutrient-dense fluid contains a high concentration of immunologic factors, proteins, and growth factors that support a newborn’s first days of life. Antenatal hand expression, or colostrum harvesting, is the practice of collecting this milk before birth, typically in the final weeks of pregnancy. This practice is often recommended for expectant parents whose infants may require supplementary feeds shortly after delivery, such as those with anticipated low blood sugar levels or a cleft palate. Having a supply of colostrum ready can help avoid the need for formula supplementation.
Essential Preparation and Safety Guidelines
Before attempting any expression, it is important to consult with a healthcare provider to confirm the practice is appropriate for your pregnancy. The stimulation involved in hand expression releases oxytocin, a hormone that can cause uterine contractions, which is why it is generally advised to wait until around 36 to 37 weeks of gestation to begin. Antenatal expression is not recommended for individuals with certain high-risk conditions, including a history of threatened or actual premature labor, a short cervix, or placenta previa. If painful contractions or any vaginal bleeding occurs during a session, expression should be stopped immediately.
Begin by washing hands thoroughly with soap and water before each session to prevent bacterial contamination. Necessary supplies include a clean, sterile container for collection, such as a small medicine cup or a tablespoon. For storage, sterile oral syringes in small volumes, like 1ml, 3ml, or 5ml, are ideal for collecting the small amounts of colostrum typically expressed.
Finding a comfortable and relaxing setting can help promote the release of colostrum, as stress can inhibit the process. Applying a warm compress to the breasts or gently massaging them beforehand can stimulate milk flow. Some people find that expressing after a warm shower or while thinking about their baby can also be helpful.
Detailed Technique for Manual Expression
Manual expression is recommended over using a pump for colostrum collection because the technique targets the milk ducts more effectively for the small volumes produced. To begin, position your thumb and forefinger in a “C” or “U” shape about one to two inches behind the areola. Gently press your fingers straight back toward the chest wall, applying pressure inward, not toward the nipple. This action compresses the milk ducts beneath the areola to release the colostrum.
Next, while maintaining the inward pressure, gently compress the thumb and forefinger together in a rhythmic, pulsing motion. Avoid sliding your fingers along the skin or pulling the nipple, as this can cause discomfort or tissue damage. Collect the droplets directly into the sterile syringe by drawing them up from the nipple opening.
To ensure all milk ducts are stimulated, rotate your finger position around the areola, imagining the face of a clock, and repeat the press-and-compress motion. Express each breast for about three to five minutes, or until the flow slows significantly, then switch to the other side. A typical session should last no more than 10 to 15 minutes in total, and most people express once or twice a day. The small volume collected is normal, as a newborn’s stomach is only the size of a marble on the first day.
Proper Storage and Administration
Once the colostrum is collected, the syringe must be properly labeled with the date and time of expression. If you are collecting multiple times in one day, you can add fresh colostrum to a syringe already in the refrigerator, but it should be frozen at the end of the day, and the label should reflect the time of the first collection.
Freshly expressed colostrum can be stored in the refrigerator at 4°C (40°F) for up to 24 to 48 hours. For longer storage, the syringe should be placed inside a clean, sealed plastic bag and stored in the back of the freezer at -18°C (0°F) or colder for up to six months. Storing it in the back of the freezer, away from the door, helps maintain a consistent temperature. Never store colostrum in the door of the refrigerator or freezer, as temperature fluctuations can compromise its quality.
When it is time to use the stored colostrum, frozen syringes should be thawed gradually by placing them in the refrigerator overnight or by running them under lukewarm water. It is critical never to use a microwave to thaw or warm the colostrum, as high heat can destroy the beneficial antibodies and create hot spots that could burn the baby. Once thawed, the colostrum should be used within 24 hours and should never be refrozen. Colostrum can be administered to the newborn directly from the syringe, or by using a small cup or spoon.