Colostrum is the concentrated, nutrient-rich first milk produced by the breasts, often described as “liquid gold” because of its protective properties. This thick, yellowish fluid is made in small amounts, perfectly suited for a newborn’s tiny stomach, and is packed with immunoglobulins and antibodies that support the baby’s immune system and gut development. Antenatal expression, or colostrum harvesting, is the practice of gently hand-expressing and collecting this milk during the final weeks of pregnancy. This process allows expectant parents to store their own milk supply for the baby’s use immediately after birth. This guide offers practical, step-by-step instructions for safely expressing colostrum while pregnant.
When and Why Antenatal Expression is Recommended
Healthcare providers frequently recommend antenatal expression when there is an anticipated need for supplemental feeding after birth. A primary reason is for mothers who have pre-existing or gestational diabetes. Infants born to mothers with diabetes are at a higher risk of developing low blood sugar, known as neonatal hypoglycemia. Having a supply of colostrum can help stabilize their glucose levels without needing formula.
Expression is also advised if a delayed onset of mature milk production is expected. Situations like a scheduled Cesarean section, a long labor induction, or certain pregnancy complications can sometimes delay the milk “coming in,” typically around three to five days postpartum. Having a small reserve of colostrum ensures the baby receives human milk from the start, even if the parent and infant are separated. Furthermore, if a baby is diagnosed antenatally with a condition that may complicate feeding, such as a cleft lip or palate, having stored colostrum provides a readily available source of nutrition.
Essential Safety Guidelines and Timing
The practice of expressing colostrum while pregnant should only begin after consulting with a midwife or obstetrician. For those experiencing a healthy, low-risk pregnancy, the recommended time to start is typically around 36 or 37 weeks of gestation. Beginning earlier than this is generally not advised.
There are specific medical situations where antenatal expression is not recommended because nipple stimulation releases oxytocin, a hormone that can potentially trigger uterine contractions. Individuals with a history of threatened or actual preterm labor, cervical incompetence, placenta previa, or antenatal bleeding should avoid this practice unless specifically cleared by their doctor. It is important to start slowly, perhaps with one short session of five to ten minutes per day, and stop immediately if any contractions or discomfort are felt.
Step-by-Step Manual Expression Technique
Hand expression is the preferred method for colostrum collection, as the thick, small volume of the first milk is not easily removed by a breast pump. Begin by washing your hands thoroughly and sitting in a comfortable, relaxed position, possibly after a warm shower to encourage milk flow. Gently massage the breast tissue using a circular motion, moving toward the nipple, which helps to stimulate the milk ducts.
The C-Hold Technique
The next step involves the “C-hold” technique. Place the thumb and forefinger on opposite sides of the areola, about one to two inches back from the nipple base. Press your fingers straight back toward your chest wall, and then gently compress the thumb and forefinger together. The pressure should be applied behind the areola where the milk ducts are located, not directly on the nipple itself.
Release the pressure and repeat the motion with a rhythmic squeeze-and-release action. Avoid sliding your fingers over the skin, as this can cause irritation. Once the flow slows down, rotate your thumb and finger position around the areola to access other milk ducts. The amount collected will be small, often just a few drops or a fraction of a milliliter, which is a normal expectation for colostrum.
Collection, Storage, and Administration
For collecting the expressed colostrum, a sterile container is necessary, with small 1mL or 3mL oral syringes being the most practical tools. You can collect the tiny drops directly into the syringe or express onto a clean teaspoon or medicine cup, then draw the colostrum up into the syringe. It is acceptable to collect colostrum into the same syringe throughout a 24-hour period.
Storage and Labeling
After each expression, the syringe must be capped and stored in the coldest part of the refrigerator, typically the back. At the end of the day, the syringe should be clearly labeled with your full name, the date, and the time of the first expression. Once labeled, the syringe should be placed in a clean freezer bag and transferred to a freezer for long-term storage, where it can be kept for up to six months.
Transport and Administration
When transporting the frozen colostrum to the hospital, it must be kept frozen in a cooler bag with ice packs. Once at the hospital, medical staff can store it properly and will assist in thawing it, ensuring it is used within 24 hours of defrosting. The collected colostrum is typically administered to the baby drop-by-drop via the syringe, a small cup, or a spoon.