Colostrum, often called “liquid gold,” is the concentrated first milk produced by the breasts, providing newborns with their initial source of nourishment and immune defense. This thick, yellowish fluid is uniquely rich in antibodies and protective white blood cells, offering a shield against infection. Colostrum also has a laxative effect, which helps the baby pass meconium (the first dark stool) and can help reduce the risk of jaundice. Antenatal harvesting is the manual expression and storage of colostrum before birth. This ensures the nutrient-dense substance is available if immediate breastfeeding is challenging.
Determining When and Why to Begin
The decision to begin antenatal colostrum harvesting should only be made after consulting with a midwife or doctor. Nipple stimulation releases oxytocin, a hormone that can cause uterine contractions. Therefore, the practice is recommended to begin no earlier than 36 to 37 weeks of pregnancy to minimize the risk of stimulating premature labor.
Harvesting is encouraged for mothers with diabetes or gestational diabetes, as their newborns may be at higher risk of low blood sugar levels. Having a reserve allows the baby to receive a concentrated dose of milk to help stabilize blood glucose without needing formula supplementation.
The practice is also beneficial if separation from the infant is anticipated, such as a planned Caesarean section or if the baby needs Neonatal Intensive Care Unit care. Mothers with a history of breastfeeding difficulties or breast surgery may also find it helpful to establish a small store before delivery.
Contraindications
Antenatal expression is not advised for all individuals. Those with a history of threatened premature labor, placenta previa, or vaginal bleeding during the current pregnancy should strictly avoid the practice. If cramping or contractions are felt while expressing, stop immediately and contact a healthcare provider.
The Manual Expression Technique
The manual expression technique is the most effective way to collect colostrum because its thick, sticky nature makes extraction difficult with a mechanical pump. Before starting, gather supplies, including sterile, blunt-ended syringes (1 to 5 mL) for collection and a clean, freezer-safe container for storage. Wash your hands thoroughly and find a comfortable, warm, and private setting. Applying a warm compress or gently massaging the breast beforehand can help stimulate milk flow.
Start by using your fingertips to gently massage the breast in a circular pattern, moving from the outer edge toward the areola. This stimulation helps activate the let-down reflex. Once stimulated, form a “C” shape with your thumb above the areola and your index finger below it.
Place your thumb and finger a few centimeters back from the base of the nipple, where the milk ducts are located. Use a rhythmic press-and-release motion: gently press inward toward the chest wall, then compress the tissue between your thumb and finger. Avoid sliding your fingers over the skin or pinching the nipple, as this can cause discomfort.
Colostrum will appear as small drops on the nipple tip; be patient, as the quantity is often very small. Use the sterile syringe to scoop up the droplets directly, or express the colostrum into a small cup and then draw it into the syringe. Rotate the position of your thumb and finger around the areola every few minutes to ensure all areas are being emptied.
Each session should last approximately 5 to 10 minutes per breast, alternating once the flow slows down. A frequency of two or three times per day is suggested for antenatal harvesting. Remember that even a few drops contain valuable nutrients, so every collected amount is worthwhile.
Storage, Freezing, and Thawing
Once the colostrum is collected into the syringe, label it immediately and accurately to maintain safety standards. The label must include the date and time of the first expression for that day, along with your name or initials. This tracking ensures the milk is used within its safe window.
Refrigeration and Combining
Freshly expressed colostrum can be stored in the refrigerator at 40°F (4°C) or lower for 24 to 48 hours. If adding subsequent expressions to the same syringe, ensure the fresh colostrum is cooled in the refrigerator first before combining it with the already cold colostrum. If the milk will not be used within two days, move it promptly to the freezer.
Freezing Guidelines
Colostrum storage times vary based on the freezer type:
- In a freezer with a separate door: Up to six months.
- In a deep freezer: Up to twelve months (though 3 to 4 months is recommended for optimal quality).
When traveling to the hospital, place the frozen syringes in a cooler bag surrounded by ice packs. This keeps them solidly frozen until they can be transferred to a hospital freezer or used.
Thawing Colostrum
To thaw frozen colostrum safely, the best method is placing the syringe in the refrigerator overnight. A quicker alternative is holding the container under lukewarm running water until the colostrum has melted. Never use a microwave to thaw or warm the colostrum, as this destroys immunological components and risks uneven heating. Once thawed, the colostrum must be used within 24 hours and should not be refrozen.