Antenatal colostrum harvesting (ACH) is the process of manually collecting and storing the first milk, known as colostrum, during the final weeks of pregnancy. This practice involves hand-expressing the concentrated, nutrient-rich fluid before childbirth. The primary goal is to establish a reserve supply of colostrum that can be used to supplement the newborn after delivery if feeding challenges arise. This proactive measure supports the infant’s initial nutritional and immunological needs. This article will explore the natural biological process that makes this possible and detail the techniques and safety precautions involved in harvesting.
The Natural Process of Colostrum Production
The ability of the breasts to produce colostrum begins relatively early in pregnancy, a process known as Lactogenesis I. This stage is initiated by hormonal changes that start preparing the mammary glands, typically around the 16th to 20th week of gestation. The hormone prolactin stimulates the milk-producing cells, called lactocytes, to begin synthesizing colostrum.
However, high levels of progesterone circulating throughout pregnancy act as an inhibitory brake on the system. Progesterone prevents the full onset of copious milk production, ensuring that only small quantities of colostrum accumulate within the ducts and alveoli. Colostrum itself is a thick, yellowish fluid that is uniquely rich in immunoglobulins, particularly IgA antibodies, and growth factors, making it an ideal first food. The sudden drop in progesterone following the delivery of the placenta is the biological trigger that signals the body to transition to Lactogenesis II, the “coming in” of mature milk.
Techniques for Antenatal Colostrum Harvesting
The method for antenatal colostrum harvesting is manual expression, which is recommended over using a breast pump due to the thick, small volume nature of colostrum. A common time to start is around 36 to 37 weeks of pregnancy, but only after receiving clearance from a healthcare provider. Begin by ensuring your hands are thoroughly washed and choosing a comfortable, relaxed environment to help facilitate milk flow.
To perform the expression, place your thumb and forefinger in a “C” shape a few centimeters back from the base of the nipple. Gently compress the breast tissue toward your chest wall, then roll your fingers forward, squeezing the tissue to encourage drops of colostrum to appear. Avoid squeezing the nipple itself, as this can cause discomfort. Initially, express for just a few minutes once a day, gradually increasing the frequency to two or three times a day for short intervals of three to five minutes on each breast.
The collected colostrum should be drawn directly into small, sterile syringes (typically 1 milliliter or 3 milliliter sizes). Once collected, the syringe must be labeled immediately with your name, the date, and the time of expression. Colostrum can be stored in the refrigerator for up to 48 hours before freezing, or it can be placed directly into a freezer at -18°C or lower for up to six months. When transporting frozen colostrum to the hospital, it must be kept in a cool bag with ice packs to maintain its frozen state.
Safety and Medical Guidance
Antenatal colostrum harvesting requires mandatory medical consultation before beginning, as it is not appropriate for all pregnancies. The primary safety concern is the potential link between nipple stimulation and the release of oxytocin. Oxytocin is responsible for the milk ejection reflex but also plays a role in stimulating uterine contractions.
For most low-risk pregnancies after 37 weeks, gentle expression is considered safe, but it is strictly contraindicated in specific high-risk situations. These contraindications include a history of premature labor, a diagnosis of placenta previa, or having a cervical stitch in place. If you feel any uterine cramping or contractions while expressing, stop immediately and contact your medical team for advice.
A healthcare provider may recommend antenatal harvesting if a baby is anticipated to have early feeding difficulties or blood sugar regulation issues, such as in cases of gestational diabetes. It is also helpful for mothers planning a cesarean section or those with a known history of low milk supply. Medical guidance ensures that the benefits of having a colostrum reserve outweigh any potential risks to the pregnancy.