Colostrum, often called “liquid gold,” is the first milk produced during pregnancy and postpartum. Its unique properties provide a head start for newborns. Antenatal colostrum expression involves pregnant individuals expressing and storing this early milk before their baby arrives. This aims to prepare for potential feeding challenges after birth.
The Importance of Colostrum
Colostrum is a thick, yellowish fluid produced by the breasts, starting around 16 weeks of pregnancy. It is highly concentrated and nutrient-dense, containing everything a newborn needs early in life. It is rich in proteins, vitamins, minerals, infection-fighting antibodies, and growth factors.
A primary function of colostrum is to provide passive immunity to the newborn. It contains white blood cells and immunoglobulins, such as sIgA, which coat the baby’s intestines and help protect against infections. Colostrum also acts as a natural laxative, aiding meconium passage and reducing jaundice risk. It also helps stabilize a newborn’s blood sugar.
Understanding Antenatal Colostrum Expression
Antenatal colostrum expression involves manually expressing small amounts of colostrum in the final weeks of pregnancy, starting around 36 weeks. This allows collection and storage of colostrum for the newborn, if needed. Hand expression is recommended over pumps for this stage, as colostrum is produced in small quantities and is thick.
Individuals may choose antenatal expression for various reasons. It is helpful if the baby is expected to have feeding problems, such as those with diabetes, cleft lip or palate, or neurological or cardiac conditions. Storing colostrum also provides a supply for anticipated low milk supply or if the baby needs separation from the parent after birth. This practice also familiarizes expectant parents with milk expression, building confidence for breastfeeding after delivery.
Dispelling the “Running Out” Myth
A common concern is whether expressing colostrum before birth will deplete future milk supply. This concern is unfounded; the body’s milk production system is not easily “run out.” Milk production is primarily governed by hormones and a supply-and-demand mechanism that fully activates after birth.
During pregnancy, hormones like estrogen and progesterone prepare the mammary glands for lactation, but they also suppress copious milk secretion. Colostrum production begins around 16 weeks, but it is a limited, hormonally-driven process, distinct from the larger volume production of mature milk.
Once the placenta is delivered, a rapid drop in pregnancy hormones, particularly progesterone, signals the body to produce larger quantities of milk. This shift, often referred to as milk “coming in,” typically occurs two to four days postpartum. Continued milk production is then largely regulated by how frequently and effectively milk is removed from the breasts. Therefore, antenatal colostrum expression does not negatively impact milk production after birth.
Key Considerations for Antenatal Expression
Consulting a healthcare provider is important before beginning antenatal colostrum expression. While generally considered safe for low-risk pregnancies, it is not suitable for everyone. Certain conditions may make antenatal expression inadvisable.
Contraindications include:
History of or risk for premature labor.
A short cervix.
A cervical suture.
Any bleeding during pregnancy.
Placenta previa.
Breast stimulation, even gentle hand expression, can potentially trigger uterine contractions due to the release of oxytocin. If any contractions or vaginal bleeding occur during expression, the individual should stop immediately and contact their healthcare provider. A healthcare professional can assess individual circumstances and provide guidance, ensuring the practice is safe for both the pregnant individual and the baby.