Antenatal colostrum harvesting (ACH) is the practice of hand-expressing or gently pumping the first milk, known as colostrum, during the final weeks of pregnancy. This nutrient-dense substance is then stored for use after the baby’s birth, especially if immediate feeding support is needed. The main safety concern is that breast stimulation could cause uterine contractions, potentially triggering labor before the baby is ready. Because of this concern, anyone considering ACH should first discuss the practice with a healthcare provider.
Understanding the Safety Concerns of Uterine Stimulation
The safety concern regarding ACH stems from the release of oxytocin. Nipple stimulation triggers the release of oxytocin, the hormone responsible for uterine contractions during labor. While this link historically caused mixed advice, the current medical consensus supports the safety of ACH for low-risk pregnancies performed in the late third trimester.
The uterus’s sensitivity to oxytocin changes throughout pregnancy. Before the final weeks, the uterine muscle has significantly fewer oxytocin receptors, making it less sensitive to the hormone. Receptors increase rapidly only as the pregnancy nears term, which is why oxytocin is used to induce labor. This physiological difference means the small, temporary release of oxytocin from expressing colostrum is unlikely to initiate labor in a healthy pregnancy.
Medical guidelines advise that low-risk individuals can begin harvesting after 36 or 37 weeks of gestation. At this point, the pregnancy is near-term, and the risk of inducing true preterm labor is minimal. Mild Braxton Hicks contractions are common during expression. If contractions become regular, painful, or persist after stopping the session, the practice must cease immediately, and a healthcare provider should be contacted.
Who Benefits from Antenatal Colostrum Harvesting?
ACH is beneficial for populations where a newborn might require immediate supplementation after birth. The most common use is managing neonatal hypoglycemia (low blood sugar), a risk for babies born to mothers with pre-existing or gestational diabetes. Stored colostrum, high in sugars and nutrients, stabilizes the baby’s blood glucose levels, potentially avoiding formula or intravenous glucose.
Babies with certain congenital conditions also benefit from a colostrum reserve. Conditions such as cleft lip and palate, Down syndrome, or cardiac issues can make immediate latching difficult. A supply of harvested colostrum ensures the baby receives crucial immunologic and nutritional support while establishing breastfeeding.
Mothers planning an elective cesarean section often find ACH helpful, as scheduled births can delay mature milk production. Those with a history of delayed milk supply or poor breastfeeding outcomes also gain a nutritional backup. Having colostrum readily available prevents the need for artificial milk supplementation, supporting the recommendation to exclusively feed human milk when possible.
The Proper Technique for Expression and Storage
Hand expression is the most recommended method for antenatal colostrum harvesting, rather than using an electric breast pump. Hand expression provides more gentle stimulation, which is thought to reduce uterine stimulation compared to a pump’s stronger vacuum. Colostrum is produced in very small, concentrated amounts—often just drops—making it easier to collect by hand than with a pump, where the sticky milk adheres to the parts.
To begin, a gentle breast massage can encourage milk flow. The technique involves forming a “C” shape with the thumb and forefinger a few centimeters behind the nipple base. Gently press the fingers straight back toward the chest wall and roll them forward toward the nipple without sliding across the skin. Repeat this process rhythmically around the entire areola.
Sessions are typically short, starting with 5 to 10 minutes on each breast, performed one to two times daily. Collect the colostrum, which may appear clear, yellow, or orange, directly into a sterile syringe or a small, clean container. Syringes are preferred because they allow for easy, hygienic storage and administration.
Once collected, label the syringe clearly with the date and time of expression. Colostrum can be collected into the same syringe over a 24-hour period, storing it in the refrigerator between collections. After the 24-hour window, the colostrum should be frozen at -18 degrees Celsius or lower, where it can be safely stored for up to six months. When transporting the frozen colostrum to the hospital, keep it in an insulated bag with freezer packs to maintain its frozen state.
Medical Conditions That Prohibit Harvesting
ACH is generally safe for low-risk pregnancies, but several medical conditions are strict contraindications due to the heightened risk of oxytocin-induced labor. Any condition that increases the risk of preterm labor prohibits nipple stimulation.
Conditions that prohibit ACH include:
- A history of previous preterm labor, a shortened cervix, or cervical incompetence.
- Placenta previa, where the placenta partially or fully covers the cervix.
- Unexplained vaginal bleeding in the current pregnancy.
- Severe preeclampsia or high blood pressure that is difficult to manage.
- Multiple gestation pregnancies (twins, triplets, etc.), which may be considered high-risk.
Conditions affecting the placenta and uterus, such as placenta previa or unexplained bleeding, carry an elevated risk of placental abruption or hemorrhage, which could be exacerbated by uterine contractions. For anyone with a high-risk pregnancy, the temporary release of oxytocin is viewed as an unacceptable risk.