Many expectant parents consider antenatal expressing, also known as colostrum harvesting, as they approach their due date. This practice involves collecting small amounts of colostrum, the initial breast milk, before childbirth. Deciding whether to engage in this activity involves understanding its purpose and potential advantages, always in consultation with healthcare providers.
Understanding Antenatal Expressing
Antenatal expressing is the gentle hand expression of colostrum from the breasts during the last weeks of pregnancy. Colostrum, often called “liquid gold,” is a yellowish, thick fluid rich in nutrients and antibodies essential for a newborn’s initial days.
The primary goal of this practice is to collect and store colostrum for the baby’s first feeds, not to establish a full milk supply. Colostrum helps stabilize a baby’s blood glucose levels and acts as a laxative to aid in the passing of meconium, the baby’s first stool. While the body begins producing colostrum around 16 weeks of pregnancy, expressing it antenatally does not impact the eventual mature milk supply after birth.
Why Consider Expressing Before Birth
Antenatal expressing can be a supportive measure when a baby might face feeding challenges or require extra nourishment shortly after birth. For instance, it can help stabilize a baby’s blood sugar levels if the parent has gestational diabetes, reducing the need for formula supplementation due to the baby’s increased risk of low blood sugar.
It is also beneficial if parent-baby separation is anticipated, such as for NICU admission, ensuring the baby receives colostrum even if direct feeding isn’t immediately possible. Babies with certain congenital conditions, like a cleft lip or palate, or those identified with intrauterine growth restriction, may also benefit from a pre-collected colostrum supply.
Individuals with a history of low milk supply or previous breast surgery might consider antenatal expressing to gain confidence in their ability to produce milk and learn hand expression techniques. Stored colostrum provides reassurance, offering a backup if initial latching difficulties occur or if supplementation is needed without formula. This preparation also builds familiarity with milk expression.
Essential Safety Precautions
Antenatal expressing should only be undertaken after a thorough discussion with a healthcare provider, such as a doctor or midwife. Nipple stimulation can sometimes trigger uterine contractions. While this is generally not enough to induce labor in uncomplicated pregnancies, medical clearance is necessary to ensure safety.
There are specific situations where antenatal expressing is generally not recommended or requires careful medical oversight. These include:
A history of preterm labor
A shortened cervix or cervical incompetence
Placenta previa
Any vaginal bleeding during pregnancy
A cervical suture
For individuals carrying multiple pregnancies, such as twins or triplets, antenatal expressing may be considered on a case-by-case basis, often with a slightly earlier start time than single pregnancies. However, this still requires specific guidance from a healthcare professional due to the increased risk of early birth. It is important to stop expressing immediately and contact a healthcare provider if any cramping or signs of uterine activity occur.
Practical Steps for Antenatal Expressing
If a healthcare provider has cleared antenatal expressing, it typically begins around 36 to 37 weeks of gestation. Hand expression is the recommended method for collecting colostrum, as it is more effective for small, concentrated amounts than a breast pump, which can cause colostrum to stick to parts.
To hand express, begin by washing hands thoroughly. Find a comfortable, relaxed position, and gently massage the breast, working from the outer parts towards the nipple. Position the thumb and forefinger in a “C” shape about 2-3 cm from the nipple base. Gently press inwards towards the chest wall, then compress the fingers and thumb together, releasing and repeating in a rhythmic motion. Avoid sliding fingers over the skin to prevent discomfort.
Initially, only a few drops may appear, which is normal. Collect these drops into a sterile syringe, often 1ml or 2ml in size. Express for short periods, typically 5-10 minutes per breast, once or twice a day, gradually increasing frequency if comfortable. After collection, label each syringe with the date and time of expression.
Colostrum can be stored in the refrigerator for up to 24 hours (allowing additions to the same syringe during this period) before being frozen for up to six months. When transporting frozen colostrum to the hospital, use an insulated bag with ice packs to ensure it remains frozen.