Colostrum is the first milk produced by the mammary glands, typically starting around the 16th week of pregnancy and continuing for the first few days after birth. This thick, often yellowish fluid is highly concentrated with immunoglobulins, proteins, and growth factors, serving as the newborn’s initial source of nutrition and immune protection. Antenatal colostrum expression involves manually extracting this first milk during the final weeks of pregnancy. The purpose of collecting colostrum is to ensure a small supply is available should feeding challenges arise after delivery. This practice is primarily accomplished through hand expression.
Why and When to Express Colostrum
The rationale for expressing colostrum antenatally centers on preparing for potential feeding difficulties or medical needs once the baby is born. Creating a small reserve can help prevent the need for formula supplementation if the baby struggles to latch or if the parent and infant are separated after delivery. The stored colostrum provides a readily available source of specialized nutrition, which is particularly beneficial for stabilizing a newborn’s blood sugar levels. Learning the skill of hand expression in advance can also increase confidence in feeding management during the early postpartum days.
The timing of when to begin antenatal expression is tied to safety, as breast stimulation can trigger the release of oxytocin, which promotes uterine contractions. To minimize the risk of initiating labor, healthcare providers recommend deferring the practice until after 37 weeks of gestation. It is necessary to consult with a midwife or physician before starting to ensure the pregnancy is categorized as low-risk and the timing is appropriate. While the amount collected antenatally is not an indicator of future milk supply, having even a few milliliters stored can prove significant for the newborn.
The Step-by-Step Manual Expression Technique
Successful manual expression begins with proper preparation, ensuring comfort and hygiene. Wash hands thoroughly with soap and water before starting and find a relaxed environment. Warmth from a shower or a warm compress can aid in milk release. Gently massage the breast tissue using light strokes from the chest wall down toward the nipple to stimulate milk flow.
Next, position the hand using a ‘C’ shape, with the thumb above the nipple and the index finger below, about two to three centimeters back from the areola. Press the fingers inward toward the chest wall, followed by a rhythmic compression of the thumb and index finger toward each other. This gentle squeeze-and-release action avoids sliding the fingers over the skin or pinching the nipple, which can cause discomfort or tissue damage.
Colostrum often appears as only a few small drops rather than a stream, which is normal. Collect these drops directly into a sterile container, such as a one-milliliter syringe or a small spoon. Once the flow slows or stops, rotate the hand position around the areola to stimulate other milk ducts. Repeat the process on the other breast, limiting the entire session to about five to ten minutes per breast.
Safe Handling and Storage of Expressed Colostrum
Once collected, immediate and appropriate handling is required to maintain the colostrum’s safety and nutritional integrity. Every container must be clearly labeled with the date and time of expression using a waterproof marker. The colostrum should be cooled promptly after collection, ideally placed in the back of the refrigerator where the temperature is most stable.
Freshly expressed colostrum can be safely stored in the refrigerator at 4°C (40°F) for up to four days. If building a freezer stash, transfer the colostrum to the freezer within 24 hours of collection. When stored at -18°C (0°F), colostrum maintains its quality for approximately six months. To prevent contamination or freezer burn, place the sealed containers inside a clean, sealable plastic bag.
Thawing must be done gradually to protect the sensitive immune components. The safest method is to move the frozen colostrum to the refrigerator overnight or place the container in a bowl of warm water. Never use a microwave to thaw or warm colostrum, as this destroys nutrients and creates dangerous hot spots. Once thawed, the milk must be used within 24 hours and should never be refrozen.
Medical Conditions and Safety Precautions
Antenatal colostrum expression is recommended for those with specific health conditions that may put the newborn at risk for feeding issues or low blood sugar. This includes any form of maternal diabetes, as these infants are prone to neonatal hypoglycemia immediately after birth. Other indications include a known diagnosis of cleft lip or palate, a planned early delivery such as an elective Caesarean section, or a history of insufficient milk production. Having a reserve of colostrum ready can stabilize the baby’s glucose levels and reduce the likelihood of formula usage.
Despite the benefits, certain conditions prohibit antenatal expression due to the risk of stimulating uterine activity. Women with a history of threatened or actual preterm labor, a short cervix, or vaginal bleeding should avoid breast stimulation completely. Conditions like placenta previa or having a cervical suture in place are also contraindications. If uterine cramping or contractions are felt while expressing, stop immediately and contact a healthcare provider. Consultation with a medical professional before beginning the practice is required.