Colostrum, often called “liquid gold,” is the first milk produced by the mammary glands, beginning around the middle of pregnancy. This highly concentrated substance is rich in protective antibodies, proteins, and growth factors, perfectly designed for a newborn’s initial needs. Antenatal expression, or colostrum harvesting, is the practice of manually collecting this early milk before birth to have a small reserve available for the baby after delivery. This proactive step can be especially helpful if the baby is expected to have feeding difficulties or if the mother’s milk supply may be delayed.
Establishing the Timeline for Antenatal Expression
Colostrum harvesting should not begin until late in the third trimester to minimize the risk of stimulating uterine activity. Most guidelines recommend starting the practice after reaching 36 or 37 weeks of gestation. This timing is a safety measure because breast stimulation releases oxytocin, a hormone that causes uterine contractions.
Delaying the start until this late stage is a precaution against preterm birth, even though the risk of inducing labor in a low-risk pregnancy is very small. The exact starting week should always be confirmed with a midwife or obstetrician, who can assess the individual’s pregnancy risk factors. Beginning the process in the final weeks allows time to become comfortable with the technique and build a small store without undue risk.
Practical Steps for Safe Colostrum Collection
Hand expression is the recommended method for antenatal collection, as the small, concentrated amounts of colostrum are difficult to collect using a breast pump. Preparation involves finding a comfortable, relaxed setting, which helps promote the flow of the milk-releasing hormone, oxytocin. Applying a warm compress to the breasts or expressing after a warm shower can also encourage the initial drops.
To begin, position the thumb and forefinger in a “C” shape a few centimeters back from the base of the nipple, ensuring placement is on the areola tissue. The technique involves pressing the fingers back toward the chest wall, then gently compressing and rolling them forward toward the nipple in a rhythmic motion. This action should not be painful; avoid any movement that causes discomfort or sliding over the skin.
As drops of colostrum appear, collect them immediately using a sterile 1-milliliter or 2-milliliter syringe. If the flow is more generous, a small, clean cup or spoon can be used, and the contents then drawn into the syringe. After expressing for a few minutes, rotate the finger position around the areola to ensure all milk ducts are drained effectively.
Guidelines for Storage and Usage
Immediately after collection, cap the syringe, label it with the date and time, and chill it in the refrigerator. Colostrum collected on the same day can be added to the same refrigerated syringe, provided the new addition is also chilled first. Once the final collection for the day is complete, or the syringe is full, it should be placed in the freezer for long-term storage.
Colostrum can be safely stored in a freezer at or below -18°C for up to six months. If stored in a refrigerator at 4°C or lower, it can be kept for up to eight days, though some guidelines recommend a shorter duration of 48 hours. When transporting the frozen syringes to the hospital, use an insulated bag or cooler with freezer packs to maintain the temperature.
Upon arrival, give the frozen colostrum to a healthcare provider for transfer to the hospital’s freezer storage. Once thawed, the colostrum must be used within 24 hours and should never be refrozen. The milk is typically administered to the newborn via a small syringe, spoon, or cup if the baby is unable to latch or requires a supplement, such as for low blood sugar.
Situations Where Harvesting Should Be Avoided
While antenatal expression is safe for most healthy pregnancies, specific medical conditions require avoiding the practice due to the risk of triggering uterine contractions. Individuals with a history of preterm labor, a short cervix, or a cervical suture should not attempt colostrum harvesting. These conditions indicate a heightened sensitivity to oxytocin release, which could stimulate the uterus prematurely.
Additionally, any pregnancy complicated by placenta previa or unexplained vaginal bleeding should avoid breast stimulation. Multiple gestations, such as twins or triplets, are also often considered a contraindication before 36 weeks due to the increased risk of early labor. It is necessary to discuss the process with a medical professional to ensure there are no specific health risks before starting collection.