Colostrum, often referred to as “liquid gold,” is the first form of milk produced by the mammary glands, typically beginning around the 16th week of pregnancy. This thick, yellowish, and highly concentrated fluid is perfectly balanced to meet a newborn’s initial needs, providing a dense source of energy, protein, and infection-fighting antibodies. Antenatal expression is the practice of collecting this colostrum by hand during the final weeks of pregnancy and safely storing it for use after the baby is born. While not universally necessary, it can be helpful if early feeding difficulties are anticipated. Before beginning, discuss the practice with a healthcare provider, such as a doctor or midwife, to confirm it is safe for your individual pregnancy.
Recommended Timing for Antenatal Expression
The most commonly accepted safe window to begin antenatal colostrum expression is from 36 or 37 completed weeks of gestation onward. This timing is chosen to balance the desire to collect a supply with the safety of the pregnancy. Starting at 36 weeks minimizes the risk of stimulating uterine contractions that could lead to premature labor.
The goal of this early expression is not to collect a large volume, but rather to gather a small reserve and practice the skill of hand expression. Start gently, expressing for just a few minutes once a day, and gradually increase the frequency to two or three times daily as you approach your due date. Gaining medical clearance is necessary before starting.
Medical Reasons to Express Colostrum
Antenatal expression is recommended when a newborn is at an increased risk of needing supplemental feeds shortly after birth. The most common reason is for mothers who have pre-existing or gestational diabetes. Babies born to diabetic mothers can experience low blood sugar levels (hypoglycemia) soon after birth, and a colostrum reserve can help stabilize their blood glucose without needing formula.
Another group that benefits includes babies anticipated to have early feeding challenges, such as those with a known cleft lip or palate, or congenital conditions like Down syndrome. Stored colostrum is also beneficial if an early delivery is planned (e.g., scheduled cesarean section or induction), or if the baby is diagnosed with intrauterine growth restriction. Having a supply ready ensures the baby receives the immunological and nutritional benefits of your milk, especially if separation from the mother is necessary after birth.
Crucial Safety Precautions and When to Avoid Expression
The primary safety concern with antenatal expression is the potential for stimulating uterine activity, as nipple stimulation releases the hormone oxytocin. Oxytocin triggers uterine contractions and is used to induce labor. Although the amount released from gentle hand expression is generally insufficient to start labor in a healthy pregnancy, caution is necessary.
Absolute Contraindications
Antenatal expression should be avoided completely if you have:
- A history of premature labor.
- A diagnosis of placenta previa.
- A cervical suture in place.
- Any bleeding during the current pregnancy.
- A high-risk pregnancy designation.
If you begin expressing and notice painful, regular uterine cramping or any vaginal bleeding, stop immediately and contact your healthcare provider for guidance.
Techniques for Collection and Safe Storage
Hand expression is the preferred method for collecting colostrum antenatally, rather than using an electric or manual breast pump. Colostrum is produced in very small, concentrated amounts—often just a few drops. Its thick, sticky consistency means it easily gets lost in the tubing and parts of a pump. Hand expression ensures every valuable drop is collected and is generally a more comfortable process.
To collect, wash your hands thoroughly and find a comfortable position. Gently massage the breast, then use a “C” shape with your thumb and forefinger a few centimeters behind the nipple. Press back toward your chest and then compress the fingers together. The drops should be collected directly into a sterile syringe, often provided by your midwife.
Label the syringe immediately with the date and time of expression before placing it in a clean plastic bag and transferring it to the freezer. Frozen colostrum can be stored for up to six months. When transporting it to the hospital for the birth, keep it frozen in an insulated bag with ice packs.