Colostrum is the first milk produced by the human body, a concentrated, yellowish fluid often described as “liquid gold” due to its rich composition. This potent substance is produced as early as the second trimester, around the 16th week of pregnancy, and is perfectly tailored to a newborn’s initial needs. Antenatal colostrum harvesting involves the gentle expression and collection of this milk before the baby’s birth. This practice allows expecting parents to store a supply of the nutrient-dense fluid for potential use in the baby’s first days of life.
Determining the Safe Time to Begin
Nipple stimulation releases the hormone oxytocin, which is the same hormone responsible for triggering uterine contractions during labor. For this reason, healthcare providers generally recommend that individuals with a low-risk pregnancy wait until reaching 36 to 37 weeks of gestation before beginning the practice.
If painful uterine contractions occur, stop expressing immediately. Certain medical conditions make antenatal expression inadvisable and should be discussed with a doctor or midwife before starting. Contraindications include:
- A history of premature labor.
- Having a cervical suture in place.
- Unexplained vaginal bleeding during the current pregnancy.
- A diagnosis of placenta previa.
Consulting a healthcare provider ensures the practice is appropriate for the individual’s specific health circumstances.
Step-by-Step Guide to Hand Expression
The technique of hand expression is preferred over using a pump for colostrum because the milk is produced in small, thick droplets rather than a flow. Begin by washing hands thoroughly with soap and water and finding a comfortable, relaxed position to encourage the milk-releasing reflex. A gentle breast massage, working from the outer breast toward the nipple, can further stimulate the flow of colostrum.
To begin the expression, form a “C” shape with your thumb and forefinger and place them about one to two inches back from the base of the nipple, just outside the areola. Press your fingers straight back toward your chest wall, then gently compress the tissue between your thumb and forefinger in a rhythmic motion. This compression should not cause pain, and it is important to avoid sliding your fingers across the skin, which can cause irritation.
Initial sessions should be short, perhaps five to ten minutes total, alternating between both breasts once the flow slows down or stops. You may only see a glistening or a few tiny drops at first, which is completely normal for colostrum. Collect the small droplets directly into a sterile, one-milliliter syringe or a sterile cup, rotating the position of your fingers around the areola to ensure all milk ducts are stimulated. Aim for one or two sessions per day when first starting out, gradually increasing the frequency if desired.
Utility of Antenatal Colostrum Harvesting
The primary motivation for harvesting colostrum before delivery is to have a readily available supply, particularly if there are concerns about the newborn’s early feeding needs. Expressed colostrum helps stabilize blood glucose levels for babies at risk of low blood sugar, such as those born to parents with pre-existing or gestational diabetes. Having a stored supply allows for quick intervention with the parent’s own milk, potentially avoiding the need for formula supplementation.
Pre-collecting colostrum is also beneficial for individuals who have a known risk factor for delayed onset of mature milk production, or for babies with certain medical conditions. For example, a history of breast surgery or a planned elective cesarean delivery may sometimes delay the “milk coming in.” Babies with congenital conditions like a cleft lip or palate may have difficulty latching initially, making the concentrated nutrition from a syringe of colostrum useful. Practicing the hand expression technique also serves as preparation, building confidence and familiarity with the process.
Safe Handling and Storage Protocols
Maintaining the safety and viability of the collected colostrum requires strict adherence to handling and storage guidelines. After expression, the colostrum should be collected in sterile, food-grade containers, with 1-milliliter syringes being the most common choice due to the small volume. Each collected syringe or container must be clearly labeled with the parent’s name, the date, and the exact time of expression.
Freshly expressed colostrum can be kept at room temperature for up to four hours, or it can be refrigerated at a temperature of 40°F (4°C) or lower for up to four days. If you plan to add to the same container over a period of hours, the new colostrum should be chilled first before being combined with the previously refrigerated milk.
For long-term storage, the colostrum should be frozen as soon as possible. It can be stored for up to six months in a deep freezer, or about three months in the freezer section of a refrigerator with a separate door. When the time comes for delivery, the frozen colostrum should be transported to the birthing center in an insulated cooler bag with a frozen ice brick. Once thawed, the colostrum must be used within 24 hours and should never be refrozen.