Antenatal expression, or colostrum harvesting, is the practice of gently collecting colostrum from the breasts before the baby is born. Colostrum is a thick, concentrated fluid rich in antibodies and nutrients that the body begins producing around the second trimester of pregnancy. Expectant parents often consider this process to have a supply available immediately after birth. Because nipple stimulation can affect the uterus, this practice requires careful consultation and guidance from a healthcare provider before beginning.
Why Consider Antenatal Expression
The primary motivation for collecting colostrum before delivery is to secure a supply for newborns who may face early feeding challenges. For example, infants whose birthing parent has diabetes are at an increased risk of developing low blood sugar levels immediately after birth, necessitating quick supplementation. Having pre-collected colostrum available can help stabilize the baby’s blood glucose without resorting to formula.
This banked milk is also beneficial for babies diagnosed with congenital conditions like a cleft palate or heart condition, or those who are small for their gestational age. Stored colostrum ensures the baby receives concentrated nutrients and immune factors even if they struggle to latch or require immediate separation from the parent. Antenatal expression also provides an opportunity for the parent to practice hand expression techniques before the postpartum period. This familiarity can build confidence and potentially promote successful feeding.
The Critical Timing Window for Safety
The most important consideration for antenatal expression is the timing, which directly relates to the safety of the pregnancy. Medical consensus advises that this practice is safe only once a pregnancy reaches full term, typically after 37 completed weeks of gestation. Starting earlier carries a risk because nipple stimulation causes the release of the hormone oxytocin.
Oxytocin is the natural hormone responsible for causing uterine contractions and initiating labor. While the stimulation from expression is usually not sufficient to trigger preterm labor in a low-risk pregnancy, the potential for uterine activity requires caution. Individuals who notice painful contractions, uterine cramping, or vaginal bleeding while expressing must stop immediately and contact their healthcare provider for advice.
For the general healthy population, guidelines suggest starting with short sessions, such as once or twice a day. The recommended duration is typically three to five minutes on each breast, gradually increasing the frequency as comfort allows. It is normal to collect only a few drops or nothing at all during the initial attempts, and this small volume is still valuable for a newborn’s first feeds.
When Pumping is Medically Contraindicated
Despite the benefits, antenatal expression is not recommended for all pregnant individuals, particularly those with high-risk factors. The practice is contraindicated if there is a history of threatened or actual premature labor in the current or previous pregnancies. Any condition that increases the risk of early delivery means the release of oxytocin, even in small amounts, should be avoided due to its effect on the uterus.
High-Risk Conditions
Individuals diagnosed with placenta previa, or those who have experienced unexplained vaginal bleeding during the pregnancy should not attempt expression. Other contraindications include a short cervix, cervical insufficiency, or carrying multiple babies. Certain medical conditions, such as pre-eclampsia or taking specific medications for high blood pressure, also necessitate avoiding antenatal expression. It is necessary to consult with a healthcare provider before starting to confirm that no underlying conditions make antenatal expression unsafe.
Practical Steps for Colostrum Collection and Storage
Once a healthcare provider has cleared the practice, the focus shifts to the logistics of collection and preservation. Hand expression is the preferred method for collecting colostrum before birth because the thick, concentrated nature of the milk makes electric pumps inefficient. Hand expression ensures that every drop is collected directly into the storage container.
The most common collection tool is a small, sterile syringe, typically 1 milliliter in volume. The syringe allows for easy collection of the tiny droplets and serves as the immediate storage vessel. Colostrum can be collected over multiple short sessions in the same syringe within a 24-hour period, provided the syringe is kept refrigerated between uses.
Storage Guidelines
Freshly expressed colostrum can be stored in the refrigerator at 4°C (40°F) for up to four days. After the final collection for the day, the syringe must be clearly labeled with the date and time, sealed in a plastic bag, and immediately placed in the freezer.
- Colostrum should be stored in the back of the freezer where the temperature is most consistent, rather than in the door compartments.
- Frozen colostrum can be stored in a standard freezer for up to six months at 0°F (-18°C) or colder.
- It can be stored for up to twelve months in a deep freezer.
- When transporting the supply to the hospital, it should be kept frozen in an insulated bag with ice packs.
- Hospital staff must be notified immediately for proper cold storage upon arrival.