Antenatal expression involves gently collecting small amounts of colostrum, the first milk, before the baby’s birth. This practice is most often recommended to create a reserve supply of colostrum, which is highly concentrated with nutrients and immune factors. Storing this “liquid gold” ensures it is available immediately after delivery, especially if the newborn has feeding challenges or requires supplemental feedings. While the practice can be beneficial, it is important to proceed with caution and always seek medical clearance from a healthcare provider before beginning.
When to Start Antenatal Pumping
The timing for antenatal expression is guided by the need to avoid stimulating uterine contractions before the pregnancy is full-term. Medical consensus generally recommends starting this practice no earlier than 36 or 37 weeks of gestation. Waiting until this late stage minimizes the theoretical risk of inducing premature labor.
The primary physiological concern is that nipple stimulation triggers the release of oxytocin, a hormone that causes the uterus to contract. Although the amount of oxytocin released during gentle expression is usually minor, the body becomes more sensitive to its effects as the due date approaches, which is why starting too early is discouraged and medical consultation is mandatory.
Before beginning, a pregnant individual must discuss the plan with their obstetrician or midwife to review their medical history and ensure there are no underlying complications that would make the practice unsafe. If a person experiences cramping or contractions during an expression session, they should stop immediately and contact their healthcare provider for guidance.
Starting with short, gentle sessions, such as one or two five-minute periods per day, is the advised approach. The goal is to gradually stimulate the breasts without overdoing it, slowly building up the frequency and duration over the final weeks of pregnancy. Even small amounts collected are valuable, and the ability to express colostrum does not predict a person’s overall milk supply after birth.
Medical Conditions That Prohibit Pumping
While antenatal expression is generally safe for low-risk pregnancies after 37 weeks, certain high-risk medical conditions prohibit the practice due to the potential for uterine stimulation. The main concern is that the oxytocin released could trigger preterm labor in a vulnerable pregnancy. Individuals with a history of preterm labor or who have been diagnosed with threatened premature labor should not engage in antenatal expression.
The practice is also advised against for those with placenta previa (low-lying placenta) or any history of unexplained vaginal bleeding. Other contraindications include having a cervical suture (stitch) or being diagnosed with a short cervix. These conditions indicate a heightened risk where any stimulation that could lead to contractions must be avoided entirely.
Pumping is also not recommended in cases of high-risk multiple pregnancies, especially before 36 weeks gestation. Any person with preeclampsia or other conditions that require close medical monitoring should only attempt expression under the advice of their specialist healthcare team. Safety is the primary consideration, and the risks associated with premature birth far outweigh the benefits of a colostrum store.
Practical Guide to Colostrum Collection and Storage
Once medical clearance is secured, hand expression is the preferred initial method for colostrum collection over an electric pump. Colostrum is thick and produced in very small volumes, making it difficult to collect with standard pumping equipment. Hand expression allows for direct collection of the small drops and provides less intense stimulation to the breast tissue.
To hand express, one should wash their hands thoroughly and massage the breast gently, working from the outer edges towards the areola. The technique involves placing the thumb and forefinger in a “C” shape a few centimeters behind the areola, pressing back toward the chest wall, and then gently compressing to coax the colostrum out. The few drops or small stream produced should be collected directly into a sterile container, such as a 1ml or 3ml syringe.
It is acceptable to use the same sterile syringe to collect colostrum over a 24-hour period, provided the syringe is capped and stored in the refrigerator between sessions. For long-term storage, the collected colostrum must be clearly labeled with the date and time, placed in a freezer bag, and moved to a freezer at -18°C or lower. Colostrum frozen immediately after collection can be safely stored for up to six months. When transporting the frozen supply to the hospital, it should be kept frozen in a cooler bag with ice packs.