Colostrum is the initial form of milk produced by the mammary glands, often appearing thick, yellowish, or sometimes clear. This “first milk” is densely packed with concentrated nutrients, antibodies, and immune factors crucial for a newborn’s development and protection. Colostrum is higher in protein and lower in fat and lactose compared to mature milk, making it perfectly suited for the baby’s developing digestive system. It contains immunoglobulins, such as IgA, which coat the infant’s intestinal lining, providing a protective barrier against infection. Antenatal collection involves expressing and storing this milk before birth to ensure it is readily available to support early feeding.
Indications for Antenatal Colostrum Collection
Antenatal colostrum collection is suggested when there is a known risk that the newborn might require supplemental feeding immediately after birth. A common reason is maternal diabetes (Type 1, Type 2, or gestational). Babies born to mothers with diabetes can experience neonatal hypoglycemia, and the mother’s own colostrum helps stabilize these low blood sugar levels quickly.
Stored colostrum is also beneficial if the infant has a congenital condition that interferes with early latching or feeding. This includes conditions like a cleft lip or palate, Down syndrome, or certain cardiac or neurological issues. If the baby cannot feed effectively at the breast right away, colostrum can be given via an alternative method. Collection is also strategic for those with a history of low milk supply or previous difficult breastfeeding experiences. Furthermore, if delivery is planned early, such as a scheduled cesarean section or induction before 38 weeks, having a supply ensures the baby receives protective benefits without delay.
Determining the Safe Timeline for Collection
The timeline for antenatal colostrum expression balances preparation with safety, primarily to avoid stimulating premature labor. Healthcare providers generally advise that collection should only commence around 36 to 37 weeks of gestation for those with low-risk pregnancies. This timing is chosen because nipple stimulation triggers the release of oxytocin, a hormone that causes uterine contractions.
Medical Consultation and Contraindications
It is necessary for any pregnant individual to consult with their midwife or obstetrician before beginning the process. This consultation ensures a thorough review of the pregnancy history and current health status. Antenatal expression is generally not recommended in high-risk pregnancies or if there is a history of preterm labor. Contraindications include known conditions like placenta previa, cervical incompetence, or a cervical stitch.
Initially, sessions should be short, perhaps once or twice a day for only a few minutes. Gradually increase the frequency if the process is well-tolerated and medically approved. If painful contractions occur during expression, stop immediately and contact a healthcare provider for advice.
The Process of Hand Expression and Storage
Hand expression is the recommended method for antenatal collection because colostrum is produced in very small volumes, making a breast pump inefficient. To encourage flow, try applying a warm compress or expressing after a warm shower. The technique involves gently massaging the breast, then forming a “C” shape with the thumb and forefinger a few centimeters behind the areola.
Press the thumb and finger back toward the chest wall, followed by a gentle compression and release motion, to push the colostrum out. The process should not cause pain, and fingers should be rotated around the areola to access different ducts. The collected colostrum, which may appear only as small drops, is best drawn up directly into small, sterile syringes, typically 1ml or 3ml in size.
Storage Guidelines
Each syringe must be clearly labeled with the date and time of expression. Colostrum collected throughout the day can be added to the same syringe, which should be stored in the refrigerator between sessions. At the end of a 24-hour period, seal the syringe in a zip-lock bag and move it to the freezer. Colostrum can be stored in a deep freezer at -18 degrees Celsius or lower for up to six months. When transporting the frozen supply to the hospital, keep it in a small cooler bag with ice packs to ensure it remains frozen.