What is Colostrum?

Colostrum is the first milk produced by your breasts from around 16 weeks of pregnancy and in the first few days after your baby is born. It is the ideal first food for your baby (have you heard of liquid gold?) and has high levels of antibodies which help to protect your baby from infections. Colostrum is easily digested by your baby and helps with the passage of meconium (your baby’s first bowel actions).

Why express colostrum during late pregnancy?

After consulting your obstetrician, if you are in late pregnancy most people can try expressing colostrum. For some people, there are situations which make it more likely that a baby might need extra milk in the first few days after birth and they will be recommended to try to collect some colostrum before their baby’s birth.

Expressing colostrum before birth might be suggested in the following situations:

• Women with diabetes or thyroid disease, multiple sclerosis, or other hormonal imbalances such as polycystic ovary syndrome.
• Women who have had breast surgery
• Women with a history of low milk supply.
• Women with a strong family history of dairy intolerance or inflammatory bowel disease (IBS).
• Babies with growth restrictions, or potentially over 4kg.
• Babies with a cleft lip and/or palate, down syndrome, heart problems.

It is great that after birth, this extra milk is the mother’s expressed colostrum. However, we want to set you up for success in your breastfeeding journey so it is important for you to know that for some people it might be difficult to express enough colostrum. If your baby needs extra milk and you don’t have stored colostrum, infant formula is available for substitution.

When antenatal expression of colostrum is not recommended

If you have decided to give antenatal expression a try, there are certain situations where antenatal expression may not be appropriate:

• You have a history of preterm labour.
• You are currently having problems with threatened preterm labour.
• You have a stitch in your cervix or are taking medication to prevent preterm labour.
• You have placenta praevia (low-lying placenta).
• You are pregnant with twins or triplets discuss this with your doctor or midwife first. You may still be able to express late in pregnancy.

A conversation with your Obstetrician, Midwife or Lactation Consultant matters more than anything you read online. They will walk you through your specific circumstances, potential risks, and whether antenatal colostrum collection is right for you. Every pregnancy is different, and guidance should be tailored to you.

When can I start expressing?

Check with your healthcare provider before you start but we recommend starting at around 36 weeks of pregnancy.

You can express each breast for 3 to 5 minutes, up to 2 to 3 times per day.

You may increase to a total of 5 to 10 minutes, three times per day. Hand express only, do not use a breast pump. It is important to STOP expressing immediately if you experience painful contractions.

Quick Tips to start expressing colostrum

1. Wash and dry your hands. Remove the syringe from its sterile packet – keep the packet to store the syringe in afterwards.
2. Gently stroke your breast, nipple and areola (the dark area around your nipple) to help your colostrum to flow.
3. Place your finger and thumb about 2 – 3 cm behind your nipple, on either side of your areola (dark area around your nipple).
4. Press your finger and thumb pads back towards your chest wall and gently squeeze them together into your breast tissue for about two seconds, then release the pressure.
5. Your fingers should be well back from your nipple. Do not squeeze or pinch your nipple. Repeat the action in a rhythmic way.
6. When your colostrum drips, start collecting it in the syringe.
7. When colostrum stops dripping, rotate the position of your fingers and thumb around your Areola and repeat the expressing action.
8. Swap to your other breast when the colostrum stops dripping. Use both breasts at least twice each session.

Storing colostrum

1. When finished expressing, put the syringe in the labelled packet into the fridge.
2. Colostrum can be collected 2 – 3 times on the same day and stored in the same syringe. Start a new syringe each day.
3. At the end of the collecting day place the syringe into a zip lock bag and place into the freezer. Label the bag with your name and date of birth.
4. Your frozen colostrum can be stored for three months in the freezer compartment of your fridge at 6 – 12 months in a deep freezer.
5. Bring your frozen colostrum into the hospital when you’re having your baby and hand it to your midwife, it will be placed in the refrigerator/freezer in the postnatal ward or special care nursery.
6. If your baby needs extra milk after birth, let the midwife or nurse caring for you and your baby know that you have stored colostrum in the freezer.
7. Colostrum also can be expressed into a clean, medicine cup or spoon and join up into a syringe for storage.

What if I can’t express any colostrum?

Some women are unable to express any colostrum before birth, colostrum is quite thick and sticky and production antenatally is for some just a few drips.

If collecting colostrum doesn’t work for you, this is not an indication of your breastfeeding ability!

If you haven’t heard it already, breastfeeding, from collecting colostrum, establishing your supply, nipple care, feeding schedule etc is all a learned skill. It takes education, support from your partner and healthcare team, as well as a lot of patience.

Antenatal colostrum expression is a tool, not a test. If it feels overwhelming or stressful, or you need some extra guidance, I see many people for antenatal consults to help you with antenatal colostrum expression and help to set you up for your breastfeeding journey.

Written by Midwife & IBCLC Lactation Consultant, Donna Gedye