Prenatal Colostrum Expression

What is colostrum?
Perhaps you have begun to leak small amounts of “colostrum” during pregnancy or maybe not. Colostrum is the “early milk” that a pregnant body begins to produce around the twentieth week and up until the first three or four days after a baby is born.

• It can be dark yellow or clear or any colour in between.
• It varies in consistency but is often quite thick and somewhat sticky.
• It is produced in very small amounts (between 5-15 mL/feeding).
• It is nutritionally dense, full of antibodies that help to protect your baby from disease.
• It helps baby to pass the meconium (baby’s first poop) which in turn, helps to prevent jaundice.

This makes it the perfect food for babies’ tiny tummies in the early days. This early milk slowly transitions to more mature milk, which is produced in much greater volumes, when the “milk comes in” between days 3-5.

Reasons to give baby prenatally-expressed colostrum

• Babies who are experiencing low blood sugar could be given colostrum that was expressed prenatally instead of formula. This could be particularly helpful for those with gestational or chronic diabetes because their babies often experience low blood sugar after birth. Babies of mothers with diabetes often experience low blood sugar after birth.
• If there is a delay in the mature milk “coming in”, your baby can be given this saved, expressed colostrum. You can also express colostrum postnatally to give to your baby. This can be helpful if you have diabetes, a history of breast reduction surgery, are recovering from a difficult birth or have other medical conditions.
• If your baby is a bit sleepy in the early days after birth and is having trouble breastfeeding effectively, your baby could also develop low blood sugar. Having expressed colostrum available, in addition to the colostrum that you produce postnatally, can help you avoid supplementation with formula.
• If your baby has a cleft lip or palate, or some other condition that makes breastfeeding difficult, having stored colostrum can be helpful.
• This can also be helpful if you and your baby need to be separated for any reason.

Getting ready

• Most women with low-risk pregnancies can begin hand-expression at 37 weeks, unless advised not to by their doctors or midwives.
• Begin by watching this excellent video.

Gathering your supplies
You will need:

• A clean cup to express the colostrum into.
• Several small 3-5 mL syringes (which you can purchase at a pharmacy or medical supply store) or clean storage containers, like small canning jars with lids.
• A clean plastic freezer bag for storing the syringes.

Getting started

• Wash your hands.
• Find somewhere comfortable to sit. Gently massage your breasts for around 30 seconds or so.
• Begin by lifting your breast slightly and placing your fingers and thumb in a “C” shape about 5 cm (2 inches) away from your nipple. Gently press your fingers and thumb back towards your chest wall, like you wanted to touch your ribs.
• Gently compress your fingers and thumb together being careful to not slide your fingers toward the nipple or pull on the skin. A small piece of medical tape placed on your breasts can help remind you where your fingers should be.
• Relax your fingers.
• Check that your fingers are still in the starting “C” position and then repeat the process: Press (back to the chest wall), Compress (bringing fingers gently together), Relax.
• You can try moving the tape markers around the breast, so you are expressing from different parts of the breast, maintaining the “C” position.
• Don’t expect to see any drops at all for several seconds.
• When the colostrum starts to flow, begin collecting it into the clean cup or directly into the syringe, if the opening is large enough.
• Begin with 3 to 5 minutes of expression on each breast, two to three times per day, expressing from each breast at least twice. You can also go back and forth between breasts many times throughout the 3 to 5 minutes. If you feel any cramping or contractions stop immediately.

Storing the colostrum

• Any colostrum collected during the same day can be stored in the same syringe, up to a maximum of 5 mls or so. Most babies in the early days only eat 5-15 mls at a feeding. You don’t want to have to throw out colostrum that your baby doesn’t eat, so it is helpful to store it in 5 ml portions. Place the syringe in the refrigerator between expression sessions. At the end of the day, put the syringe in a clean plastic freezer bag and place it in the freezer.
• If you don’t have any syringes on hand the colostrum can be stored in a clean, sealed container in the freezer, like a small canning jar with a lid. The milk can be thawed and fed to your baby with a tiny spoon, syringe or medi-cup when the time comes.
• Be sure to label the syringes or containers with the date, time of the first expression, and your initials. The colostrum can be stored in the freezer for 4 to 6 months.

Taking your colostrum with you

• When it comes time for your baby to be born, take the colostrum with you to the hospital (or birthing place). Transport it in a cooler surrounded by ice packs to keep it cold.
• Only take two or three syringes with you. You can always ask someone to bring you more if you need them. You don’t want them to thaw if they are not needed. Any thawed syringes need to be used within 24 hours and you don’t want your hard work to go to waste. The jars or syringes can be thawed quite quickly by placing them in lukewarm water.

Having some of your own colostrum to feed your baby in the early days or even just beginning to practice hand-expression in pregnancy can help you to feel prepared to get breastfeeding off to a good start.

Updated 2023