Antenatal expression of colostrum

What is colostrum?

Your breasts produce their first milk, known as colostrum, from around 16 weeks of pregnancy until the first few days after birth.

Colostrum is a thick, sticky, yellowish liquid. It can leak from your breasts onto the nipples and form yellow crusts. If this happens, you may feel the need to wear absorbent nursing pads.

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Colostrum is high in antibodies and other protective substances that help to support your newborn baby’s immunity. Although only a small amount of colostrum is produced, it is very high in energy, protein and fat. Colostrum is also easy for newborns to digest.

When does colostrum appear?

It’s not always obvious that colostrum is being produced until you check, but you may notice that you are making colostrum from around 16 weeks of pregnancy until the first few days after birth.

What are the benefits of expressing colostrum in pregnancy?

There can be benefits to expressing and storing colostrum during pregnancy in case your baby needs it after birth. This might happen if, for example, your baby is at risk of experiencing feeding problems.

The potential benefits of expressing during pregnancy include:

• helping to support successful breastfeeding after birth — people who express are generally motivated to do all they can to increase their chances of exclusively breastfeeding their baby
• building a supply of colostrum is useful in case your baby needs extra feeds and allows you to avoid offering formula top-ups
• managing potential feeding problems relating to a congenital condition
• managing feeds for your baby if you have diabetes, which increase the risk of your baby having problems maintaining a normal blood sugar level
• having a store of colostrum if your baby is likely to need special care and may be separated from you, preventing you from breastfeeding regularly

Why might I have a low supply of breast milk?

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Sometimes there are reasons your breasts may not produce as much milk as your baby needs. Storing a small supply of colostrum means the baby can have access to extra kilojoules (energy). These reasons include:

• a history of breast surgery
• some medical conditions, such as multiple sclerosis or polycystic ovarian syndrome
• taking certain medicines
• smoking
• a history of having low milk supply

Are there any reasons I shouldn’t express colostrum during pregnancy?

Although there are benefits in expressing colostrum during pregnancy, there are times when it’s not recommended. There is a risk that stimulating the breasts may trigger premature labour.

Don’t try to express milk from your breasts if you:

• are at risk of, or had threatened premature labour
• had a cervical suture inserted, or been diagnosed with a short cervix
• experienced bleeding during your pregnancy
• have been diagnosed with placenta praevia
• have been advised by your doctor or midwife not to
• cannot store colostrum safely and hygienically

If you aren’t sure whether it’s a good idea to express colostrum during pregnancy, check with your doctor or midwife.

When and how do I express colostrum?

Because colostrum is thick and your breasts only make a small amount, it’s often best to express by hand.

Pick a time when you’re relaxed, and follow these steps:

1. Wash your hands with soap and water and dry well.
2. Using your thumb on top of your breast and your forefingers underneath, gently press your fingers towards your chest.
3. Compress the breast tissue, hold briefly and then release. Try not to squeeze or pinch the nipple.
4. When you don’t notice any more colostrum flowing, rotate your hand position around the areola and repeat the process.
5. Swap to the other breast after 2 or 3 minutes, or when the flow of milk slows down or stops.
6. Collect the colostrum in either a sterile syringe or a clean container.
7. Express each breast twice during each expression. You can collect colostrum twice a day in each syringe or container. Between expressions, store the colostrum in the fridge.
8. Label with the date, cap the syringe and put in a plastic bag and into the freezer.

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Aim to express 2 to 3 times each day from around 36 weeks of pregnancy. Start gently and slowly, building up to 3 to 5 minutes, expressing on each breast twice each day.

Don’t feel discouraged if you only express a small amount, or don’t manage to express anything, especially at first. Colostrum is usually produced in small amounts, and it can also take a few tries to learn how to express effectively. You may also find that you get larger volumes as your technique improves.

How do I store colostrum safely?

Room temperature (26°C or lower) Fridge (4°C or lower) Freezer

• 6 to 8 hours

• up to 72 hours
• Store at the back of the fridge

• 2 weeks in a freezer compartment inside fridge
• 3 months in fridge freezer with a separate door
• 6 to 12 months in a deep freezer

Who can I speak to for advice on expressing colostrum?

The person who is providing your maternity care — such as your doctor or midwife — will be able to give you more advice about what’s right for you. Some pregnancy-related conditions increase the risk of premature labour. It’s important not to express colostrum if you’re at risk of having your baby early.

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Resources and support

Visit the Australian Breastfeeding Association website for more information about antenatal expression of colostrum and hand expressing breast milk.

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