Pregnancy

How early in pregnancy can you start expressing and storing colostrum?

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Known as “liquid gold”, colostrum is the first milk pregnant women produce and is incredibly nutritious for your baby during the first stage of their life. 

And, like many things related to pregnancy, birth and breastfeeding, it can be difficult to know everything.

So, we've gathered all of the information you need to know about colostrum including what it is, how to express colostrum and where to store it, so you can get the most out of the experience of antenatal milk expressing.

What is colostrum?

Colostrum is the first yellow fluid produced before breastmilk and is often referred to as “liquid gold” by health professionals due to its nutritional value for your baby. 

Colostrum is high in protein, vitamins and minerals that help newborn babies fight bacteria and infections in their first few days of life, while also protecting them against allergies and disease.

There is a much higher concentration of antibodies in colostrum than there is in mature breast milk. 

A newborn baby's stomach is only about the size of a marble and because colostrum is a very concentrated substance, it provides an ideal amount of nutrients they need

Colostrum also helps your baby do their first poo (known as meconium) and prevent jaundice.

When does colostrum appear?

Colostrum can start being produced from 16 weeks pregnant and some women may find they are leaking from 28 weeks.

Leaking is absolutely nothing to worry about and is completely normal.

If you find it’s bothering you, you can buy breast pads to prevent this leaking from interrupting your everyday activities and routines. 

Some women choose to hand express colostrum before birth to have a supply ready for the newborn.

The amount of colostrum that’s produced will vary from woman to woman — sometimes only a few drops and other times, a teaspoon full.

When should you start antenatal expression?

Antenatal expressing refers to a technique where you hand express the colostrum before the birth of your baby.

You can start hand-expressing from 36 to 37 weeks pregnant but you should always discuss this with your midwife to make sure it’s the right time and decision for you. 

The colostrum that comes from hand expressing doesn't flow in large quantities.

For this reason, it is recommended that you use a sterile syringe to collect the droplets (more on the expressing process later).

This can then be fed directly to your newborn as needed. 

When it comes to expressing colostrum, it's recommended to do this by hand versus using an electronic device.

Electronic pumping devices are great to use after giving birth to express breastmilk when your mature milk is in full supply.

To make this process easier, The Lactation Massager is a must-have product.

This breast massager stimulates milk production and flow, which is perfect when expressing colostrum and can be used hot or cold.

Once your breastmilk comes in, The Lactation Massager also works wonders on unblocking milk ducts, aiding the let-down reflex, relieving swelling and helping fight off infection.

While the antenatal expression of colostrum might not be high on your to-do list pre-birth, a 2011 study actually found that doing so may reduce future breastfeeding difficulties, including having a low supply of breastmilk.

In fact, the group of pregnant women who expressed colostrum daily after 37 weeks did not find it difficult to begin breastfeeding after birth (either vaginal or C-section delivery) and sufficient milk started flowing within half an hour of starting breastfeeding in 94.4 per cent of the study group compared to 70 per cent of the control group, which didn't engage in antenatal expressing.

Antenatal expression of colostrum

There is a technique for the antenatal expression of colostrum in order to get the most out of the experience, but the best thing to remember is that it might not happen straight away.

Being patient and kind to yourself throughout is important.

You can always ask for the help of your midwife to act as a support person if you have any questions or need some help.  

  • Start by washing your hands and making sure you have a sterile container ready to collect the liquid
  • Creating a "C" shape with your fingers, gently press the area
  • Release the pressure and then repeat, getting into a rhythm 
  • Once you get some practice in, you should produce a few drops of fresh colostrum that you can collect with your sterile container before storing in your syringe
  • Expressing after a warm bath or following a warm compress to your breasts can help encourage your supply

It may take a few days to get the hang of it, so don’t feel disheartened if it doesn’t happen on your first attempt. 

If you find that it's not coming naturally, stop expressing and try it again later that day or the following day when you're feeling comfortable and ready to give it another go.

If you need further help after a few attempts at hand expression, get in touch with your midwife.

The Lactation Massager uniquely combines temperature, movement and compression to tackle all key breastfeeding problems.

How often can you express colostrum before birth?

Collecting colostrum via hand expression prior to birth has a number of benefits for all women, however, it’s particularly beneficial if: 

  • You’re having twins or triplets
  • Your baby is considered large or small gestational age
  • You are diabetic (or developed diabetes in pregnancy) 
  • You have a raised BMI 
  • Your plan to have a caesarean section 
  • You have a pregnancy-induced high blood pressure or taking blood pressure medication
  • You've had previous breast surgery 

If you choose to hand express colostrum, it’s recommended that you express for a few minutes once a day to begin with and build this up to five to ten minutes two to five times a day.

After this, you can express as much as you feel is necessary. 

Colostrum turns into mature breast milk around five days after giving birth.

You might find that your breasts start to feel a little firmer, which is a sign that your breast milk flow is increasing.

This mature breast milk will help your baby to start gaining weight.

If you've previously had feeding problems or low milk supply, expressing colostrum can actually help breastfeeding mothers and make the experience much more enjoyable — especially in those early days.

Does antenatal expression bring on labour?

It’s previously been thought that expressing colostrum during pregnancy can bring on labour but there is limited scientific evidence to prove this

Having said that, if you do feel cramping or something doesn't feel right, stop expressing and contact your midwife. 

Leaking colostrum also doesn’t mean that you’re going into labour, either, so no need to worry about this.

It’s also important to note that not all women experience leaking colostrum before birth, so don’t worry if this isn't happening for you.

Your colostrum may come in after birth, which is completely normal.

How to store colostrum

Knowing how to store your colostrum is important, especially if you’re expressing and storing colostrum during pregnancy before your baby is born, which is also known as colostrum harvesting.

Start by labelling your frozen colostrum with the date and time that you expressed, then place the syringe into a clean, clear zip-lock bag and put it into your freezer.

It’s a good idea to make sure there’s a dedicated section in the back of your freezer for your colostrum so it’s organised for when you need it.

Avoid keeping it in the door or somewhere that is exposed to warmer temperatures regularly upon opening and closing. Keep your colostrum at -18°C.

If you plan on bringing your frozen colostrum to the hospital with you (which is welcomed and encouraged), be sure to keep the syringes in a clean container in an insulated bag with ice surrounding it and have labels of the date and time it was removed from your home freezer.

Many hospitals will be able to store your frozen colostrum for you — just be sure to let them know you have it.

When you’re ready to feed your newborn baby the stored colostrum, it needs to be down to room temperature.

You can do this by placing the bag containing the syringe of colostrum into a warm bowl of water.

Your midwife can help show you how to best feed the expressed colostrum to the baby once it’s down to the correct temperature.

You can store colostrum at room temperature for four hours, in the fridge for up to four days, and in the freezer for six to 12 months.

Colostrum that has been defrosted should be used within 24 hours. Once your expressed colostrum has been defrosted, it cannot be frozen again.

How often should you feed your newborn colostrum?

Your newborn may need feeding as often as every hour in the first few days.

This will begin with shorter feeds, which is why a small supply in your syringe works perfectly for them.

As your baby grows, it will start having longer feeds that happen less often.

Professionals say that it's not possible to overfeed and breastfed a baby so go at the pace that suits you and your bub.

References

https://www.sciencedirect.com/science/article/abs/pii/S0271531702003731

https://www.nhs.uk/conditions/baby/breastfeeding-and-bottle-feeding/breastfeeding/the-first-few-days/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4921432/

https://west-sussex-family-assist.custhelp.com/app/answers/detail/a_id/47/~/collecting-colostrum-and-how-to-express

https://www.nhs.uk/pregnancy/related-conditions/common-symptoms/leaking-nipples/ 

https://www.uhs.nhs.uk/Media/UHS-website-2019/Patientinformation/Pregnancyandbirth/Collecting-your-colostrum-while-you-are-pregnant.pdf