How to express colostrum: A step-by-step guide

When you see breastmilk in movies or on TV, it's usually white, watery and either in a baby bottle or inconveniently leaking on a shirt.

But that's not the only type of breast milk there is. There are three stages in your breastfeeding journey, each with its own milk, and they're all important. In the early days of parenthood and during late pregnancy, you'll have colostrum — a highly nutritious liquid that looks very different from mature breastmilk.

The experience of expressing colostrum can be different for everyone as your colostrum can start leaking as early as 28 weeks, while others don't produce colostrum until after birth.

To make this process a little more straightforward, we're covering everything you need to know about hand expressing colostrum both before and after birth.

What is colostrum and why is it important?

When you think of breastmilk, you’re probably thinking of the white, watery stuff that you see in baby bottles. But that’s actually mature breastmilk. Before you reach that stage, you’ll have another type of milk — colostrum.

Colostrum is the first milk you express. Colloquially, it is known as ‘liquid gold’ — because it is yellow or orange in colour and it has huge health benefits for your baby.

It’s much thicker than mature breastmilk and has almost a completely different nutrition profile. Colostrum is full of antibodies and protein, which help build up your baby’s immune system and give newborns the nutrients they need to grow.

Expressing colostrum before birth

Your body is actually able to produce colostrum before your baby is born. Some people choose to start expressing colostrum before birth, which is known as antenatal expression or colostrum harvesting.

There are a few reasons you might consider antenatal expressing:

• Your baby may need extra nutrients and a supply of frozen colostrum can help
• Your baby may need special care which means they are separated from you
• Your baby may experience feeding problems and expressed colostrum can be fed from a syringe instead of breastfeeding
• Women with diabetes may choose to express early to address risks of low blood sugar

If you choose to express colostrum before birth, you can begin in late pregnancy, between 36 to 37 weeks. You can do this by hand expressing for a few minutes per day.

You'll want to avoid using a breast pump until your mature milk has come in — which is a few days after birth. Some women also find that expressing colostrum antenatally helps them practice their technique and get used to the feeling of breastfeeding.

Is antenatal expression safe?

For most mums, expressing colostrum early is safe. But, there are some risk factors to be aware of.

You should not express early if:

• You are at risk of preterm labour
• You have been diagnosed with placenta praevia
• You have experienced bleeding during pregnancy
• You have been advised not to by a healthcare professional

These reasons are just a sample, so make sure to also ask a qualified doctor, obstetrician or midwife for advice.

If at any time you feel uterine contractions while you hand express, stop and seek medical advice.

How much colostrum should you be able to express?

It’s known as ‘liquid gold’ so who could blame you for wanting as much as possible? But, the truth is, you won’t express much colostrum at all.

In a study of women with diabetes, the median amount of colostrum expressed was just 5mls. For comparison, when your breastmilk fully comes in — you’ll express up to 800mls per day.

This is another reason some mums consider expressing colostrum early. You won’t get much colostrum with each expression, so to build a supply you might like to try collecting colostrum before your baby arrives.

Having said that, we’d hate to see you worried about having enough colostrum. Your newborn's stomach is very small and they don’t need much with each feed. What's most important is that they are feeding frequently.

How to increase colostrum 

Our bodies are amazing at what they do. They did all that growing and nurturing throughout your pregnancy, and they’ll continue to support you and your newborn baby after birth.

You can trust that you have enough colostrum. There are no ways to increase your natural supply and the amount you have is enough to meet your baby’s needs.

The only exception to this is antenatal expressing. It won’t increase your natural colostrum supplies, but it will help you build a supply of expressed colostrum in the freezer.

This way you'll always have a backup on hand.

Some women have real issues with low milk supply — of both colostrum and later on, breastmilk. Reasons for this can include medical conditions like multiple sclerosis or polycystic ovary syndrome, and previous breast surgery.

If your doctor decides you are at risk of low supply, they might recommend expressing colostrum antenatally.

What is the best way to express colostrum?

Hand expressing is the ideal way to collect colostrum. It’s a gentle method that most women are able to teach themselves. Don’t worry if you find it hard to get right at first — breastfeeding is a skill like any other. You might need some practice before you master the art.

If you're struggling with expressing, remember that you can always ask your midwife, doctor or a lactation consultant for help.

How to hand express colostrum

Hand expressing colostrum is relatively easy, but you should still start slow. Take your time to practice the technique. When you really get the hang of it, you can aim to express twice per day for three to five minutes on each breast.

Here’s how to do it: 

Step 1: Wash and dry your hands

Step 2: Gently massage your breasts and nipples to stimulate the flow of milk

Step 3: Place your hand under your breast and your thumb and index fingers on either side of the areola, away from your nipple

Step 4: Gently press your fingers into your breast, bringing them toward each other behind the nipple — hold for two seconds, then release

Step 5: Repeat this movement until milk begins to appear

Step 6: When your flow slows down, move your fingers to a new position at the edge of the areola and continue

Eventually, your flow will slow to only drips. This is when you can change to the other breast.

You shouldn’t feel any pain or friction when you hand express. The full expressing process takes around 25 to 30 minutes.

How to store your collected colostrum

The best place to keep colostrum is in your fridge or freezer. You can collect it in a sterilised syringe or a clean container.

Here’s how long it will last.

Fridge

You can store colostrum in the fridge for three to five days. It’s best stored at the back of the fridge where it is coldest.

Freezer

• If you have a freezer compartment within your fridge, it can last for two weeks
• If you have a freezer with a separate door, it can last for three months
• If you have a deep freeze, it can last for six to 12 months

Remember to clearly label each syringe or container with the date you expressed, so you know how long it will last. You might also like to write down the date it should be used by.

Being a new parent can be pretty tiring, so it helps to be clear in your instructions to yourself and others. Frozen colostrum should be used within 48 hours of being thawed.

You should keep it in the fridge until it's ready to be warmed and used. If you need to transport your colostrum — whether chilled or frozen — you should keep it in a cooler bag.

You might like to add an ice pack as well.

How will you know when your milk has changed?

When we said that colostrum was your first milk, we really meant it. Your breastmilk will start to change colour and texture around three to five days after birth.

By the two week mark, you can expect your mature breastmilk to come in.

There are a few signs that show you it has changed:

• Your breasts will start to feel full and firm
• Your milk will become thinner and whiter in appearance
• You’ll be producing much greater volumes

When your mature milk has settled in, you’ll be able to breastfeed with it for six months to one year. Some women even continue longer than this. But, breastfeeding isn’t always easy. You can struggle with cracked nipples, leaking breasts, engorgement or even mastitis — an infection of the breast tissue which is usually caused by a blocked milk duct.

Here at Kin, we are on a mission to normalise the conversation around reproductive health — whether that’s fertility, contraception, conceiving and pregnancy or postpartum health.

We want you to know that your health should be on your terms. For more great articles about all kinds of women’s health, head over to Kin The Know.