Expressing Colostrum Antenatally - your baby's first immune boost

Colostrum, the yellowish ‘first milk’ produced from the second trimester of pregnancy is an antibody rich immune booster and has often been called  ‘baby’s  first immunisation’.  

Colostrum helps to activate early immunological responses in your baby's gut, promoting the development of normal gut flora and preventing the growth of harmful bacteria. It also increases peristalsis, helping the newborn to pass meconium. This reduces the reabsorption of bilirubin and the potential to develop jaundice if bilirubin levels become elevated.

Colostrum, baby's first feed

In perfect circumstances, colostrum should be every newborn’s first feed, however there are medical conditions and issues for some mothers and babies that may mean infant formula is offered to newborns. For instance, babies of mothers with diabetes are particularly at risk of hypoglycaemia (low blood sugar) in the first few hours after birth, so although colostrum can be useful in this period to stabilize your baby’s blood sugar levels, these babies are often given formula.

One way to see that your baby is less likely to be offered formula in this important newborn period, is to express and store colostrum during the last weeks of pregnancy. Discuss this with your health- care providers and write a post birth plan (see below) so that everyone caring for you knows your wishes – before your baby is offered formula as his first feed.

In the sixties and seventies – mothers were advised to express colostrum during late pregnancy, supposedly to clear milk ducts and increase the production of colostrum. There was evidence that women who expressed during pregnancy were more confident with breastfeeding but despite this, advice about antenatal expressing was abandoned, possibly due to concerns that nipple stimulation could cause early labor.

Recent studies including a study of women who breastfed through pregnancy( Moscone and Moore 1993),  show that uterine contractions will only occur following the up-regulation of oxytocin binding sites in the uterus, when your body is ready to begin labor.  This means that nipple stimulation won’t induce labor unless you are at term.

If you have a history of premature labor, prenatal expressing may be contra-indicated and if any cramps do occur while you are expressing colostrum, stop and discuss this with your health professional.

To express colostrum:

  • You will need -  1 and 3ml syringes ( from a pharmacy, ask for capped syringes, although uncapped ones are also fine;) and plastic ziplock bags or a plastic storage container to store your syringes in the freezer
  •  Start hand expressing once daily at 36 weeks, unless otherwise advised by your health carer. For instance if you are being induced earlier for medical reasons or if you are in premature labor and are expected to birth your baby. You can build up to expressing 2 to 3 times a day.
  • It’s best to express after your shower when your breasts are warm and your hands are clean. Otherwise wash your hands and warm your breasts with a heat pack before expressing.
  • Gently massage your breasts to stimulate the ‘let down’ reflex (see this video for gentle Breast massage techniques). This massage and expressing  technique is very effective whether you are expressing colostrum or you need to express after your baby is born.
  • Compress your breasts with thumb and fingers above and below the areola (the dark skin around the nipple), pressing back towards the chest wall, not squeezing towards the nipple. Try to mimic the rhythm of a baby sucking - the action is ‘press, compress, release’.  As the flow slows, move your fingers around to express different ducts.
  • Express for about 3 to 5 minutes each side – as flow stops on one side, swap to the other breast, repeat so each breast is expressed twice in a session.
  • As colostrum drops appear, collect these in a syringe. If you have a good flow, you can express into a clean medicine glass or spoon (wash in hot soapy water, rinse and dry) and draw the colostrum up into a syringe.
  • NOTE: some women will only get a 'glisten' of liquid antenatally, the amount of colostrum you have antenatally isn't an indicator of your potential milk supply - your milk-making hormones will be triggered after birth and expulsion of the placenta.
  • Store your expressed colostrum in the fridge between each expressing if you are using the same syringe next time (you can use the same syringe for 24 hours).
  • Use a new syringe each day, store syringes in a ziplock bag in the freezer and label with your name and the date. Colostrum can be stored in the freezer for 3 months and in a deep freeze for up to 6 months.
  • Stop expressing if cramps occur
  • Please don't worry if you only get a 'glisten' of colostrum, this is no indicator of how your supply will be postnatally - as your placenta is released, your postnatal hormones will trigger lactation

Most importantly, write a post birth plan that includes uninterrupted skin to skin cuddles as soon after birth as possible, delayed weighing, delayed bathing so baby keeps his amniotic smell longer (and don’t wash your own chest the first day so baby follows this amniotic smell back to the breast and latches more easily), and advise (pop a notice on your baby's cot if he is in a nursery)  “Colostrum in freezer for  baby if needed.”  

For more tips about preparing to breastfeed, download our FREE ebook, "Prepare to Breastfeed Like a Boss (Before You Have Your Baby)" by Pinky McKay IBCLC.


Liz's story of expressing colostrum to nourish her newborn

 "In preparation for the birth of our son, I hand expressed colostrum. When we went into hospital I took in the expressed 150 mls. This was lucky as he weighed 4.6 kilograms and had low blood glucose levels. He breast fed and then needed top ups. Instead of giving him formula, the staff were able to give him my expressed colostrum.

I wanted the best for him and if I hadn't had enough expressed breast milk, formula would have had to bridge the gap. I was told by one of the staff that they would have to give him formula as they were getting low in my milk and his blood glucose levels were borderline. I was a little worried and expressed a few mls and then tried on him on the breast. He breast fed really well from both sides and continued to do so and has not stopped breast feeding since.

He's been a real champion and I am so proud of him. When I'm holding my baby boy in my arms I feel so content and in love and love the hormonal changes that occur. It's such a lovely content feeling. I love it when we look at each other when he's feeding and he smiles. Pure bliss."

Liz is a fan of Boobie Bikkies too! "At Christmas time we went to see my husband’s family which is a little stressful. I was worried about the effect of the stress on my supply. I purchased a box of Boobie Bikkies and took them with me and they worked perfectly. I was so thrilled as was my son." Liz lives in ACT, Australia