How to express and store colostrum antenatally

If you’re pregnant and nearing your due date, something you might have heard about is expressing antenatally.

So what does this mean and how do you do it?

After your baby is born it might take a few days for your milk to come in. In the meantime, your body produces something called colostrum, aka liquid gold, to feed baby.

What is colostrum?

Colostrum is high in protein, helps to protect baby from illness and contains vitamins, minerals and salts to keep baby hydrated.

Although colostrum is made and collected in small amounts, it’s very high in energy and all your baby needs until your milk comes in.

In a Facebook live with TMBTV Midwife Tylah says “baby really only needs that one meal in the first 24 hours of life to survive, and that’s a really minuscule amount,” she says. “Their stomachs are only 7mL on day 1, so if you put that into perspective, a small amount of milk is going to be enough.”

Expressing colostrum antenatally

Towards the end of the third trimester, some care providers might recommend hand expressing colostrum antenatally from 36 weeks.

Some reasons for expressing colostrum antenatally are:

• when babies are born to mums who have diabetes; they may have low blood sugar after birth. Having extra colostrum on hand can help to stabilise their levels.

• when babies are diagnosed before birth with a condition that might make it hard to breastfeed (for example, a cleft lip). Mum will need to express extra breastmilk for baby – just incase.

• to prepare for breastfeeding. Getting to know your breasts and how they function is a great way to build confidence before your breastfeeding journey begins. Others might also start expressing antenatally to help  bring on labour. Just make sure you chat with your midwife or obstetrician first!

Is it safe?

A study, published in the journal Lancelot, known as the DAME (Diabetes and Antenatal Milk Expressing) study set out to research the effects of antenatal expressing on women with diabetes in pregnancy. The results found expressing antenatally was safe in a low-risk pregnancy. But as always, it’s a good idea to have a chat with your healthcare provider first.

When can I start expressing?

Women may start to express antenatally from 36 weeks (after chatting with your midwife).

To get started, spend 3-5 minutes hand expressing each breast two or three times a day. However, if you experience contractions, cramps or discomfort, you should stop expressing.

When expressing for the first time, don’t worry if you can’t collect any colostrum straight away. The amount should increase over the next few days. There is no link between expressing small amounts of colostrum antenatally and having a low milk supply.

Additionally, the average amount of colostrum expressed antenatally in the DAME study (link above), was 5 ml. So you’re really only after a small amount.

When you shouldn’t express antenatally

Women should avoid expressing antenatally if they have:

• a history of preterm labour
• experienced bleeding throughout pregnancy
• placenta praevia
• your doctor has told you not to.

How to express and store colostrum

Although it’s common to use a syringe to store colostrum, Midwife Tylah says it’s easier to grab a urine jar.

“Generally, we say to express it [colostrum] into syringes, but what I prefer over syringes is a urine jar. You can ask for them when you’re at the hospital at your antenatal appointment, or you can get them from the chemist,” says Tylah.

“Urine jars are completely sterile, so you don’t have to do any sterilisation. They’ve also got a place for you to write the date and time you’ve expressed, which is really important.”

You can add expressed colostrum into the same urine jar over the day (keeping it in the fridge), but then it needs to go in the freezer. Label the jar with the time and date you expressed the first drops of colostrum.

“Expressed milk is only going to last in the fridge for three days,” says Tylah. “But it can last in a freezer for three months and a deep freezer for six months.”

When it’s time to head to the hospital, make sure you bring some (but not too much) of your liquid gold with you.

“When you come to the hospital, you’re only really wanting to bring a little bit,” says Tylah.

“Once you take expressed milk out of the freezer, it only lasts 24 hours. So you just want to be careful to bring a little bit. You can always send someone back home to bring us some more.”

For a more detailed look at how to express colostrum antenatally, Global Health Media has a video that you can watch below.