Antenatal Colosturm Expressing
As estrogen and progesterone levels rise, your body prepares for lactation. About midway through pregnancy your body creates colostrum. Colostrum is the first milk your body produces during pregnancy. It develops in the mammary glands (breasts) and is essential for boosting your baby's immune system. If you plan to breastfeed, colostrum will be the first milk your baby receives. Also known as "liquid gold", it is packed with protein, vitamins, minerals, and immunoglobulins (antibodies) that help strengthen your baby's immune system, giving it a rich, golden color and valuable health benefits.
Hand expressing colostrum is a valuable skill that enables you to collect this important first milk for your baby. Rich in nutrients and essential antibodies, colostrum plays a key role in boosting your baby's immune system. While hand expression may take some practice to master, it becomes easier over time. Follow these steps to ensure you express colostrum effectively and comfortably.
STEP ONE: Prepare for Expression
- Wash your hands thoroughly with soap and warm water or use a hand sanitiser.
- Have clean containers or syringes with caps ready to collect the colostrum.
- Sit up in bed or in a chair and lean slightly forward. This position helps facilitate the let-down reflex
STEP TWO: Massage and Stimulate the Breasts
- Begin with a gentle breast massage using a circular motion.
- Stroke from the top of the breast towards the nipple and from the sides of the breast to the nipple with a light tickling stroke. This helps stimulate milk flow by facilitating the let-down reflex.
STEP THREE: Position Your Fingers Correctly
- Position your thumb and first fingers about 2 – 3 cm behind the nipple. This measurement is a guide; the areola size can vary among women. You may need to try adjusting your finger placement depending on the size of your breast.
- Place your thumb above the nipple (at the 12 o’clock position) and your fingers below (at the 6 o’clock position), ensuring the milk reservoirs lie beneath them.
- Ensure your fingers are well back from the nipple, on the outside of the areola, and do not tug or drag on the nipple.
STEP FOUR: Begin Hand Expressing
- Push your thumb and fingers straight back towards the chest wall without spreading them apart. If you have larger breasts, lift them slightly before pushing back.
- Gently press your thumb and fingers together, rolling them forward as if making thumb and fingerprints simultaneously. This rolling motion compresses and empties the milk reservoirs without hurting sensitive breast tissues.
- Avoid squeezing or pinching the nipple, as this can cause discomfort and is not effective for expressing colostrum.
- Repeat this process in a rhythm similar to a baby's sucking: position, push, roll; position, push, roll.
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.
STEP FIVE: Collect the Colostrum
- Collect the colostrum into a clean container or directly into the provided syringes with caps.
- When the flow of colostrum slows down, rotate the position of your thumb and fingers around the areola and repeat the expressing process.
- When the flow slows from one breast, switch to the other breast and repeat the steps.
STEP SIX: Label and Store the Colostrum
- Label the collected colostrum with the date and time of the first breast expression using the supplied label.
- Colostrum can be collected two to three times each day in the same syringe. It's reccomened to store the syringe in the fridge between uses.
- Colostrum can be frozen. Place the syringe in a zip-lock bag before putting it in the freezer. Frozen colostrum can be stored in the freezer for up to six months. Once thawed, it should be used within 24 hours.
- You can bring frozen colostrum to the hospital using a freezer block and an insulated bag. To defrost, hold the syringes under warm running water or leave them at room temperature.
FAQs
Why express colostrum before birth?
Many healthcare providers recommend that women express colostrum in the later weeks of pregnancy to store for use after delivery. This practice ensures that you have colostrum readily available for your baby right after birth, if needed.
While it’s common for mothers with gestational diabetes to do this to help their babies manage blood sugar levels, more women with uncomplicated pregnancies are also beginning to express colostrum. Having a supply on hand can be beneficial in the immediate post-birth period before breast milk fully comes in.
Additionally, expressing colostrum can be particularly useful for mothers who may face separation from their babies after delivery, such as in cases of emergency cesarean sections or when a baby requires neonatal intensive care.
Why is colostrum important?
Colostrum is sometimes referred to as your baby's first vaccination, because it contains a high concentration of protective antibodies and white blood cells. It’s also rich in beneficial bacteria that help colonize the gut, giving your baby a strong, healthy start in life.
Here are some of the nutrients in colostrum:
- Immunoglobulin- an antibody that fights off infections, and illnesses + protects baby against eczema, allergies and wheezing.
- Leukocytes- white blood cells that produce antibodies
- Lactoferrin- a protein that wards off infections
- Epidermal growth factor-protein stimulating cell growth
- Carotenoids- an antioxidant
- Vitamins A, B12 and K
- Magnesium
- Copper
What does colostrum look like?
Colostrum is typically golden yellow or orange due to its high beta carotene content. While it can sometimes appear clear, white, or creamy, it most often resembles the color of an egg yolk. In terms of texture, colostrum is thicker and stickier than breast milk.
If your colostrum appears pink, red, rust-colored, or brown, don’t be alarmed. Sometimes blood within milk ducts can make its way into your colostrum resulting in the above colours, which is not harmful.
Colostrum VS breast milk: What’s the difference?
Both incredibly important, colostrum and breast milk are similar but different in a number of ways. Colostrum is the first stage of breast milk and has more protein and Vitamins A, E and K. Milk is produced after colostrum production has stopped and lasts for months or years after birth.
Colostrum is an impressively concentrated substance that acts as your baby’s first immune system defense after birth. It also helps protect baby's gut and works as a laxative to push through babys first poo! You'll notice relatively small amounts of colostrum immediately after birth and for the first couple of days before it begins to transition to mature milk.
How will I know that my milk has changed?
You may hear other mothers or healthcare providers mention your "milk coming in." This refers to the transition from producing colostrum to mature milk, which typically occurs 2-5 days after birth. Many women can feel this change as their breasts become heavy, warm, tender, engorged, or even painful.
The colour and consistency of the milk also change from thick and yellow/orange to a thinner, more "milk-like" appearance. Over the next few weeks, as you and your baby establish breastfeeding, this milk will remain as your body adjusts to meet your baby’s needs.
