How To Collect Colostrum During Pregnancy

As you prepare for birth, you may hear about colostrum harvesting (also known as antenatal colostrum expression or ACE). But is it something you need to do?

Pediatrician and breastfeeding medicine specialist Heidi Szugye, DO, IBCLC, NABBLM-C, explains why and how you may want to collect colostrum before delivery, including how to store it.

What is colostrum?

Colostrum is the first milk your body makes during pregnancy. It’s extra rich in nutrients and thicker and more yellow than breast milk. That’s why you may hear it called “liquid gold.”

Your body may start to make colostrum during your second trimester. This lasts until two to four days after your baby’s birth. Then, your body makes transitional milk and mature milk.

Hormone shifts after birth gradually trigger mature milk production. That means that you can’t “run out” of colostrum before your baby’s birth if you choose to harvest it.

Why colostrum harvesting may help your baby

Colostrum harvesting can provide key nutrition in case your newborn has low blood sugar or feeding difficulties soon after birth. It may also help you become more comfortable with hand expression after they’re born.

Most of the research on antenatal expression focuses on pregnant women with preexisting or gestational diabetes. These babies are at increased risk of low blood sugar after birth.

Low blood sugar needs quick treatment. In most cases, your own breast milk, donated breast milk, formula or an IV sugar solution (in severe cases) are the main options to boost your baby’s blood sugar.

But antenatally expressed colostrum is another possible treatment. “The colostrum that you collect toward the end of pregnancy and bring to the hospital can help provide the extra nutrients your baby may need,” Dr. Szugye says.

So, what about those who don’t have diabetes? There are other reasons your baby may need supplementation, like if they have feeding issues or need extra care in the NICU.

“Research is ongoing if antenatal expression is helpful in other cases,” she adds. “That’s why it’s best to talk with your pregnancy care provider first to make sure it’s right for you. Everyone, especially those at risk of preterm labor, needs to consult with their provider before starting.”

When to start collecting colostrum

Your healthcare provider may give you the OK to start collecting colostrum at or after 36 weeks of pregnancy. Talk it over with them first.

You may notice colostrum leaking from your breasts as early as the second trimester. It’s normal and safe if it leaks on its own. But you shouldn’t try to make colostrum come out this early.

“We don’t recommend collecting colostrum before 36 weeks,” Dr. Szugye states. “It may lead to preterm labor if you stimulate your nipples during the process.”

How to collect colostrum

Hand expression is the main way to collect colostrum. But before you collect it, you’ll need some supplies, including:

• A small clean container to express the colostrum into, like a spoon, cup or bowl
• Small sterile syringes (with caps and without needles) that hold 1 to 3 milliliters (ml) to draw up the colostrum and store it

Once you’re ready, wash your hands and find a relaxing and comfortable place to sit. You can apply heat to your breasts for a few minutes with a heating pad, if you want. Gently massage or pet your breasts. This shouldn’t be a firm touch. Think of it like petting a cat. Avoid touching your nipples, which can increase the chances of uterine contractions.

To hand express colostrum, follow these steps:

1. Make a “C” shape with your clean hand, and cup your breast a few inches away from your nipple (generally behind your areola).
2. Press your breast tissue (not your nipple) with your thumb and pointer finger back toward your chest.
3. Gently squeeze your thumb and fingers together and roll them forward.
4. Hold your small container close to your nipple. If colostrum comes out, it’ll form drops on your nipple, not squirt out. Allow the droplets to fall into the container.
5. Repeat steps 1 through 3 for a few minutes.
6. Rotate your hand so you’re squeezing a different area of your breast.
7. Do this for no longer than 10 minutes total (five minutes per side).

You can collect colostrum up to twice a day.

How much to expect

You may be surprised by how little colostrum comes out (if any at all). But it’s supposed to be that way.

“A newborn’s stomach is about the size of a marble. They can only take in a small amount of colostrum at a time,” Dr. Szugye clarifies. “So, it’s normal and expected to release only a few drops of colostrum — or none at all.”

On average, people collect 1 to 3 ml per session and about 40 ml total prior to delivery.

If nothing comes out, that’s OK. It may be frustrating, but try not to read into it. Dr Szugye reassures, “Antenatal expression doesn’t bring your milk in faster or increase long-term milk production.”

Storing colostrum

After each harvesting session, use a small syringe to collect the colostrum. Label the syringe with your name and the date. Freeze the syringe unless you expect to use it in the next four days. (It’s safe in a refrigerator for up to four days.)

Once you thaw frozen colostrum, it’s only good for 24 hours.

These timelines can make bringing colostrum to the hospital tricky once it’s time for delivery. It’s hard to know how long your labor will last. And most hospitals can’t store your colostrum in a refrigerator until after your baby is born.

“We generally advise that you have someone bring your collected colostrum to the hospital once your baby is born,” Dr. Szugye says. “If you bring the colostrum when you first arrive, it may expire before it’s needed. Most hospitals require the milk to be labeled with your baby’s hospital label in order to store it.”

Hospital policies may vary. Ask your healthcare provider for more information.

The bottom line

Pregnancy and preparing for birth can leave you with information overload. So, here are the key takeaways of colostrum harvesting:

• It’s not necessary; it’s an option.
• Talk it over with your healthcare provider first.
• It’s usually safest to start at or after 36 weeks of pregnancy.
• Use the hand expression method.
• Collect colostrum no more than twice a day for no longer than 10 minutes each time.
• Store it safely.
• Don’t sweat it if nothing comes out.

Even if you don’t get any colostrum, the process may still be beneficial. It can help you become more comfortable with hand expression, Dr Szugye notes. “This skill is helpful if you and your baby are separated after birth and you want to provide breast milk. It can aid in latching and help relieve engorgement, as well.”