Colostrum

Colostrum is produced from before birth through the first few days of life. It is followed by transitional milk, a mix of colostrum and mature milk, and then by mature milk, from about the second week after birth. Breasts start producing colostrum somewhere between 12 and 20 weeks of pregnancy. You may notice you leak colostrum in the last half of pregnancy; but you may not. Whether colostrum leaks or not has no relationship to  milk production.¹ Colostrum is often thick and sticky. It is usually yellow but can also be clear or white. The yellow color is due to beta-carotene, an antioxidant present in colostrum. Colostrum is measured in drops or teaspoons – perfect, small feedings for the small stomach your baby has at birth. It is easily digested. Why is colostrum important for your baby? Although there are only small amounts of colostrum available at birth, it is the perfect food for babies in the first few days of their lives. At the same time, colostrum develops your baby’s immune system and feeds the good bacteria in your baby’s gut. Immune factors are transferred from you to your baby through colostrum. The importance of colostrum has not always been recognized in some cultures leading to “colostrum taboos” in the first three to five days after birth. These taboos are less common today, but may still be encountered. See Colostrum Through a Cultural Lens. Research tells us that colostrum in the first few days of life is a unique opportunity to develop a strong immune system and gut microbiome. It is a superfood.² ³ Compared to mature milk made later (starting about the second week after birth), colostrum has: More growth factors, which promote cell and tissue repair. More human milk oligosaccharides (HMOs). HMOs are indigestible complex sugars that act as a prebiotic feeding the good bacteria in the gut. They help to grow a healthy gut microbiome. Good bacteria can help seal the baby’s gut. They help keep inflammation levels low and prevent infection. They contribute to overall good health. Higher amounts of fat-soluble vitamins. Vitamin A can be three times higher in colostrum than in mature milk. Carotenoids (antioxidants) can be 10 times higher. Vitamin E can be two to three times higher than mature milk.⁴ ⁵ Colostrum acts as a laxative to help your baby pass meconium. Meconium is the black, tarry stool that the baby passes in the first few days of life. Passing meconium helps prevent jaundice. If your baby is not having a bowel movement at least each day of life in the first few days or if their stool is not turning yellow, yellow-green, tan or occasionally green by day four, please talk to your La Leche League Leader, lactation consultant, or healthcare provider. Lack of stooling can be an indicator of a feeding issue that needs to be addressed. If you have diabetes or another risk factor to milk coming around the third day, you may want to consider collecting colostrum prior to birth. See Colostrum: Prenatal /Antenatal Expression Article. The colostrum and early milk mothers make for their preterm baby are very different from the colostrum and milk made for a full-term baby. Preterm colostrum has the same disease protection – through antioxidants, antibodies and immunoglobulins (immune factors) – as term colostrum. However, because it has more of these components, it is even more powerful. This superfood reduces inflammation in the gut of a preterm baby and can prevent necrotizing enterocolitis (NEC), which can damage the gut lining, in early preterm babies. Preterm babies receiving their own mother’s colostrum have significantly better health outcomes, in the short-term and in the long-term.⁶ Colostrum is waiting for your baby at birth. Nursing in the first hour will yield a colostrum feeding that is protective and satisfying for your baby. Remember that your baby’s stomach is tiny at birth, so a large feeding may look very small! Learning to suck and swallow milk is easier in small amounts. If for some reason your baby cannot nurse in the early hours, hand express the colostrum so it can be fed to your baby. Hand expressing colostrum generally yields more volume than using a breast pump in the early days.⁷ Babies usually take two to ten ml/feeding on day one, five-15ml/feeding on day two. The volume gradually increases. On day four, babies usually take 30 to 60ml per feeding.This volume will slowly increase to about 700ml or more per day. The amount your baby drinks – and your colostrum – will increase slightly each day as your baby’s stomach gently stretches. By the fourth day, most babies will be drinking colostrum mixed with more mature milk. There is a gradual transition from colostrum to mature milk.⁷ ⁸ Colostrum is the most important first food for all infants. Although it is available only in small amounts, it is a powerful superfood! Endnotes:¹ Walker, Breastfeeding Management for the Clinician: Using the Evidence,  (Jones & Bartlett, 2023),.21, 94, 95.² Marsha Walker, Breastfeeding Management for the Clinician: Using the Evidence,  (Jones & Bartlett, 2023), 21.³ O Ballard and AL Morrow, “Human milk composition: nutrients and bioactive factors”. Pediatr Clin North Am, 60(1) (Feb 2013): 49-74, doi: 10.1016/j.pcl.2012.10.002. PMID: 23178060; PMCID: PMC3586783. ⁴ Ruth A. Lawrence and Robert M Lawrence. Breastfeeding : A Guide for the Medical Profession  (Elsevier. 2022). ⁵ Sy Kim and DY Yi, “Components of Human Breast Milk: From Macronutrient to Microbiome and MicroRNA”, Clinical Experiences in Pediatrics,; 63(8) ( Aug 2020): 301-309. PMID:32252145;PMCID:PMC7402982. https://pmc.ncbi.nlm.nih.gov/articles/PMC7402982/₆ Marsha Walker, Breastfeeding Management for the Clinician: Using the Evidence, (Jones & Bartlett, 2023), 376-377.₇ Academy of Breastfeeding Medicine, Clinical Protocol #3: Supplementary Feedings in the Healthy Term Breastfed Neonate, Revised 2017. ABM Clinical Protocol #3: Supplementary Feedings in the Healthy Term Breastfed Neonate, Revised 2017⁸ Lawrence and Lawrence, Breastfeeding: A Guide for the Medical Professional, (Elsevier. 2022), 100. Resources:Maya Bolman, The Basics of  Breast Massage and Hand Expression. https://www.mayabolman.com/videos/v/basicsofbreastmassage Colostrum: Prenatal /Antenatal Expression ArticleHand Expressing ArticleThe Power of Hand Expression Article Calostro: Información GeneralLLL Italia: ColostroЛЛЛБГ, ЛЛЛ България: Наука за майчиното млякоЛа Лече Лига Россия: Что такое молозиво?