Colostrum: Prenatal /Antenatal Expression - La Leche League International

During the second trimester of pregnancy, the breasts begin producing colostrum in small amounts. Colostrum will be your baby’s first food. It is usually a thick, yellow liquid, but the color may be clear or white. Colostrum may leak onto your bra or other clothing, or it may be visible as a ‘crust’ on your nipple. Not everyone will have this. There may be no outward signs that your breasts are preparing to produce milk, even late in pregnancy. This says nothing about your ability to make milk. When your baby is born, your breasts will roughly produce around 30ml (one ounce) of colostrum. This becomes a little bit more everyday, until transition milk comes in more fully, somewhere around the third day after your baby is born. Frequent feedings of small amounts of colostrum are exactly what your baby needs. Although you might hear that it is worthwhile to collect colostrum before the baby is born, it usually isn’t necessary to do so. The increase in milk production after birth is initially caused by the placenta leaving your body. After that, it’s milk removal that tells your breasts to make more. Prenatal removal of colostrum does not directly contribute to the postnatal increase in milk supply.  You may want to collect colostrum before the baby is born (antenatal or prenatal colostrum collection) if you have Type 1 or Type 2 diabetes or gestational diabetes, are having a planned cesarean section, have polycystic ovary syndrome, or anticipate a delay in milk ‘coming in’ for other reasons. A discussion with your healthcare provider, lactation consultant, or La Leche League Leader may be helpful in making that decision. Some concerns you might have about prenatal expression of colostrum: Hand expression will trigger premature labor contractions. Prenatal (antenatal) expression of colostrum has not been shown to trigger labor contractions if the pregnancy is otherwise stable. In fact, “nipple stimulation” is not especially effective in starting or enhancing labor contractions. Professor Forster et al, of the DAME Study (Diabetes and Antenatal Milk Expression), concluded, “There is no harm in advising women with diabetes in pregnancy with low risk of complications to express breastmilk from 36 weeks’ gestation.”¹ “I’ll hurt myself.”  Only you should attempt to express colostrum. Initially, you might have difficulty, embarrassment or discomfort expressing colostrum. You may find that hand expressing makes you feel more comfortable with your body. Pump or Hand Expression? Studies show the best way to collect colostrum is with hand expression (see links below on ways to hand express). Colostrum sticks to the sides of the collection bottles with a pump and so there is less to give the baby. Will I take away the colostrum for my baby by removing it antenatally? Don’t worry, for each drop you express you will make more to replace it. How to store colostrum: Use small, food-safe storage containers with secure lids. You might express colostrum into teaspoons or shot glasses, and then transfer the colostrum to small syringes. See the handout from the UK National Health Service (NHS) for more information. Collecting your colostrum while you are pregnant Newborns will take roughly one to three ml per feeding. If the colostrum is frozen in one ml syringes, babies can be fed a number of syringes (if needed), without waste. Colostrum should be thawed under running warm water, not in a microwave oven. Use the thawed colostrum within 24 hours. ¹ Della A. Forster et al., “Advising women with diabetes in pregnancy to express breastmilk in late pregnancy”,  Diabetes and Antenatal Milk Expressing [DAME]: a multicentre, unblinded, randomised controlled trial, The Lancet, Volume 389, Issue 10085, ( 2017). https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)31373-9/abstract Hand Expressing ArticleCollecting Your Colostrum While You are Pregnant, National Health Service (NHS), United Kingdom, July 2024. https://www.uhs.nhs.uk/Media/UHS-website-2019/Patientinformation/Pregnancyandbirth/Collecting-your-colostrum-while-you-are-pregnant-1461-PIL.pdfMaya Bolman, IBCLC, The Basics of Breast Massage and Hand Expression. https://www.mayabolman.com/videos/v/basicsofbreastmassage