Expressing colostrum during pregnancy
Information for women and birthing people from the Infant Feeding Team
This leaflet helps pregnant women and birthing people learn how to express colostrum before baby arrives. If after reading this leaflet you still have questions, please speak to your midwife.
What is colostrum? Why is it good for my baby?
The first breast milk your body makes is known as colostrum. It is produced from about 16 weeks of pregnancy. It is usually a golden yellow colour and often very sticky. It is very easy for baby to digest and therefore the perfect first food for baby.
It is concentrated in nutritional properties, so baby will only need small amounts in the early days.
Colostrum is full of antibodies to help protect baby from infections.
It has a laxative effect, to help baby pass their early stools (poo).
It can reduce the effects of jaundice in baby.
Giving baby colostrum is a good way to help to regulate their blood sugar levels.
Why are you recommending that I should learn to express colostrum before my baby is born?
Learning how to express colostrum can be a useful skill to learn before your baby is born. It can be very helpful if we think your baby may have challenges:
with breastfeeding, or
keeping their blood sugar levels stable in their early days.
It is useful for all mothers or birthing people to learn the skill of hand expression. Hand expression:
is the best way to express colostrum
can help baby attach to the breast
can relieve engorgement (when your breasts get too full of milk)
can help you deal with a blocked milk duct.
If you are unexpectedly separated from your baby, they can have access to your milk immediately.
Do I have to learn how to express my colostrum during pregnancy?
It is your choice if you wish to express colostrum during your pregnancy. Learning to express colostrum can be useful in preparation for breastfeeding, but is not essential to ensuring successful breastfeeding.
When should I start learning how to express my colostrum?
We suggest you start learning how to express colostrum after 36 weeks of pregnancy.
You can start hand expressing once a day for a few minutes, gradually increasing up to 5 to 10 minutes, two to five times a day.
It is usual to see only a drop or two to start with; this should increase over the days as you express more. Do not be alarmed if you cannot express any colostrum, as this is not an indication of your milk supply. Please ask your midwife for further support if you are worried about the amount of colostrum you are able to express.
Find a time when you can be comfortable and not rushed. Research suggests expressing colostrum works best when you are relaxed and can take your time.
Expressing colostrum by hand is better than using a pump. Only small amounts of colostrum will be produced and this could be lost when using a pump.
How do I express colostrum?
Before you begin, wash your hands with soap and hot water, and then dry.
It may be useful to massage your breasts before you start to express or try expressing after a warm bath or shower.
Cup your breast and place your thumb and finger about 2 to 3cm from the base of your nipple.
Use your thumb and the rest of your fingers in a C shape and gently squeeze. Pressure should be firm but not painful.
Release the pressure and then repeat again and again. Avoid sliding your fingers over your skin, as this can cause soreness and may damage your skin.
Move your fingers around your breast and repeat the process on a different part of your breast.
Small drops of colostrum should begin to appear, this may take practice and several tries.
You may find moving your fingers slightly forward, toward your nipple or further away, may work better for you.
What if expressing the colostrum hurts? Should I stop?
Breasts may feel tender during pregnancy. Collecting colostrum should not make your breasts sore. You may find you need to change the pressure you use or the placement of your fingers for a more comfortable experience. Please speak to your midwife or visit your local breastfeeding group if you need more support.
If you experience painful contractions after you have expressed colostrum, that do not subside after you stop, please contact Maternity Triage on 01227 206737 for help and advice.
Can I collect and store my colostrum?
Collecting and storing colostrum to bring to the hospital can be useful if:
your baby is large or small for their gestational age
you are expecting twins or triplets
your baby has a cleft lip or palate; or
they have a heart or other diagnosed condition.
It might be useful for you if you:
are diabetic or have developed diabetes in pregnancy
are taking beta-blocker medication for raised blood pressure
plan to have a caesarean birth
have had breast surgery; or
have other reasons identified by you or your healthcare provider.
What can I collect and store the colostrum in?
Colostrum can be collected in 1ml syringes.
Use a new syringe for each expression.
Label each syringe with one of your patient identification labels. Add the date and time that you expressed the colostrum to the label.
How do I store my colostrum to bring to hospital?
Colostrum can be stored for 2 weeks in the ice compartment of a fridge or up to 6 months in a freezer.
Should I bring my colostrum to hospital when I give birth?
Yes. Frozen expressed colostrum can be brought into hospital. It should be placed between ice packs and stored in a cool bag.
Please let a member of staff know you have frozen colostrum when you arrive. The staff member will check it is labelled correctly and sign it in to the freezer for you. When you are ready to use the colostrum, a member of staff will sign it out of the freezer for you.
Please remember to take any unused colostrum with you when you leave the hospital. Colostrum left in the freezer after you go home will be disposed of if we cannot contact you.
How do I give colostrum to my baby safely?
Giving your baby colostrum from a syringe should only be done under guidance from maternity staff. They will make sure you know how to do this safely.
Important safety information
Infant feeding syringes purchased by families might have a free-fastening lid. The lid must be removed before giving expressed colostrum or milk to your baby.
Are there any risks to learning to express colostrum during pregnancy?
Mothers or birthing people should not hand express colostrum if:
they are at risk of pre-term labour
have a history of pre-term ruptured membranes; or
they have a cervical suture in place.
Hand expressing before 36 weeks is unlikely to start labour for those who are not at risk of pre-term labour. Some may experience some painless tightening’s, often known as Braxton Hick contractions, this is normal.
Useful information
What if I have any further questions or concerns?
You are welcome to go to a breastfeeding support group during your pregnancy for further information and support. Your local group can be found on the Bedside You web site.
Please speak to your midwife if you have any questions, or contact the Infant Feeding Team.