Antenatally Expressing Colostrum

Antenatally Expressing Colostrum

Antenatally expressing colostrum is a relatively new practice that assists with providing your baby with that precious liquid gold in situations where breastfeeding is difficult or delayed after birth. This may be a new idea to you so here we outline the reasons why you might want to express prenatally and how you go about it.

What is Colostrum?

Colostrum, also known as liquid gold, is the thick yellow milk that is the first milk produced to feed your baby. It is full of protein, essential nutrients and vital immune factors that play a crucial role in building your baby’s immune system. It also filled with prebiotics that line your baby’s gut so it can build good bacteria to protect your baby’s immature gut.

We start producing colostrum from around the 16^th week in pregnancy. Some women will leak colostrum during pregnancy. Colostrum will continue to be produced through the pregnancy until a few days after birth until the transition phase to milk.

Should I express prenatally?

Whether you express prenatally is a personal choice. It is not essential for you to express prenatally as your baby will receive colostrum in the first few days from breastfeeding.

However, it can be helpful to have some stored colostrum in case there is a reason you are separated from your baby in the first few days after birth.

When is it helpful to express prenatally?

We all hope that birth is uneventful and mum and baby are both well at the end. Sometimes issues arise that make breastfeeding difficult or illness can separate mum and baby for the first few days. It is times like these that antenatally expressing colostrum can come in handy.

If you have are aware of any medical conditions for you or your baby during pregnancy you may know that you have a risk that your baby might need to be admitted to the special care nursery. At times this means that breastfeeding is delayed, so having a stash of colostrum means that your baby can be fed in your absence.

If you don’t have colostrum available your baby may need to be fed formula as their first feed. While formula is a suitable breastmilk substitute, it is better for your baby to be given all of nature’s goodness from colostrum for the reasons listed above.

Times when extra colostrum is useful include:

• When a mother has diabetes. Babies born to mothers with diabetes are at high risk of having low blood sugar after birth. These babies may need extra feeding as colostrum will assist with bringing the blood sugars back to normal range. Babies of mothers with diabetes may also be admitted to the special care nursery to assist with managing blood sugar levels and mum might not be able to be there to feed when required.
• Your baby is diagnosed with a medical condition prior to birth such as cleft lip and/or palate, a neurological or heart condition.
• Multiple births.
• Mothers who have a history of breast surgery or breast surgery where establishing breastfeeding might be difficult.

Is it safe to antenatally express colostrum?

It is essential that you talk to your obstetrician or midwife if you are interested in storing colostrum during your pregnancy. Antenatal expressing is safe for most women. For some women, however, there may be a risk that makes expressing during pregnancy unsafe and can induce pre term labour.

Do not express antenatally if you have:

• a history of preterm birth,
• pregnancy complications such as irritable uterus or incompetent cervix,
• had bleeding throughout pregnancy,
• been diagnosed with placenta previa,
• any other condition that may induce pre term labour.

For those women who are advised that pre natal expressing is safe, it is recommended you start at around 36 weeks gestation. If you are expecting multiples, you may be able to express earlier than this.

How do I express colostrum?

It is recommended that you hand express colostrum in pregnancy, rather than pump. You will only produce colostrum in small quantities and you are more likely to waste it than collect it with a breast pump at this stage.

You can try hand expressing 2-3 times a day. While you will only express small quantities, you will notice it increase as you express each day.

Tips for expressing:

• Wash your hands before you start expressing.
• Using a heat pack or expressing after a warm shower can be helpful to get the colostrum flowing.
• Place your thumb and forefinger on either side of your areola well back from the nipple.
• Gently press your thumb and forefinger back into your breast tissue,
• Press your thumb and forefinger together in a slight rolling action. This will compress the ducts and squeeze the colostrum out.

As the colostrum starts to be released from the nipple, collect it with a colostrum collector or draw it up with a syringe. Express twice on each side before storing your colostrum.

Storing your colostrum

• It is safe to store your colostrum in a syringe. This is useful as it you can store it in small amounts and once it is thawed it can be syringed into your baby’s mouth easily without wasting it or requiring a bottle. It is also helpful if your baby ends up requiring tube feeding as this makes it easy to transfer the colostrum.
• Only fill your syringe ¾ full as colostrum will expand when frozen.
• Draw back the syringe to leave an air bubble in the end and cap the syringe.
• Label the milk with the date and YOUR NAME so that when you take it to hospital it is not mixed up with someone else’s.
• Store your syringe with the tip facing up – placing it in cup in the freezer is ideal.
• Once your syringe of liquid gold is frozen, pop it into a zip lock bag so its ready to take to the hospital. ‘
• Colostrum can be stored for 3 months in the freezer. If you take the colostrum to the hospital, it is still safe to feed it to your baby when you come home, even after your milk has come in.

Taking your colostrum to hospital

Depending on how much colostrum you express antenatally, you won’t need to take it all in to the hospital once you go into labour. You can always send someone home to collect more if you need it, so make sure it is in an easy to find space in your freezer.

You will need a small portable esky or cooler bag and some solidly frozen ice packs. Some hospitals recommend you take around 40ml of colostrum with you to hospital, so select the number of syringes for this amount and pack them in zip lock bag and wrap them in a tea towel.

Lodge the colostrum between two ice packs in your cooler bag. This should keep them frozen for a number of hours until you have access to a fridge or freezer. Make sure you let staff know you have brought the liquid gold with you so they can freeze it for you.

Remember, once your colostrum has been defrosted it cannot be re-frozen and it must be consumed within 24 hours.

Will you express colostrum?

Antenatally expressing colostrum is not for everyone. It is something to consider depending on your health and the health of your baby and whether you feel that it would be useful. If you do decide to express during pregnancy there are a number of colostrum collecting kits available assist you.