How to Express Colostrum Before Birth (And Why You Might Want To)

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Wondering if you should express colostrum before birth? Colostrum is rich in nutrients and antibodies, and expressed colostrum can be used instead of formula if you need to supplement in the hospital. Learn why expressing colostrum birth might be a good idea.

If you find your breasts leaking during pregnancy, you might be wondering if you should be collecting and saving that milk. If you’re not leaking, you might be wondering if you’ll be able to make enough milk. And if you’re curious, you might be tempted to see if what comes out if you try to express milk.

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But should you try? Is it a good idea? Or can it trigger labor?

The answer is: It depends. Allow me to explain.

How to express colostrum before birth and why you might want to

COLOSTRUM VS. MATURE MILK

Colostrum is just a fancy name for early milk. We sometimes talk about it like it’s different from breastmilk, but it IS breastmilk. Colostrum has the same ingredients your mature milk will have, just in different amounts. And leaking colostrum in pregnancy—or not—has nothing to do with how much milk you’ll be able to produce later. 

Before birth, hormones during pregnancy—especially progesterone—prevent your body from making breastmilk in large quantities, but some milk is still made when you’re pregnant. In fact, your body begins making milk as early as 16 weeks gestation (source). So it’s not really accurate to say that milk “comes in” after birth. Because it’s been there all along! Instead, it simply increases in volume. 

Typically your milk does not increase in volume until about 3-4 days after birth. Once the placenta is delivered, a sharp drop in pregnancy hormones sends a signal to your body to start the process of more copious milk production. After 3-4 days, this usually becomes apparent. 

But not always.

Expressed colostrum during pregnancy in a collection container
Colostrum tends to be thick and a deeper yellow than mature milk. Colostrum expressed before birth may look like this, be lighter in color, or seem watery. There is a range of normal.

FACTORS THAT CAN DELAY WHEN MILK INCREASES IN VOLUME

There are a number of different factors that can delay when your milk increases in volume, including health conditions and birth circumstances (source). For example, Cesarean births, high IV fluid loads in labor, prolonged labors, and uncontrolled diabetes can all delay milk from “coming in.” 

Bur remember that there are no guarantees that your milk will “come in” late, even if you have risk factors. Despite having type 1 diabetes and Cesarean births, my milk always increased in volume right on time—early, even. Try not to stress about when your milk will “come in,” and remember that even if it is “late,” you can still meet your breastfeeding goals.

SHOULD YOU EXPRESS COLOSTRUM IN PREGNANCY JUST IN CASE?

Medical Disclaimer: This information is for educational purposes only. Always consult your healthcare provider if you plan to express colostrum before birth. See full medical disclaimer here.

Most parents who plan to breastfeed don’t need to worry about expressing colostrum before birth. Expressing colostrum early won’t necessarily prevent a delay in your milk “coming in,” and it won’t affect how much milk you’re able to produce after birth, either. 

The only thing that reliably boosts milk supply is frequently and thoroughly draining your breasts—by nursing or pumping—after baby is born (source).

That said, antenatal milk expression (the practice of collecting colostrum before baby is born) can be a good idea if you have gestational, type 1, or type 2 diabetes (source, source, source). 

If a birthing parent has poorly controlled blood sugars in labor, baby can experience low blood sugar levels after birth. This happens because in utero, baby produces extra insulin to keep his or her blood sugar in range whenever maternal blood sugar levels are high. This extra insulin is still in baby’s system at birth and can cause baby’s blood sugar to drop too low after birth (source). Breastfeeding parents who wish to avoid formula supplementation may decide to supplement with expressed colostrum if this happens. 

Baby having blood glucose checked in the hospital
Newborn glucose checks are done on the heel rather than the fingers.

One study found that newborns of diabetic mothers who were given expressed colostrum to correct low blood sugars experienced more blood sugar stability compared to those given formula, and they were less likely to need to be admitted to the NICU for glucose stabilization (source). This was the case even though the volume of colostrum they received was comparatively small. 

Furthermore, since diabetes in pregnancy sometimes delays milk “coming in,” it can be helpful to have antenatally expressed colostrum on hand in case you need to supplement. In most cases, breastfeeding parents can simply hand express colostrum after birth if supplementation is needed, so expressing colostrum before birth is not always necessary.

That said, any time you are aware that you might be at risk for breastfeeding interruptions or difficulties (e.g. planned C-section, high-risk pregnancy, history of previous breast or chest surgery, history of PCOS or requiring medical assistance to conceive, etc.) you might consider expressing colostrum before birth. Bring the idea to your healthcare provider!

READ MORE: How to Successfully Breastfeed With Diabetes

Some parents express colostrum before birth in case baby needs to be supplemented. It can be fed from the syringe when it is thawed.
Having expressed colostrum on hand in advance can be especially helpful to birthing parents with gestational, type 1, or type 2 diabetes. Learn about breastfeeding with diabetes here.

ARE THERE ANY RISKS?

Many are concerned that early milk expression can trigger early labor. But there is evidence that breast stimulation only triggers labor when the birthing parent is already ready to go into labor anyway (source, source). Furthermore, hand expression stimulates the breast differently than a pump (source), so it’s unlikely that a few minutes of hand expression daily will trigger labor (source). It’s also worth noting that sexual intercourse is known to trigger labor but is not routinely discouraged during pregnancy. 

If you’re pregnant with diabetes, you’ll be glad to know that one study concluded “There is no harm in advising women with diabetes in pregnancy at low risk of complications to express breastmilk from 36 weeks’ gestation” (source).

If you’d like to express colostrum before baby is born, some recommend waiting to do so until you are at least 36-37 weeks pregnant on the off chance labor is triggered. Others recommend expressing as early as 34 weeks in order to allow sufficient time to gather a good amount of colostrum (source).

If you are at risk for—or have a history of—early labor, cervical incompetence, or placenta previa, antenatal milk expression is not recommended. Always inform your doctor if you are interested in antenatal milk expression.

You can express colostrum before birth and store it in a syringe
Expressed colostrum can be collected and drawn up into 1ml, 3ml, or 5ml syringes before being frozen for later use.

HOW DO YOU EXPRESS COLOSTRUM BEFORE BIRTH?

Hand expression is usually the most effective way to express colostrum (source). Pumping antenatally is usually ineffective, and it is too easy for precious drops to get lost in the crevices of your pump’s milk collection bottles.

Begin by grabbing a clean collection container (a clean spoon would also suffice, but you risk easily spilling), and washing your hands. Consider expressing after a warm bath or shower (applying gentle heat to the breasts can help) and after massaging the breasts.

(The following images depicting hand expression technique are reproduced with kind permission from Off to a Good Start: All You Need to Know About Breastfeeding © Public Health Scotland 2020)

© Public Health Scotland 2020

Step 1. Position the pads of your thumb and fingers just behind the areola (the darker skin around your nipple), with your thumb on top of the nipple and your fingers below. You’ll be making a “C” shape around your nipple with your hand.

© Public Health Scotland 2020

Step 2. Gently press your breast towards to chest wall to put pressure on the milk ducts.

© Public Health Scotland 2020

Step 3. Compress your breast between your fingers and thumb to help the milk flow towards the nipple. 

© Public Health Scotland 2020

Step 4. Release compression and repeat steps 2 and 3 rhythmically. 

Step 5. When milk stops flowing, rotate your hand. If you think of the face of your nipple like a clock, your fingers were at 12 and 6. Rotate your your hand so that your fingers are at 1 and 7, 2 and 8, and so on. 

© Public Health Scotland 2020

This process should not be uncomfortable: always apply gentle pressure. Most people can safely express colostrum by hand for 3-5 minutes, 1-3 times a day. If you notice contractions, stop expressing. 

Don’t be surprised is colostrum only comes out slowly, one drop at a time! Expressing colostrum before birth can feel tedious.

When you’ve finished collecting, draw up what you’ve collected in a sterile 1ml, 3ml, or 5ml syringe. If you plan to collect again in the same day, cap the syringe and place it in the back of your fridge. If you’re done collecting for the day, cap the syringe, label the syringe with the date, and place it in the freezer. (I recommend also labeling each syringe with how much colostrum is inside before freezing, since freezing expands the contents of the syringe, making each syringe appear a few milliliters more full.) 

When you go to the hospital, bring your frozen colostrum with you and be sure to let your team know you plan to use it if needed!

Boost Your Milk Supply & Keep It Up

Our FREE guide will give you 5 simple, proven tips to boost your milk supply and increase your pump output. Get results in as little as just a couple days!

If you enjoyed this post, be sure to check out our digital library of helpful resources that quickly teach how to avoid common breastfeeding problems and give you the peace of mind and confidence you need to meet your breastfeeding goals.

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