The following blog post is written by Sally Rickard, a London lactation consultant
In this blog post, we will discuss when you should harvest colostrum, why it is important to do so, and how you can do it safely.
One important thing to bear in mind is that many women do this and they don’t get any colostrum until after their baby comes. It doesn’t make any difference to whether or not you’re going to have a good milk supply in the future, if you get none, it really doesn’t mean you’re broken. It doesn’t mean you’ve got bad technique. It just may not happen for you until after your baby is born.
For this reason it’s helpful to focus not on collecting but on practice. It’s an opportunity to get to know your individual breasts, how they feel and what the differences are as you milk production picks up.
There are so many different techniques that you can search online, you’ll find many different theories and ideas around how to extract colostrum but the most important thing is simply to practice. Experiment with the techniques in the hope that when your baby comes, if you do hit any bumps in the road, and they are slow to feed or you got any kind of separation or some other problems, you’ll already know what you’re doing, because it’s really tough time to try and learn a brand new skill when you’ve just had a baby and you are on the post natal ward.
If you do find yourself able to extract colostrum during your pregnancy you will be able to store it in case it’s useful in the early days.
How can I collect my colostrum?
There are quite a few different techniques for hand expression, it’s wise to experiment & find what suits you best:
Stanford university hospital : https://med.stanford.edu/
The UNICEF video on hand expression:
https://www.unicef.org.uk/
Global Health Media video on how to express colostrum:
https://globalhealthmedia.org/
And a film about how to actually use the syringes:
https://www.instagram.com/tv/
Frequently Asked Questions
What is colostrum?
Colostrum is the first milk a lactating human produces. The qualities and components of colostrum are uniquely different from mature human milk. Mothers produce colostrum in their last trimester of their pregnancy and for the first two or three days after their baby is born.
How long do you breastfeed colostrum? How long does it take for colostrum to turn into milk?
Colostrum gradually transitions to more plentiful, drippier, whiter milk over a few days.
When your placenta leaves your body a hormonal chain of events is triggered, although this process begins 30 or 48 hours after birth breastfeeding parents don’t usually perceive the difference until 40 or 60 hours after birth. For some mothers this means suddenly finding themselves uncomfortably full with hard, taught breasts that they don’t recognise. For other mothers the change is much more gentle.
This rapid milk increase happens faster if you have breastfed before and can happen later if you have had a Caesarean or if you had gestational diabetes.
Send Lactation Consultant would avoid using the term “milk coming in” as there is a concern this gives families the impression that there is no value in colostrum or that the baby is not getting anything until the milk comes in.
How much colostrum does a newborn need?
The low volume of colostrum is deliberate and encourages frequent feeding.
Different studies have found different volumes for the average milk per feed in the early days. Examples include:
First day 2-10ml
second day 5-15ml (another study found 27 ml)
fifth day 30-60ml
What are the benefits of colostrum for newborn babies?
Colostrum provides essential nutrients and antibodies to help protect newborns from infections.
Colostrum is a laxative helping to clear meconium and excess bilirubin (excess bilirubin causes jaundice).
Why is it important to learn to express colostrum?
UNICEF UK recommends that every mother is taught and expression.
A pilot study, conducted at Stanford and soon to be published, demonstrates that teaching mothers to hand express in the first hour not only improves exclusive breastfeeding at discharge in both vaginal and cesarean births but also reduces attachment problems.
Learning to harvest colostrum whilst pregnant can provide an excellent safety net to avoid early formula supplementation. Learning and practising harvesting colostrum means that you become familiar with your breasts . If you do need to feed your baby colostrum with syringes in the early days you will already have the skill and knowledge to be able to hand express the colostrum. Your baby will benefit from your expressed colostrum if they have low blood sugars, are reluctant to feed or suffer with jaundice, or if you are separated for some reason, if your baby needs to be cared for in the neonatal intensive care or special care baby unit. Your expression skills can help avoid early formula supplementation which can be damaging:
Just one bottle—helpful or harmful?
“While it may sound harmless and helpful, bottles of infant formula given to newborn breastfeeding infants have been shown to interfere with the successful establishment of breastfeeding, reduce both the exclusivity and duration of breastfeeding, and permanently alter the infant gut microbiome. One bottle of formula per day for the first week of life is enough to shift the gut microbiome toward….a condition where gut inflammation becomes the precursor to both acute and chronic diseases and conditions such as autoimmune diseases and obesity”.
When should you harvest colostrum?
From 36 weeks.
Twice a day for no more than about 5/6 mins each time.
Is it safe to express colostrum in pregnancy?
Research tells us that as long as there’s no history of late miscarriage or other difficulties it’s fine to express from 36 weeks with no risk of premature labour. Do discuss your personal circumstances with your midwife.
Any signs of cramping, pain or bleeding-stop and discuss with your midwife.
Is it safe to store colostrum at home? How do I store my colostrum?
Yes, it is safe to store colostrum at home if you keep it refrigerated or frozen.
It’s important to keep colostrum refrigerated or frozen, in sealed containers such as a ziplock freezer bag (and labelled!)
• Expressed colostrum can be kept in a refrigerator below 4°C for up to five days. The door is often the warmest part, so colostrum should not be stored there.
• Colostrum can be stored for two weeks in the ice compartment of a fridge or for up to six months in a freezer.
• Defrost the frozen colostrum in the fridge, or under a running tap, or at room temperature and use within 24hrs.
Conclusion
Becoming familiar with what is normal for your breasts during your pregnancy, learning to locate your glandular tissue and milk ducts and practising the techniques of expression may provide you with a valuable safety net if you’re breastfeeding journey gets off to a tricky start.
Early supplementation with formula is very common but as the paper from Marsha Walker shows, a little formula in the early days can change health outcomes and damage the breastfeeding journey.
Having either a store of antenatally expressed colostrum, or even just being familiar with the skill, will give you a plan B and could bridge a gap.
*Remember*
Tell the hospital staff and note in your birth plan if you have colostrum stores
* an interesting note* if you find yourself purely hand expressing in the first few days you might be reassured to read this interesting new research which showed that expressed volumes of colostrum typically dropped after the first 6hrs before picking up again.
“The decline in expressed milk volume during the early post partum period caused concern among mothers. Therefore, mothers should be informed of the post partum trajectory of human milk volume”.
https://pubmed.ncbi.nlm.nih.
Buy colostrum kit with instructional videos & info page here:
https://www.baby-thrive.com/
REFERENCES:
Making More Milk, Diana West & Lisa Marasco
Breastfeeding atlaspage 36
“Hand expression is an effective way to obtain colostrum and feed to a sleepy baby or non-nursing newborn. Mothers can express drops of colostrum directly into a spoon to offer to the infant…”
https://ibconline.ca/
Research antenatal safety:
https://pubmed.ncbi.nlm.nih.
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*Hand expression videos*
Stanford university hospital : https://med.stanford.edu/
The UNICEF video on hand expression:
https://www.unicef.org.uk/
Global Health Media video on how to express colostrum:
https://globalhealthmedia.org/
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4 amazing immunological qualities of colostrum:
1 Every millilitre of colostrum contains 5 million living cells, much more than in mature human milk.
2 Colostrum contains many immunological components:
Almost 90% of the cells in colostrum are macrophages. These are white blood cells which patrol for antigens and engulf and absorb pathogens.
3 Colostrum lines the gastro intestinal tract with healthy microorganisms preventing adherence of pathogens.
4 Colostrum contains lactoferrin which protects against infections