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Colostrum Harvesting

Written by Amina Hatia RM
Medically reviewed by Marley Hall BA RM Diphe
April 15, 2021

Colostrum is the first breast milk that your body makes. Its colour can range from almost see-through to yellow. It contains everything your baby needs in the first few days including proteins, fats and infection-fighting antibodies, and it will help stabilise your baby’s blood glucose (sugar) levels. Colostrum is produced in small quantities; a new-born baby’s stomach is as big as a marble so they will just need a few millilitres of colostrum to be full and content. However, they may want to feed quite often (maybe every hour).
Your breasts will start to produce colostrum from about 20 weeks pregnant. As colostrum is made during pregnancy, it is possible to begin to hand express, collect and freeze colostrum before the baby is born. This is often called colostrum harvesting. Being able to express colostrum is a useful skill to have, as well as many benefits to saving expressed colostrum.
Breastmilk is a complete and perfect food for your baby. If the unexpected happens and you and your baby are separated, or if your baby has feeding difficulties or health problems, you will find it easier to express your milk for your baby if you have practised beforehand.
Colostrum harvesting is especially beneficial if you have diabetes. Some women may have difficulties breastfeeding and maintaining their baby’s glucose levels. If your baby needs extra feeds, you can use colostrum instead of formula milk.
If you want to harvest your colostrum, you can start hand expressing for a few minutes once a day when you are 36 to 37 weeks pregnant. Do not use a breast pump until after you have given birth.
Do keep in mind that antenatal expression of milk is just for additional milk baby can receive during the early days… you will still need to work on latch and nurse on baby’s demand to establish breastfeeding.

When should I start collecting Colostrum?
If you do want to harvest your colostrum during pregnancy, talk to your midwife or doctor first. If there’s no medical reason such as gestational diabetes for you to harvest colostrum, you can start hand expressing from around 37 weeks. If it’s likely that your labour will be induced or you’re having a planned c-section before your due date, your midwife or doctor may recommend that you start earlier.

Is it suitable for everyone?
Anyone can try to express her breast milk antenatally. Don’t worry if you can’t get much out, especially if it is your first baby. This doesn’t reflect whether or not you will have a successful breastfeeding journey!
Women who are most likely to benefit from harvesting colostrum are those who know their baby is at an increased risk of having a low blood sugar in the first few hours after birth.
When baby drops their blood sugar or struggles to feed, women may be encouraged to supplement breastfeeding with formula. If you already have a store of breastmilk, you can give this to your baby by a syringe instead, ensuring they receive this nutritious colostrum and avoiding the need for formula.
Some of the women who may particularly benefit from having a store of colostrum include:
• Women with diabetes in pregnancy (pre-existing or gestational).
• Babies diagnosed during the antenatal period with cleft lip and/or palate and congenital conditions.
• Anyone who is having an elective caesarean section.
• Babies with intrauterine growth restriction.

Should anyone avoid harvesting colostrum?
There are some circumstances in which harvesting colostrum may not be recommended. Your midwife or doctor may advise caution if you have a history of premature labour, have any issues with your cervix or pregnant with more than one baby for example.

When you express, it stimulates your nipples. Nipple stimulation encourages your body to produce oxytocin, the hormone that helps to kick start labour. In late pregnancy, there is a small chance that nipple stimulation could cause your womb (uterus) to begin contracting.

How to express/harvest colostrum?
Get comfortable, as it can take a while to encourage flow. A warm, private place with few distractions will help. You can even try visualising your baby to help stimulate your milk to flow.
• Always wash your hands before expressing.
• Applying a warm compress to your breast or expressing after a warm bath or shower can help the flow of colostrum.
• Start with a gentle breast massage, stroking from the back of your breast towards the nipple to encourage the let-down reflex.
• Put your thumb above the nipple and your first few fingers below the nipple. You will be cupping the breast in a ‘C’ shape.
• With your thumb and fingers, feel a few centimetres back from the nipple.
• Press back towards your chest, then compress (press your fingers together), and release.
• Repeat this process, building up a rhythm. Press, compress, release.
• Have a look on our Instagram page for our midwife videos on how to hand expressing
Colostrum should start to arrive drop by drop. Initially it may just be a glisten on the end of your nipple, and it may take a few days of practice before drops appear.
Collect the colostrum into a clean container, like a syringe (1ml or 2ml syringe). If nothing happens, adjust your finger position slightly to find the spot that works for you. Try not to pinch your nipple or slide your fingers uncomfortably over the skin.
Rotate the position of your fingers and thumb around the areola (imagine a clock face) and repeat the expressing process to stimulate and remove colostrum from different parts of your breast.
Express each breast twice during each session.
Colostrum can vary in appearance. Sometimes it may appear quite thick and yellow or orange and at other times paler and thinner. Expressing colostrum antenatally will not decrease or increase your milk supply after baby is born.

How should I store colostrum?
Freeze the container/syringe at the end of the process and make sure it’s clearly labelled with the date you expressed. Colostrum can be stored in a freezer for up to six months.
When you need to use your colostrum you can defrost it under warm running water or at room temperature. You can keep defrosted colostrum in the fridge for up to 24 hours.

If you know when your labour is going to be induced or have a date for a planned caesarean, you can express colostrum a day or two beforehand and keep it in the fridge. Give it to your midwife to store in the milk fridge on the postnatal ward. As long as it’s refrigerated, it will be safe to use within 48 hours.

You can bring your frozen colostrum into hospital too. Pack it into a cool bag and give it to your midwife. They will make sure it is clearly labelled with your name, hospital number and date it was removed from the freezer. Some hospitals have freezer units for breastmilk, so ask your midwife if you’re not sure.

I tried expressing colostrum but it’s not working for me!
If you don’t manage to express colostrum in pregnancy, don’t let it knock your confidence. Many people go on to successfully breastfeed their babies after birth, despite having had difficulty with hand expressing during pregnancy.

There’s no need to feel guilty if you decide not to express at all during pregnancy. You’re not depriving your baby of anything. Your breasts produce colostrum for the first few days after birth, so breastfeeding or expressing soon after birth will give your baby all the nutrients they need.