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Antenatal expression of colostrum

When it is anticipated that a baby may experience difficulties with feeding or maintaining their blood sugar levels after birth, expressing colostrum antenatally means that your baby will have a supply of breast milk available if required, therefore reducing the need to use infant formula.

Reasons this may be required include babies:

  • whose mother experienced diabetes in pregnancy
  • with a cleft lip and/or palate identified during pregnancy
  • with congenital conditions such as Down syndrome or cardiac complications
  • diagnosed with intrauterine growth restriction
  • who are born prematurely.

There are also reasons why women may need to consider supplementing their babies feeds. These include women:

  • who have experienced previous low milk supply
  • who have a breast hypoplasia (limited breast development)
  • with polycystic ovarian disease
  • who have had previous breast surgery
  • with multiple sclerosis.

What is colostrum and why is it important?

  • Colostrum is a fluid which is produced by the breasts from about the twentieth week of pregnancy and during the first few days after the birth of your baby.
  • The appearance of colostrum may vary from dark yellow to clear; it can also be quite thick and sticky.
  • Colostrum is easily digested and the ideal first food for your baby.
  • Colostrum provides perfect nutrition specifically for your newborn baby. It has a much higher proportion of proteins than mature milk; many of these are immunoglobulins which help boost your baby’s immunity. There are also fat-soluble vitamins and some minerals as well as a relatively high salt content which assists in protecting your baby from dehydration in the early days.
  • Colostrum is low in volume but high in energy and helps with the early passage of meconium (baby’s first bowel motion) which in turn assists in preventing jaundice (yellow skin colour).

Why should I consider antenatal expressing?

  • Human milk is the recommended food for all babies, but especially for babies with additional health requirements (see list above)
  • Expressing and storing colostrum before birth, may decrease the risk of your baby requiring or being given infant formula after birth.
  • Expressing can assist in the promotion of successful, exclusive breastfeeding for you and your baby.

When can I start expressing?

Please discuss this with your midwife, lactation consultant or doctor for individual advice prior to commencing expressing. Generally you may commence expressing at 36 weeks gestation. Begin with three to five minutes of expressing on each breast; two to three times a day. You should stop expressing immediately if you are having contractions at any time.

Do not express if:

  • you have a history of, or are currently experiencing, threatened or actual preterm labour
  • you have a history of, or are currently experiencing, cervical incompetence
  • you have had a suture put in your cervix to prevent preterm labour.

Expressing must be comfortable; seek assistance from a health professional if you experience any discomfort. If you require additional assistance or support, please contact Mater’s Breastfeeding Support Centre on 07 3163 8200.

Expressing and collecting colostrum

For details on how to hand express, refer to Mater’s information on expressing breast milk

Collecting and storing your colostrum

  • When colostrum is pearling up or dripping easily, collect the colostrum either into a clean container, such as a medicine cup, or directly into the syringes provided for this purpose.
  • When milk ceases to flow, rotate the position of your fingers and thumb around the areola (imagine a clock face) and repeat the expressing process.
  • Swap to the other breast when the flow slows down or after two to three minutes.
  • Use each breast twice during each expressing session.
  • Colostrum can be collected two to three times each day in the same syringe. You will need to store the capped syringe in the fridge between uses.
  • At the end of the collecting day, the colostrum can be frozen—place the syringe into a zip-lock bag before putting into the freezer.
  • Label the syringe and bag (separately) with a computer generated sticker detailing the date and time of the first expression collected and also initialled by you to confirm correct identification.       
  • The frozen colostrum can be stored for three months in the freezer or six to 12 months in the deep freezer (see storage guidelines below).

Your colostrum will remain frozen until the time comes for your baby’s birth at which time the containers can be brought to hospital labelled with the mothers’ name, hospital record number, date and time the colostrum was expressed.

Transporting colostrum to hospital

Your expressed colostrum (fresh or frozen) must be transported to hospital in a cooler pack with ice bricks to maintain the temperature. Initially, only bring 2–3 syringes to hospital.

If there is an accessible fridge available (in your room, or centrally located on the ward), it is preferable to refrigerate your colostrum. Frozen colostrum will defrost in the refrigerator and once fully defrosted must be used within four hours or discarded. Once defrosted, colostrum cannot be re-frozen.

If you wish your frozen colostrum to remain frozen, it can be transported (in the cold pack) to the Formula and EBM Room.

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What happens after the birth of my baby?

  • You will be encouraged to have skin to skin contact with your baby in the first one to two hours following birth, including caesarean births, if possible.
  • Breastfeeding is encouraged and should be unrestricted.
  • If your baby is experiencing difficulties or is uninterested in breastfeeding at this time you will be encouraged (and assisted if necessary) to express some colostrum to give to your baby. You may also use any colostrum you have brought into hospital with you.
  • Should your baby continue to experience challenges with feeding at the breast or their blood glucose levels become an issue, your baby’s paediatrician will advise you on further treatment and feeding.  
Mater acknowledges consumer consultation in the development of this patient information.
Mater Doc Num: PI-CLN-430095
Last modified 09/1/2018.
Consumers were consulted in the development of this patient information.
Last consumer engagement date: 10/11/2017
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