Collecting colostrum (first milk) for your baby

We hope this information will be a useful introduction to how to collect and store colostrum (your first milk) for your baby. You can also talk to your midwife who will be able to answer any questions you may have.

The first breast milk your body makes is known as colostrum. This is the perfect source of nutrition for your baby because it:

•        contains antibodies which protect your baby from infection and help their immune system to develop.

•        helps your baby’s digestive system to develop, which protects your baby from allergies.

•        encourages your baby to open their bowels and pass ‘meconium’ (your baby’s  first black sticky poo) which reduces the risk of jaundice.   

Colostrum is very concentrated. At birth, a baby’s stomach is about the size of a marble, so they will only need a small amount of colostrum to receive all the nutrients they need.

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Collecting colostrum

During your pregnancy, your breasts will start to produce colostrum (the exact timing varies from person to person). You can collect and freeze this milk during the last few weeks of your pregnancy. This is also known as ‘colostrum harvesting’.

Collecting your colostrum will be especially beneficial for your baby if they are likely to have difficulties with feeding or maintaining their blood sugar levels during thefirst few days after birth.

This may be because your baby:

  • is large or small for their gestational age
  • is a twin or triplet
  • has a cleft lip or palate
  • has Down’s syndrome or a heart complication
  • are taking beta blockers to control high blood pressure
  • have developed pre-eclampsia during pregnancy
  • are diabetic or have developed diabetes during pregnancy
  • have polycystic ovary syndrome (PCOS)
  • have breast hypoplasia (a condition in which the breast doesn’t fully develop) or you have had breast surgery
  • have a raised body mass index (BMI)
  • plan to give birth by Caesarean section

Colostrum collection can also be beneficial for your baby if you:

If your baby needs extra feeds, you will be able to use your colostrum instead of formula milk if you have collected sufficient quantity in advance.

Before you start colostrum collection

Your midwife will discuss colostrum collection with you when you are 26 to 30 weeks pregnant, if it is appropriate. However, the benefits of colostrum collection may not become apparent until much later in your pregnancy. It is never too late to start colostrum collection.

You may be advised not to collect your colostrum if you:

  • have a cervical suture (a special stitch to hold your cervix closed) in place
  • have experienced premature labour in the past
  • have had contractions, vaginal bleeding and/or premature rupture of membranes (your waters breaking early) during this pregnancy

Your midwife will explain how to hand express and store your colostrum and give you a selection of oral syringes, caps and labels. It is important to use this opportunity to ask any questions you may have.

We would recommend reading a helpful booklet called ‘Off to the best start’ which explains the technique for hand expressing breast milk in more detail. Ask your midwife for a free copy or download it from the NHS Start 4 Life website.

How to start colostrum collection

If you would like to collect and store your colostrum, you can start hand expressing for a few minutes once a day when you are 36 to 37 weeks pregnant. Gradually build up to gently expressing for aboutfive to ten minutes at a time, two tofive times a day, and then as often as necessary in thefirst few days after you give birth. If your baby is premature or unwell, you will be encouraged to start expressing within two to three hours of giving birth.

You can collect your colostrum while you’re pregnant by hand expressing in the same way that you will express milk when your baby is born. While you’re pregnant you should only use your hands for expressing. You are advised not use a breast pump until after you have given birth.

Hand-expressing your colostrum

NHS Start 4 Life has two helpful videos you can watch on how to hand express breast milk/ colostrum.

  • To collect your colostrum, you will need a clean, sterilized syringe and a clean, sterilized larger container. Have these items ready before you start.
  • Make yourself comfortable and try to relax. Warmth will help, so try expressing in the shower or bath at first. You can gently massage your breasts with a warm flannel.
  • Use your hand to cup one of your breasts. Your hand should be in a ‘C’ shape around the nipple with four fingers under the breast and the thumb at the top. Your thumb and fingers should be about 2-3cm away from the base area around the nipple.
  • Use your thumb and index finger to gently squeeze. Release the pressure and then repeat to create a rhythm. This shouldn’t hurt. Avoid sliding your fingers over your skin as this may cause discomfort. If the colostrum doesn’tflow, try moving your fingers slightly towards the nipple or further away,finding the spot that works best for you. You could also try gently massaging your breast.
  • Collect your colostrum with the sterilised syringe and if necessary decant to the larger sterilised container. Colostrum is very concentrated and will come out of your breast drop by drop. At first, only a few drops will come out at each session, but with practice and time, you should get more.
  • When the drops slow down, move your fingers round to try a different section of your breast and repeat.
  • Repeat the process for your second breast.

Picture of hand expressing

Note the C Shape and the distance of the fingers from the nipple. The breast is squeezed but the fingers do not move position.

The amount of colostrum you collect when you express can vary from just a few drops to a teaspoon full. Every drop counts, so don’t lose heart if you feel you haven’t collected much colostrum. This doesn’t mean your baby will find it difficult to breastfeed.

It is very rare for colostrum harvesting to cause the onset of labour. You may feel your womb tightening and relaxing. This is called a Braxton Hicks contraction and isn’t a cause for concern. If you begin to feel ‘period-like’ cramps or mild labour contractions, stop expressing, rest and then start again slowly.

Storing your colostrum

  • Label the syringe or container with your name and the date and time you expressed the colostrum.
  • Put the syringe or container in a clean re-sealable bag and place it in your freezer at a temperature of -18°C.
  • You can store your milk in the back of the fridge at a temperature of 2-4°C for up to 24 hours before you freeze it.
  • Fresh breast milk that has only been stored in the fridge must be used within five days.
  • Breast milk that has been frozen can be defrosted in the fridge. It must be used within 24 hours.

You can express and freeze your colostrum at home and bring it into hospital when you have your baby.

To bring your colostrum into hospital you will need:

• re-sealable food bags

• a small cool bag

• two large ice blocks

When you go into hospital to have your baby, put a few of your (labelled) frozen syringes into a re-sealable food bag. Place this inside the cool bag between the two ice blocks.

Tell your midwife that you have colostrum with you when you arrive. It will be labelled with the date and time it was removed from your freezer and stored in the hospital fridge or freezer. This will be documented in your notes.

If you are in hospital during the later weeks of your pregnancy, discuss colostrum collection with your midwife. You will be given syringes so that you can harvest your colostrum and store it in the hospital freezer.

Feeding your baby with colostrum

Some newborn babies are unable to feed well at the breast and others are unable to maintain the necessary blood glucose levels (blood sugar levels). In these situations, you can feed your baby with your stored colostrum.

Your midwife will take your colostrum out of the hospital fridge or freezer and check the label with youfirst. The syringe of colostrum will need to be brought to room temperature. You could immerse a plastic bag containing the syringe of colostrum in a bowl of warm water or place it next to your skin.

Your midwife will show you how to feed your baby with a syringe or a small cup. Having a small feed will give your baby energy and increase their blood sugar levels. It often encourages babies to breastfeed well.

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