Expressing colostrum during pregnancy – your newborn’s first immune boost!

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Colostrum, the yellowish ‘first milk’ produced from the second trimester of pregnancy is an antibody rich immune booster and has often been called  ‘baby’s  first immunisation’.  Colostrum helps to activate early immunological responses in your baby’s gut, promoting the development of normal gut flora and preventing the growth of harmful bacteria. It also increases peristalsis, helping the newborn to pass meconium. This reduces the reabsorption of bilirubin and the potential to develop jaundice if bilirubin levels become elevated.

In perfect circumstances, colostrum should be every newborn’s first feed, however there are medical conditions and issues for some mothers and babies that may mean infant formula is offered to newborns. For instance, babies of mothers with diabetes are particularly at risk of hypoglycaemia (low blood sugar) in the first few hours after birth so although colostrum can be useful in this period to stabilize your baby’s blood sugar levels, these babies are often given formula.

One way to see that your baby is less likely to be offered formula in this important newborn period, is to express and store colostrum during the last weeks of pregnancy. Discuss this with your health- care providers and write a post birth plan (see below) so that everyone caring for you knows your wishes – before your baby is offered formula as his first feed.

In the sixties and seventies – mothers were advised to express colostrum during late pregnancy, supposedly to unplug milk ducts and increase the production of colostrum. There was also evidence that women who expressed during pregnancy were more confident with breastfeeding but despite this, advice about antenatal expressing was abandoned, possibly due to concerns that nipple stimulation could cause early labor. However, recent studies including a study of women who breastfed through pregnancy( Moscone and Moore 1993),  show that uterine contractions will only occur following the up-regulation of oxytocin binding sites in the uterus, when your body is ready to begin labor.  This means that nipple stimulation won’t induce labor unless you are at term. However, if you have a history of premature labor, prenatal expressing may be contra-indicated and if any cramps do occur while you are expressing colostrum, stop and discuss this with your health professional.

To express colostrum:

  • You will need –  1 and 3ml syringes ( from a pharmacy) and plastic ziplock bags to store your syringes in the freezer
  •  Start hand expressing once daily at 36 weeks (unless otherwise advised by your health carer. For instance if you are being induced earlier for medical reasons or if you are in premature labor and are expected to birth your baby). You can build up to expressing 2 to 3 times a day.
  • It’s best to express after your shower when your breasts are warm and your hands are clean. Otherwise wash your hands and warm your breasts with a heat pack before expressing.
  • Gently massage your breasts towards the nipple to stimulate the ‘let down’ reflex.
  • Compress your breasts with thumb and fingers above and below the areola (the dark skin around the nipple), pressing back towards the chest wall, not squeezing towards the nipple. Try to mimic the rhythm of a baby sucking – the action is ‘press, compress, release’.  As the flow slows, move your fingers around to express different ducts.
  • Express for about 3 to 5 minutes each side – as flow stops on one side, swap to the other breast, repeat so each breast is expressed twice in a session.
  • As colostrum drops appear, collect these in a syringe. If you have a good flow, you can express into a clean medicine glass or spoon (wash in hot soapy water, rinse and dry) and draw the colostrum up into a syringe. Store the expressed colostrum in the fridge between each expressing if you are using the same syringe next time.
  • Use a new syringe each day, store syringes in a ziplock bag in the freezer and label with your name and the date. Colostrum can be stored in the freezer for 3 months and in a deep freeze for up to 6 months.
  • Stop expressing if cramps occur

Here is a great link to a video on massage and hand expression – this technique is very effective whether you are expressing colostrum or you need to express after your baby is born.

Most importantly, write a post birth plan that includes uninterrupted skin to skin cuddles as soon after birth as possible, delayed weighing, delayed bathing so baby keeps his amniotic smell longer (and don’t wash your own chest the first day so baby follows this amniotic smell back to the breast and latches more easily), and advise (pop a notice on your baby’s cot if he is in a nursery)  “Colostrum in freezer for  baby if needed.”

 

Liz’s story of expressing colostrum to nourish her newborn

liz-volker-blog
In preparation for the birth of our son a year ago I hand expressed from 32 weeks gestation. When we went into hospital I took in the expressed 150 mls. This was lucky as he weighed 4.6 kilograms and had low blood glucose levels. He breast fed and then needed top ups. Instead of giving him formula the staff were able to give him my expressed breast milk. I wanted the best for him and if I hadnt had enough expressed breast milk formula would have had to bridge the gap. I was told by one of the staff that they would have to give him formula as they were getting low in my milk and his blood glucose levels were borderline. I was a little worried and expressed a few mls and then tried on him on the breast. He breast fed really well from both sides and continued to do so and has not stopped breast feeding since. He’s been a real champion and I am so proud of him.

When I’m holding my baby boy in my arms I feel so content and in love and love the hormonal changes that occur. It’s such a lovely content feeling. I love it when we look at each other when he’s feeding and he smiles. Pure bliss.

Liz is a fan of Boobie Bikkies too!

I love breast feeding my little boy. At Christmas time we went to see my husband’s family which is a little stressful. I was worried about the effect of the stress on my supply. I purchased a box of Boobie Bikkies and took them with me and they worked perfectly. I was so thrilled as was my son.

Liz Volker lives in ACT, Australia

8 COMMENTS

  1. This story brought tears to my eyes. So beautiful! My baby was born full term but had low blood glucose at birth too. I had a gut feel about expressing colostrum but didn’t; as my previous bub was prem and I was trying to go to 40wks. I was worried expressing might induce labour. I’d had pregnancy complications, internal bleeding (hematoma), low PAPP-A levels, took mini-aspirin to prevent placental clotting, and had polyhyramnios. On the day of birth, I remembered to ask for delayed cord clamping and skin to skin time. It was magical, our gorgeous baby girl tried breastfeeding immediately. I was with her (and our family) back in my suite layer that day and they visited regarding low blood glucose results. I had no colostrum to give them do they gave her formula. The formula was vomited back up so they took her to Special Care Nursery. We found out the following day after glucose drips, unsuccessful tube feeds, unsuccessful breastfeeds, and my baby girl was “wasting away”, refusing feeds and no energy at all, foaming at the mouth constantly. She was xrayed and they found her oesophagus wasn’t connected to her stomach, and her windpipe was. (Tracheal Oesophageal Fistula and Oesophageal Atresia). She was rushed to Brisbane for surgery. Oh how I wished I had expressed and stored colostrum!!! She got none of it. I expressed as much colostrum-milk after the birth as I could, bags and bags and bags of it, a freezer full. But she didn’t get the pure gold stuff. I was devastated. Relieved about the delayed cord clamping as I had no idea she would so badly need that extra nutrition! But devastated I didn’t follow my instinct about the colostrum.

  2. I was just wondering, my babies all have milk protein allergies, do u think the allergens from what I eat would go through into the colostrum? I would imagine I would need to go milk protein free from when I started expressing.

  3. Just wondering if after expressing the colostrum early does that mean the milk comes in quicker or will the baby still get some colostrum from the breast?

    • Not necessarily – your post birth hormones trigger lactation , skin to skin cuddles and allowing the baby access to the breast will help kick start your milk supply.

    • Your post birth hormones will trigger lactation so your baby gets colostrum until mature milk comes in – your body knows exactly what to do.

  4. I was diagnosed with Gestational Diabetes when pregnant with out first baby (born 2/06/15).
    I was advised to express from 37 weeks and store colostrum incase this was needed to counteract babies blood sugar levels once he was born.
    In 10 days I had managed to express 95mls of colostrum!
    Our little man Chet was born at 40 weeks and 2 days, 6 Pound 15 52cm long very healthy and a bit of a guts! We were able to establish feeding right from the start… 🙂
    I still have the 95mls of colostrum in out freezer!

    • Boobie Bikkies are safe to eat while pregnant but we really don’t know how helpful they are for colostrum. We have had mums say they helped though, so feel free to try them and let us know.

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