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Printed at: 11:06:10 / 18-04-2021

Antenatal Colostrum Collection

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Why is colostrum important?

The first milk your breasts produce is called colostrum. Colostrum contains important antibodies and nutrients for a newborn baby. It is high in carbohydrates and protein but low in fat. It will help the baby pass his or her first stools, which is important to prevent jaundice. Jaundice is a common, usually harmless, condition in newborn babies which causes yellowing of the skin and the whites of their eyes. The antibodies contained in colostrum serve as an immunisation. This allows the mother to pass on immunity to her baby, from the many germs that could otherwise harm him or her. There is a much higher concentration of these antibodies in colostrum than there is in mature breast milk. It contains nutrients that a newborn needs for healthy brain, heart, and central nervous system development.

Colostrum is also very high in vitamins, minerals, and antioxidants. It comes in perfect small quantities for newborn babies. It is also perfectly designed to line your baby’s gut and be absorbed, laying the groundwork for future healthy development and proper digestion. Research also shows that colostrum helps to stabilise blood sugar levels in babies which is very helpful particularly in those babies of mothers who had diabetes in pregnancy.

Getting off to the best start
This is produced from about sixteen weeks of pregnancy onwards. Your breasts may leak colostrum from 28 weeks. The amount of colostrum will vary from woman to woman. It can range from nothing initially, to a few drops, progressing to a teaspoonful or more. Learning to express colostrum can increase confidence and ability to breastfeed, especially in situations where the first feed may be delayed, high risk pregnancies and other special situations for example:
· Women with diabetes
· Multiple pregnancy (twins or triplets)
· Women with breast abnormalities or previous breast surgery
· Women with pregnancy induced high blood pressure and /or taking blood pressure medication
· Previous negative experience/difficulty with breast feeding
· Planned caesarean/induced birth especially if your baby is going to be born early
· Babies who are thought to be small or are expected to be under 2.5kg at birth

This can be done safely from 36 weeks of pregnancy as long as you have no risks of bleeding in pregnancy and you are not at risk of a pre-term birth.

How to hand express
1. Have a clean sterilised container to hand before you start. Ensure you are comfortable and then gently massage your breasts for at least 10 minutes.
2. Cup your breast and feel back from the end of the nipple to where the texture of your breast feels different.
3. Using your thumb and the rest of your fingers in a C shape, gently squeeze this area. It shouldn’t hurt.
4. Gently compress and release the pressure. Repeat again and again, building up a rhythm.
5. Avoid sliding your fingers over the skin.
6. At first, only small drops will appear but just keep going as it will help build up your supply. With practice and a little more time, milk will flow freely.
7. When the flow slows down, move your fingers round to a different section of your breast and repeat. When the flow slows down, swap to the other breast. Keep changing breasts until the milk is dripping very slowly or stops altogether.
8. If the milk doesn’t flow, try moving your fingers slightly towards the nipple or further away, and try a gentle breast massage.

How often can I express?
Before you have your baby and in the first few days after birth only hand express. You could practise in the bath or shower as relaxation and warmth often helps with expressing. It is very normal to get nothing initially, even learning how to hand express will get you off to a great start for when you have your baby

Why hand express rather than use a pump?
You will only be expressing small amounts of colostrum, so using the pump at this stage will be impractical and may not be as effective. Before your baby is born, you will only need to express until you have a few drops of colostrum expressed. By expressing up to three times a day, you can express enough for baby’s first feeds as babies require no more than a teaspoon of colostrum.

What do I need?
Ask your midwife for a colostrum collection kit. This will contain some 1ml sterile oral syringes, labels, hand expressing guide, a sterile bottle and tamper proof seals. It is extremely important to label EVERY syringe or bottle with your name, hospital number, date and time of the expression.

Storage
Breast milk can be stored in the fridge for up to 5 days at 4°C or lower. It should be stored at the back of the fridge, never in the door. Breast milk can be stored for up to 6 months in a freezer. Any breast milk expressed in the antenatal period should be stored in the freezer. When you are in labour, bring your stored colostrum with you in a cool bag with ice packs. The Midwife will store it in the milk fridge until it is required. Please ensure it is correctly labelled as per guidance.

For more advice and video demonstration, please follow this link: https://www.unicef.org.uk/babyfriendly/baby-friendly-resources/breastfeedingresources/hand-expression-video/