Why, When and How to Collect Colostrum Antenatally

Why should you care about Colostrum Collection?

I will start by saying that I used to tell women that unless there was a concern about their pregnancy, baby or supply, they didn’t need to collect. Because in a perfect world, the baby comes out, we trust the baby and the body to work together and it all just happens. And that is what should happen. BUT, unfortunately however, in todays birthing culture, we have a high induction and intervention rate in labour which tends to lead to complicated drawn out labours, IV fluids, epidurals and potentially caesareans. And when these things happen, the initial increase in milk supply from colostrum to milk can be delayed. When supply is delayed, often formula is then introduced and this then creates a situation where a baby is too full to want to breastfeed and the impact on milk supply continues to go down an unfortunate road. Also, collection is highly recommended if there is a situation where we have a parent with Gestational Diabetes, a planned or expected caesarean or any reason to be concerned about milk supply. Please ensure you speak with your midwife, OB or other care provider and as long as it is cleared by your health professional, you can start expressing, usually from 38 weeks gestation.

IMPORTANT NOTE: If you are at risk of pre-term labour or have medical indications that would cause you to be concerned about going into labour early, antenatal colostrum collection would NOT be recommended.

So how does Antenatal Colostrum Collection help us?

Well, it does a number of things. It helps women get to know their body, learn about their breasts and start stimulating their breast tissue, glands and ducts. The colostrum that is collected can be saved, frozen and taken to the hospital to be given to the baby if required. It can also help to kickstart your breasts so if anything does cause a delay, then we have given everything a little pre birth boost. It can also prevent unnecessary formula use if we have it in our back pocket, so for that reason, I do recommend giving it a go.

So how do we do It?

First of all, do not be concerned if you do not get anything. When we are pregnant, the placenta produces progesterone. Progesterone is the enemy of breastmilk. It’s function is to protect the pregnancy and the baby. Once the baby has arrived and the placenta is delivered, progesterone levels drop. The baby is then put to the breast and the nipple stimulation and that gorgeous baby increase the parents level of oxytocin. Oxytocin triggers prolactin which is the hormone responsible for breast milk production! So while your breasts have started producing colostrum since somewhere around 14 weeks gestation, you may or may not be able to express it. Please do not let this add unnecessary stress to you. Second time parents are also more likely to be able to collect colostrum.

If you have it and you able, collect that liquid gold!! It is full of immunity building properties, lines your babies gut like a coat of paint, sealing in everything good and keeping out all of the bad guys.

Step 1 - Set the scene! You may want to first try this in the shower to see what you can do and get familiar with your breasts when you are nice and relaxed and your breasts are soft and warm.

Step 2 - Give the breasts a lovely little massage. Gentle little circles around all of the sides. No vigorous massage!

Step 3 - Make a C with your fingers around the edge of your areola, push back towards your ribcage and give a gentle squeeze down and towards your nipples. You don’t need to apply too much pressure or tweak and damage your actual nipples. Move the C around in each direction to evenly stimulate the breasts.

Step 4 - See if any lovely golden drops come out.

Step 5 - Collect the colostrum when you are out of the shower - You don’t want to contaminate it with water, so the collection needs to happen when you are dry. You can use syringes that may be provided to you with little caps from your hospital or Haaka also make these handy Colostrum collectors.

Here is a video showing you a technique on how to express milk and give breast massage.

Watch this video from Stanford - It’s an oldie but a goodie and will give you the idea!

How To Top Up:

So now you are at the hospital and your baby needs a top up. Remember to breast feed first if possible, they usually do the best job of getting milk out and stimulating the breasts. Then you would give the expressed breast milk that you have, hand express and pump every 2-3hrs to continue stimulating the breasts and then as a last resort give donor milk or formula.

This will all help to keep stimulating your breasts, protect your supply and feed your baby. Remember to keep the amounts of milk age appropriate per day of life. Newborns should be supplemented by either a syringe, cup or tube feed at the breast or tube fed with a finger depending on your unique situation. Bottles should be a last resort as we want to protect the breastfeeding relationship.

Remember newborns have teeny tiny tummies and require very small amounts of milk but frequently as they fill up and empty out quickly. If we fill up a baby with more than the amount they need per feed per day of life, they will be then too full to want to breastfeed!

Below is an indicative guide for how much to feed your baby in those first days of life. Newborn babies need to feed every 2-3hrs so that’s 8-12 times in a 24hrs period. These are provided in a range because every baby and situation is different. Remember breastfeed, hand express, top up then formula if required.

Day 1 - 5-7mls

Day 2 - 10-15mls

Day 3 - 15-30mls

Day 4 to 7 - 30-60mls

Day 7 to 10 - 45-60mls

2-3 weeks of age - 60-90mls

3 weeks old - 90-120mls

4 weeks to 3 months old - 120-150mls

There is a rough run of thumb as they get older that they need 150mls for every kilo of body weight per day. So for example, a 6kg baby needs 900mls per day and then you divide that by how many feeds they have per 24hrs. So 8 feeds would be approx 112mls and 10 feeds would be approx 90mls. This of course depends on your individual baby, where they are on weight scales, if they need to gain more weight you would need to increase that amount but please speak with a professional doctor or IBCLC to work out your individual babies requirements.

Remember - Breastfed babies take serious amount throughout the day and always go back to the top 3 feeding signs - peeing, pooping and gaining weight!