From as early as 16 weeks of pregnancy and until three-to-five days after birth, you will produce colostrum. This is a thick honey-like substance that precedes mature breast milk and contains a host of nutrients and antibodies that boost your baby’s immunity. You usually only produce tiny amounts of this nectar; it is very concentrated, and your newborn’s stomach will be marble-sized, so they can only handle small amounts of food anyway.

Mums are usually encouraged to express and freeze (or “harvest”) colostrum from 36–37 weeks; if you are expecting multiples or a preterm birth, speak to your medical team about whether colostrum harvesting is indicated in your case. As a first-time mum, sometimes expressing that colostrum antenatally can be quite tricky. Don’t worry if you find this difficult to do - you should be able to express colostrum more easily once the baby arrives.

What can colostrum do for my baby?

Colostrum’s main role is immune support for the vulnerable newborn. Colostrum provides antibodies, good bacteria, HMOs, and other protective cells. Whether you’ve chosen to breastfeed or formula-feed, giving the colostrum can make a real difference to your baby’s developing gut. Expressed colostrum can be especially helpful if your baby has trouble feeding or stabilising their blood sugar in the hours after birth. It also encourages your baby to open their bowels and pass ‘meconium’ (your baby’s first black poo), which reduces their risk of jaundice. You may have heard midwives refer to it as “liquid gold,” as although it’s small in volume, its ‘value’ per ml is very high!

What are the other benefits of expressing colostrum?

Learning how to express while you are pregnant helps you get to know your breasts and how they work, and it gives you extra confidence for when you set out on your breastfeeding journey. Colostrum harvesting can be helpful for all women, and especially so for those who have risk factors for a more complex breastfeeding journey such as those with diabetes of any kind, following breast surgery, or if you have breast hypoplasia. Women planning a caesarean birth may also have had it recommended to them so they have extra support to their feeding journey as they recover from surgery.

Are there any reasons I should not express colostrum?

There are a few situations in which it’s not recommended. Speak to your doctor or midwife if you have a cervical suture (stitches) in place, have experienced premature labour before, are expecting multiples, or if you have had contractions, vaginal bleeding, or had your waters break during your current pregnancy.

How do I express colostrum?

It can be tricky to get the hang of initially as many of us have not done anything similar before. Hand expressing is more effective than pumping in the colostrum stage, and is a good way to get to know your own body and how it works.

Here’s how to hand-express and collect that liquid gold!

You will need:

A clean, sterilised syringe (usually a 1ml syringe is a good size).

A clean, sterilised teaspoon or shotglass sized container

A label and pen so you can date the syringe or container before freezing

Make yourself comfortable, and try to relax. Warmth is your ally in this process. Try expressing yourself in the shower or bath at first.
Gently massage your breasts.
Use your hand to cup one of your breasts. Form 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 2–3 cm away from the areola.
Use your thumb and index finger to gently squeeze.
Release the pressure, and then repeat it to create a rhythm. This shouldn’t hurt at all, but it’s normal for it to be a slow process. You may not see anything the first time you do this, and only after a few days practise start to see a few drops. A realistic expectation is to express while watching a 40-minute TV show fill a 1ml syringe..
If the colostrum does not flow, try moving your fingers slightly towards the nipple or further away, finding the spot that works best for you. Try changing the position of your fingers - imagine the breast as a clock and you can express at any angle.
Collect your colostrum with the sterilised syringe. You may find it easier to collect the colostrum onto the teaspoon or shotglass and draw into the syringe from there. When the drops slow down, move your fingers around to try a different section of your breast and repeat. Repeat the process for your second breast. Thaw frozen colostrum with warm water, never in the microwave, and use it within 24 hours. You may find that a 1ml syringe can even be thawed and warmed by simply holding in your hands for a few minutes.

Can expressing colostrum induce labour?

This is very rare, especially if your pregnancy is uncomplicated. Concerns may stem from the evidence that nipple stimulation releases oxytocin, which causes contractions, but expressing your colostrum daily is not thought to do this in levels of concern. If you’ve not been told to refrain from sex, you should likely be fine (the same hormone, oxytocin, is also released during an orgasm!). However, as mentioned above, women who’ve previously given birth prematurely, experienced contractions, vaginal bleeding, or had their waters break in their current pregnancy are usually advised against colostrum harvesting. If you feel period-like cramps while doing it, stop and rest until they go away. Persistent pain may be an early sign of labour, and it's definitely a reason to call your midwife.

Do I need to buy anything during pregnancy to prepare for breastfeeding at birth?

As long as you have a comfy place to sit and maybe a breastfeeding-friendly top, all your baby really needs to feed is you. There are so many gadgets and tools out there that are supposed to support breastfeeding that you could spend a fortune before the baby arrives and before you know if any of them are necessary in your personal situation.

A breast pump Although many mothers will eventually find a pump useful, we advise holding off on this purchase until you know what form your pumping needs will take. Each pump has a specific purpose and advantage (or disadvantage), and when you do make the investment to buy one, you want to make sure it’s the right pump for your needs. Assuming breastfeeding is going well and there’s no medical need to pump, we usually recommend waiting 6 weeks or so after birth to pump for reasons of convenience.

Nipple shields. Again, there are specific times when these can be helpful, but they are never recommended until at least your milk comes in and should be used in conjunction with skilled support to ensure that there is adequate milk transfer.

Breastfeeding cushions. For most women, a breastfeeding cushion is not only unnecessary, but it can also be the reason you are only getting a shallow latch or why your back aches during a breastfeed. If the cushion causes you to hunch over your baby while they lie on their backs, this is not helpful for either of you. See lesson 5 for further tips on comfortably latching your baby.

Any other gadgets or gizmos. It is wonderful that these have been developed to help families through breastfeeding challenges, but there is no need to pre-emptively buy any of them. Sometimes the unnecessary introduction of complications in the first few weeks can even cause more issues than they solve.

Should I express colostrum and buy breastfeeding tools for birth?

What can you do to prepare for feeding while you're still pregnant? Unii knows.