Expressing Colostrum: How, Why, and When?

Expressing Colostrum: A Simple Guide for You

Expressing colostrum doesn’t have to be difficult: We have a guide that will help you collect the nutritious pre-milk through hand expression. Additionally, we answer the most common questions about colostrum expression: When, how often, and why should you express colostrum? And how do you store newborn milk?

What is Colostrum and Why is it So Valuable?

Due to its valuable composition, the yellowish colostrum is also referred to as "liquid gold" – and indeed, every tiny drop of the first breast milk is precious for your newborn baby. However, there are sometimes reasons that make breastfeeding possible only at a later time or may even prevent it altogether. But don’t worry: Your newborn doesn’t necessarily have to miss out on the benefits of pre-milk. You can express the milk with your hands and provide it to your child in other ways. How to do this and when it might be beneficial for you is explained here!

What is Colostrum and Why is it So Valuable?

Colostrum is the first form of breast milk produced by humans and other mammals. The later forms are referred to as transitional milk and mature milk. The term derives from the Latin word colostrum for beast milk – as pre-milk is still called in animals today. Other common names include pre-milk, first milk, colostral milk, or newborn milk. Maternal colostrum is produced in small amounts by your mammary glands starting from the 16th week of pregnancy, has a sticky, thick consistency, and has a golden-yellow color.

And it is a true superfood for babies that you are producing! Newborn milk is a complex cocktail of particularly high nutrients: It contains plenty of protein, vitamins, minerals, growth factors, stem cells, and a number of other ingredients whose significance has not even been clarified yet. And because only a few drops of food fit into the stomach of a newborn baby at first, all components of the first milk are present in a highly concentrated form – so just a few drops contain everything your child needs right now. However, the most valuable property of colostrum is probably its immunizing effect: Colostrum contains a high number of maternal immune substances (immunoglobulins) that support the still immature immune system of the newborn and thus protect it from diseases. Additionally, pre-milk stimulates your baby's digestion and can help eliminate meconium. This can contribute to preventing newborn jaundice.

What Reasons Are There to Express Colostrum?

If you can breastfeed your baby directly after birth, there is no reason to express colostrum. However, this is not always possible. For example, if …

• your baby needs medical care after birth,
• your baby needs to be fed through a tube,
• your baby has a feeding difficulty and cannot (yet) drink at the breast.

This can occur due to adjustment disorders, an illness, or after birth complications. Other possible reasons may include difficulties in breastfeeding after a cesarean section, a multiple birth, and anatomical or hormonal problems that affect your milk production or milk flow. And of course, if you do not wish to breastfeed or decide to use weaning tablets. Even then, you can still express early breast milk after birth through hand expression and provide it to your newborn. In two special cases, mothers are even explicitly recommended to express colostrum:

• In the case of a premature birth: When babies are born too early, they often cannot yet drink independently at the breast. However, colostrum (like breast milk in general) is particularly valuable for premature babies. Their immune system is especially immature – and requires an extra portion of protective antibodies. Nature has taken care of this: After a premature birth, your pre-milk contains an even higher concentration of defense substances than after a full-term birth. And as a premature baby’s mother, you automatically produce colostrum for a longer time and only later produce transitional milk. But not only is the immune system supported, the easily digestible composition of first milk is ideal for premature babies: The high nutrient concentration strengthens the tiny ones without overwhelming their intestines. In fact, colostrum even helps build gut flora and mature the still immature intestinal functions. It is recommended that mothers of premature babies start expressing colostrum by hand within the first hour after birth and then use a breast pump to stimulate milk production.
• In the case of gestational diabetes: If you have gestational diabetes, manual expression of colostrum is recommended during pregnancy (prepartum colostrum expression). This also applies if you have diabetes mellitus type I or II. Because babies of diabetic mothers have an increased risk of developing hypoglycemia after birth – timely administration of colostrum can help prevent this. Pre-milk is the best means to stabilize the baby's blood sugar level and is best administered 30–60 minutes after birth. If the baby is not ready to breastfeed at that time or you do not have fresh colostrum available, your supply of expressed colostrum can be used.

How Can You Express Colostrum?

First of all: Don’t panic, you will generally not be left alone when it comes to expressing colostrum. The midwives in the hospital will assist you after birth and support you – so you don’t have to memorize this guide. And if you want to start expressing colostrum during pregnancy, you can also seek the help of a midwife or a lactation consultant. However, it’s not that complicated; here you will find a step-by-step guide.

Guide: How to Express Your Colostrum

• Get Ready: Wash your hands and try to relax. A warm shower or compress on the breast can help. To stimulate the release of oxytocin, you can also look at a picture of your baby (if it has already been born) – or imagine it.
• Prepare: Have a suitable container ready to catch the colostrum. This can be a syringe with a cap (1 ml, 2 ml, or 5 ml) or a special collection container; both can be obtained at the pharmacy or online.
• Stimulate: Massage the breast in preparation for colostrum expression. Place one hand above and the other hand below the nipple horizontally. Move your hands back and forth in opposite directions, and repeat the process vertically as well. Now support the lower part of your breast with one hand and massage in circular motions with the fingers of the other hand around your nipple. This breast massage can also stimulate milk production later – thus stimulating milk formation and milk flow.
• Express: Now place your thumb and index finger of one hand about three to four centimeters from your nipple so that your fingers form a "C". Press your fingers inward towards your ribs. Then move your fingers back forward and gently squeeze them around your nipple. Then relax again. Repeat the entire process multiple times; move your "C" fingers around the nipple – this will empty all the milk ducts of the breast. Ideally, a fluid, milking hand motion will now occur.

There’s no need to squeeze or press too hard – this could injure your nipple. Repeat the process during pregnancy 1 to 3 times a day for about 10 to 20 minutes per breast. And: Don’t expect large amounts of colostrum. After birth, your body typically produces only a few milliliters of it, about 40 to 50 ml within 24 hours. Before birth, between 0.1 to 0.9 milliliters per day can be expected.

When is the Best Time to Start Expressing?

If none of the reasons mentioned above apply to you, there is no need to express colostrum before birth. You can collect pre-milk directly after delivery in the delivery room if needed. In the case of a threatened premature birth, a multiple pregnancy, or if a planned cesarean section is imminent, it is advised to start only with the onset of labor or after delivery. Manual expression of pre-milk is suspected to potentially promote contractions. If your belly hardens or you experience pain while expressing, stop the process. If you have an uncomplicated pregnancy and have been advised to store a small reserve during pregnancy, then start expressing only after the 37th week of pregnancy. And always consult with your midwife, doctor, or physician beforehand. Consulting with an IBCLC lactation consultant or breastfeeding counselor can also be helpful; you can find addresses near you.

Where and How to Store Colostrum?

If you want to store a supply at home, catch the colostrum in specially designed collection containers or a sealed syringe. Place the syringe or tube in a zip bag and label the colostrum reserve with your name and the date of freezing – this will make it easier for the clinic to identify later. It is recommended to freeze the expressed colostrum immediately in the bag at -18 degrees Celsius. The frozen breast milk is then good for up to six months. For transport to the hospital, it is best to transport the frozen colostrum between ice packs in a cooler bag and have it placed directly back in the freezer on-site. Your baby can then be fed directly through the syringe later.