Bring Extra Colostrum With You to the Hospital: Here’s How

Colostrum is the yellow, first milk women produce from about their 20th week of pregnancy. It is the ideal first food for your baby. Known as “liquid gold”, it’s full of immunoglobulins that provide the vital initial framework for your baby’s immune system. Ideal circumstances would ensure all babies receive colostrum after birth- but sometimes circumstances may prevent this. Here’s my guide on how to hand express colostrum to bring with you to the hospital for supplementation.

Who's at Risk for Early Supplementation?

Being a labour and delivery nurse, I know health care professionals strive to help women provide their baby’s with colostrum right away, but there are situations that arise that can put your baby at risk for needing supplementation. Some examples of this are:

  • An infant whose mother has gestational diabetes
  • An infant who is born prematurely
  • An infant who has been stressed during the birth process
  • An infant whose mother has gestational hypertension

Other reasons women might need to consider supplementing are:

  • Women who have had previous breast surgery
  • Women who have experienced low milk supply with previous children
  • Women who have breast hypoplasia (limited breast development)
  • Women who have polycystic ovarian disease
Diabetes tools

How Can We Lessen Supplementation with Formula?

One way to avoid having to give your baby formula after birth if you would prefer not to, is to consider antenatal hand expression. What is this? It is expressing and storing your colostrum while still pregnant so you have extra colostrum available for your baby if he or she needs supplementation.

I recommend always checking with your health care provider prior to starting antenatal hand expression to make sure it is safe for your pregnancy. Some examples of reasons why it may not be safe are:

  • If you have a history of preterm labour prior to 37 weeks gestation.
  • If you have a history of a shortened cervix, or if you have had a suture in your cervix to prevent preterm labour.
  • If you have a low lying placenta or placenta previa.

These are just a few examples. At your next prenatal appointment, discuss if you can start antenatal hand expression safely.

formula for supplementation

When Can You Start Collecting Colostrum?

After discussing with your health care provider, most women can start at 37-38 weeks gestation. Start with around 5 minutes per breast each day but it is important to stop if you are having contractions at any time.

What Supplies Do You Need For Hand Expression?

Hand expression does not require much for equitment and can typically be done with minimal tools but there are a few necessary items: 

  • Oral Syringes’ with caps like these (it is often a good plan to have a variety of sizes 1 mL, 3 mL and 5 mL-but not necessary). 
  • Clean medicine cups or a clean spoon to express into (I prefer the cups as they feel more secure and you don’t want to lose any colostrum to accidental spills).
  • A Ziploc freezer bag to store the syringes in.

How Do I Hand Express Colostrum?

  • Always wash your hands before starting. I suggest expressing after a warm shower or bath.
  • Sit up, leaning slightly forward.
  • Massage your breast from the base to the nipple. This will stimulate a “let down”.
  • Gently press your pointer finger and your thumb towards your chest wall, press together, and hold for a few seconds. Your fingers should not touch or squeeze your nipple. Think “press, hold, release, repeat”.
  • Collect colostrum into a syringe as you see it appear at the end of your nipple. Don’t be discouraged if you see none when you first start expressing, it can take time and practice.
  • Use a clean syringe each time. Label with date and time. Your colostrum can be stored in the freezer for three months and the deep freeze for six months.

Hand Expression Shouldn’t Hurt!!!

Oral syringe

You've Hand Expressed Colostrum- What Now?

Add your frozen milk to your list of things to bring to the hospital. It is a good idea to transport the colostrum in a cooler with ice packs to prevent it from thawing on the trip. Keep in mind any thawed colostrum is no longer usable after 24 hours. When you arrive, ask your nurse to put it in a freezer safe for breastmilk. If you can label the syringes of colostrum- great! If not, make sure the nurses label these prior to storing them for you- you don’t want all your hard work and precious colostrum to go to waste!

mom with baby breastfeeding

Hand Expression and Your Breastfeeding Journey

I find hand expression at the end of pregnancy helps moms feel more comfortable with expressing and handling their breasts prior to their babe arriving. A new baby is a STEEP learning curve and learning to breastfeed is a process. Practice hand expressing prior to baby’s arrival and you will find the comfort level you already have with hand expression has a significant impact on your comfort level breastfeeding your baby, resulting in a less stressful journey to exclusive breastfeeding. If you feel like you need support with antenatal hand expression or breastfeeding further find a nurse who will be so happy to help you here.

As always I am sending you SO much love and support.

Carrie Bruno RN, IBCLC


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