During pregnancy, the breasts produce their first milk, known as colostrum. Colostrum is high in antibodies and protective substances that help to support a newborn baby's immunity. Although not much colostrum is produced, it is very high in energy, protein and fat. Colostrum is also easy for newborns to digest.

There can be benefits to expressing and storing colostrum during pregnancy in case it is needed after birth. If there is a risk of premature birth or of your baby having feeding problems, the person providing your maternity care may recommend you express and store some colostrum.

What is colostrum?

Colostrum is a type of early breast milk, produced by the breasts from around 20 weeks of pregnancy until the first few days after birth. Colostrum is a thick, sticky, yellowish liquid. It can leak from the breasts onto the nipples and cause yellow crusts to form. Sometimes colostrum leaks and absorbent nursing pads need to be worn.

When does colostrum appear?

Many pregnant women notice they are producing colostrum earlier than 20 weeks, especially if they’ve been pregnant before. It’s not always obvious that colostrum is being produced until the woman checks.

What are the benefits of expressing colostrum in pregnancy?

There are several benefits from expressing during pregnancy, including:

• helping to support successful breastfeeding after birth — women who express are generally motivated to do all they can to increase their likelihood of exclusively breastfeeding their baby
• building a supply of colostrum is useful in case the baby needs extra feeds and avoids offering formula
• managing potential feeding problems relating to prematurity or a congenital condition
• managing feeds for babies of diabetic mothers where there is a risk of having problems maintaining a normal blood sugar level
• having a store of colostrum if the baby is likely to need special care and is likely to be separated from their mother

Why might there be a low supply of breast milk?

Sometimes there are reasons why a mother’s breasts do not produce as much milk as their baby needs. Storing a small supply of colostrum means the baby can have access to extra kilojoules. These reasons include:

• breast surgery or problems with breast growth during pregnancy
• some medical conditions, such as multiple sclerosis or polycystic ovarian syndrome
• a history of having low milk supply

Are there any reasons not to express colostrum during pregnancy?

Not all women are keen or able to breastfeed. Some choose to express colostrum and offer this as well as formula after their baby is born. Although there are benefits in expressing colostrum during pregnancy, there are times when it’s not recommended. There is a risk of premature labour by stimulating the breasts.

Don’t express your breasts if you:

• are at risk of, or have had, threatened premature labour
• have had a cervical suture inserted, or been diagnosed with cervical incompetence
• have experienced bleeding during your pregnancy>
• have been diagnosed with placenta praevia
• have been advised by your maternity care provider not to
• cannot store colostrum safely and hygienically

When and how to express your colostrum

Pick a time when you’re relaxed and feeling calm.

1. Wash your hands with soap and water and dry well.
2. Using your thumb on top of your breast and your forefingers underneath, gently press your fingers towards your chest.
3. Compress the breast tissue, hold briefly and then release. Try not to squeeze or pinch the nipple.
4. Collect the colostrum in either a sterile syringe or a clean container.
5. Express each breast twice during each expression. You can collect colostrum twice a day in each syringe or container. Between expressions, store the colostrum in the fridge. Label with the date, cap the syringe and put in a plastic bag and into the freezer.

Aim to express 2 to 3 times each day from around 36 weeks of pregnancy. Start gently and slowly, eventually building up to 3 to 5 minutes of expressing on each breast twice each day.

How to store colostrum

Room temperature (26° C or lower)	Fridge (4° C or lower)	Freezer
6-8 hours Store in the fridge if available	3-5 days Store at the back of the fridge	2 weeks in a freezer compartment inside fridge 3 months in fridge freezer with a separate door 6-12 months in a deep freeze

Top 5 tips for expressing colostrum

1. Start expressing at around 36 weeks into your pregnancy. Stop if at any time you start to feel contractions or vaginal bleeding.
2. Remember that any amount of colostrum will be beneficial to your baby. The amount of colostrum women can express varies widely while they are pregnant.
3. Be patient as you learn how to express and store the colostrum safely.
4. Take the clearly labelled and frozen colostrum with you (in an esky or cooler bag) when you have your baby.
5. Only use your hand, not a pump to express your colostrum.

Who can I speak to for advice on expressing colostrum?

The person who is providing your maternity care — such as your doctor or midwife — will be able to give you more advice about what’s right for you. Some pregnancy-related conditions increase the risk of premature labour and it’s important not to express colostrum if you’re at risk of having your baby early.