Expressing breast milk during pregnancy

Your first breast milk is called colostrum. It's produced from about 16 weeks of pregnancy until the first few days after your baby is born.

It's not always obvious that your breasts are making colostrum, but you may find that it leaks from your nipples.

What does colostrum look like?

Colostrum is a thick, sticky, yellowish liquid. It can also be a thinner, more clear or white liquid.

What is colostrum?

The amount of colostrum you make is small, but it's very high in:

• protein, including antibodies and other substances to support your newborn baby's immunity
• energy
• fat

Colostrum is easy for newborns to digest.

Expressing and storing colostrum after 36 weeks of pregnancy can be helpful if your baby is likely to have feeding problems.

Expressing during late pregnancy can:

• help you get comfortable with your breasts and the feeling of expressing milk
• support successful breastfeeding after birth
• build a supply of colostrum in case your baby needs extra feeds, instead of using formula top-ups
• help you prepare for potential feeding problems relating to a congenital condition
• help you manage feeds if you have diabetes, as your baby may have problems maintaining normal blood sugar levels after birth
• build a supply of colostrum if your baby is likely to need special care and may be separated from you, preventing regular breastfeeding

Sometimes your breasts may not produce as much milk as your baby needs.

Having a small store of colostrum means your baby can get extra kilojoules (energy).

Reasons you might have a low supply include:

• medical conditions, such as multiple sclerosis or polycystic ovarian syndrome
• taking certain medicines
• smoking
• a history of breast surgery
• a history of low milk supply

Expressing breast milk during pregnancy is not advised if you are at risk of having a premature birth. Stimulating your breasts may trigger premature labour.

You should not express colostrum before 36 weeks of pregnancy.

Don't try to express milk from your breasts if you:

• have had, are at risk of, or are having premature labour
• have a cervical suture
• have been diagnosed with a short cervix
• have experienced bleeding during your pregnancy
• have been diagnosed with placenta praevia
• have been advised by your doctor or midwife not to express colostrum
• can't store colostrum safely

Check with your doctor or midwife whether it's a good idea to express colostrum during your pregnancy.

Colostrum is thick and your breasts only make a small amount, so it's best to express by hand.

Pick a time when you're relaxed, and follow these steps:

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 nipple.
3. Compress the breast tissue, hold briefly and then release. Try not to squeeze or pinch your nipple.
4. When you don't notice any more colostrum flowing, rotate your hand position around the areola and repeat the process.
5. Swap to the other breast after 2 or 3 minutes, or when the flow of milk slows down or stops.
6. Collect the colostrum in either a sterile syringe or a clean container.
7. Express each breast twice during each expression. You can collect colostrum twice a day into the same syringe or container. Between expressions, store the colostrum in the fridge.
8. Label with the date and time of expression, cap the syringe and put it in a plastic bag in the freezer. If you're bringing your colostrum to the hospital, add your name and date of birth to the container.

Don't feel discouraged if you only express a small amount, or don't express anything at first.

Colostrum is usually made in small amounts. It might take a few tries to learn how to express effectively.

As you get better at expressing, you might notice that you can express more milk.

Your doctor, midwife or lactation consultant will be able to give you more advice about what's right for you.

Visit the Australian Breastfeeding Association website for more information about antenatal expression of colostrum and hand expressing breast milk.