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HOW ANTENATAL HAND EXPRESSION CAN HELP WITH EARLY BREASTFEEDING SUCCESS

Updated: Nov 29

Breastfeeding has the potential to be one of the most rewarding aspects of early parenthood, but getting off to a smooth start can sometimes be challenging. One helpful technique that can boost early breastfeeding success is antenatal hand expression of colostrum. While not always well-known, expressing colostrum before your baby is born can provide numerous benefits for both you and your baby, setting the stage for a more successful breastfeeding experience.


a pregnant woman hand expressing a drop of colostrum into a medicine cup during antenatal hand expression

What is colostrum and why is it so important?


Colostrum is the first milk produced by the breasts from about the 20th week of pregnancy and during the first few days after the birth of your baby. Known as “liquid gold”, colostrum provides the perfect nutrition specifically for your newborn baby. It is a concentrated form of mature milk, which is very high in protein, antibodies, and other protective components that are important for your newborn. Colostrum is easily digested and the ideal first

food for your baby.


What is antenatal expression and is it necessary?


Antenatal hand expression refers to the process of manually expressing colostrum in the final few weeks of your pregnancy. Sometimes referred to as 'colostrum harvesting'. While antenatal colostrum expression is not essential for every parent, it can be particularly beneficial for certain situations. Ideal circumstances would ensure all babies receive colostrum after birth however there are situations that may 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 who is diagnosed with intrauterine growth restriction (IUGR)

• An infant who is small or large for gestational age


Other reasons women might need to consider supplementing:

• 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 (PCOS)


By learning how to express colostrum during pregnancy, you’re not only preparing your body for breastfeeding but also ensuring that you have a supply of colostrum ready if you face any breastfeeding challenges after birth.


When and How to Start Hand Expression of Colostrum


When to Start Expressing Colostrum

The ideal time to start antenatal colostrum hand expression is around 36-37 weeks of pregnancy. Please discuss this with your doctor, midwife, or lactation consultant for individual advice prior to commencing expressing.


how to hand express


To hand express breast milk, you can: 

  1. Wash your hands: Use soap and water to reduce the spread of germs. 

  2. Massage your breast: Gently massage your breast in a circular motion, starting at the outer areas and working your way in toward the nipple. This can help encourage the let-down reflex. 

  3. Position your fingers: Place your thumb above your nipple and your fingers below it, about 1 to 2 inches behind your nipple. Your fingers and thumb should form a "C" or "U" shape. 

  4. Compress and release: Press your fingers and thumb back toward your chest, then gently compress them together. Release, then repeat in a rhythmic pattern. 

  5. Move your fingers: Rotate your hand around the areola, moving your fingers slightly forward or back to express different areas. 

  6. Switch breasts: Once you've expressed as much as you can from one breast, repeat the process on the other breast. 

  7. Collect the milk: Once your colostrum starts dripping easily, start collecting! You can use a syringe to suck the colostrum right off the nipple, collect drops on a plastic spoon or into a med cup.

  8. Repeat: You can hand express each breast for 3 to 5 minutes, 2 to 3 times a day.




Video: hand expressing into a med cup



Video: hand expressing onto a spoon



Video: collecting colostrum into a syringe


Storing Colostrum


If you’re expressing colostrum ahead of time, it’s important to store it correctly to ensure its quality and safety:

  • Storage Containers: Use sterile containers such as breast milk storage bags, syringes, or small containers with tight-fitting lids. Avoid using regular plastic bags or bottles that haven’t been specifically designed for breast milk storage.

  • Label and Date: Always label your milk with the date and time it was expressed, so you can keep track of freshness.

  • Refrigeration and Freezing:

    • Short-Term Storage: If you plan to use the colostrum within the first few days after expressing, it can be stored in the refrigerator (at or below 4°C / 40°F) for up to 4 days. Make sure milk is cooled before adding it to another collection in the fridge.

    • Long-Term Storage: After 4 days, if you need to store it for a longer period, colostrum can be frozen for up to 6 months. Be sure to store it in small amounts, as your baby may not need a large quantity at once.

  • Transporting Colostrum to the Hospital: If you plan to bring your colostrum to the hospital, store it in an insulated cooler bag with ice packs to keep it cold. Make sure to bring it in a sterile container and inform the hospital staff that it’s colostrum. The nurses will store your colostrum in our special breastmilk freezer until you need to use it. You can keep it at room temperature for up to 4 hours. Once your frozen colostrum has been thawed, it cannot be refrozen. Don't forget to take home your unused colostrum from our freezer!

What If You Can't Express Colostrum?


It’s completely normal to feel frustrated if you’re unable to express colostrum during pregnancy. Not every parent will be able to express colostrum before birth, and that’s okay! Also, the amount of colostrum you produce in pregnancy can vary widely, and some people simply won’t see any noticeable output before their baby arrives.

Be Patient and Don’t Panic

  • Patience is Key: Don’t worry if you don’t see a lot of colostrum at first. It’s important to remain patient and allow your body time to adjust. For some, it might take several tries before any milk comes out.

  • Stay Positive: Even if you’re unable to express colostrum, remember that your body is still capable of producing milk after birth. If your baby has difficulty breastfeeding initially, the maternity nurses or your lactation consultant can provide support.

  • Get your partner to help: Parents often say the partner is able to collect more colostrum when they do hand expression while the mom relaxes. Try doing after a nice warm shower or bath!


Contraindications and Consulting Your Healthcare Provider


While antenatal hand expression of colostrum can offer many benefits, it's not recommended for everyone. There are certain situations where expressing colostrum before birth may not be appropriate.


Do not express if:

• You have a history of, or are currently experiencing, threatened or actual preterm labour

• 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

• If you have had multiple c-sections or a previous "classical c-section" incision

These are just a few examples. At your next prenatal appointment, discuss with your healthcare provider to ensure that this technique is safe for you and your baby.

Join Our Workshop: Your Feeding Experience


Antenatal hand expression of colostrum can make a significant difference in your early breastfeeding journey. Whether you're looking to increase your confidence or simply prepare for a smoother transition into motherhood, learning how to express colostrum before birth can be incredibly helpful. If you're ready to elevate your breastfeeding preparation, consider joining our Your Feeding Experience workshop for the guidance and support you need.


By preparing ahead of time, you’ll approach the postpartum period with greater confidence, knowing you've taken steps to set both you and your baby up for breastfeeding success.


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