Expressing milk before your baby is born

Colostrum (first milk) is produced from around 16 weeks of pregnancy. This continues in pregnancy in preparation for your baby’s birth. This leaflet will support you in expressing colostrum before you give birth, to support your baby in the early hours after they are born.

Colostrum triggers the baby’s immune system, helps to stabilise blood glucose levels and is particularly high in infection fighting properties including antibodies. It also contains vital immunological properties and helps to coat your baby’s gut with healthy bacteria, which helps to protect against allergy and disease. It is produced in small quantities which are the perfect amount for your baby’s stomach.

There is evidence that giving formula can increase your baby’s risk of developing diabetes, asthma and other illnesses. It is better for your baby to receive only your milk in the early weeks. If the unexpected happens and you and your baby are separated, or if your baby has feeding difficulties or health problems, having saved colostrum can be extremely helpful, and you will find it easier to express your milk if you have practised beforehand.

If you are experiencing challenges with breastfeeding at the beginning, you can give your milk to baby through a syringe or cup (it is best to avoid bottles while establishing breastfeeding) so that baby is only getting your milk from the very start.

When to express

If you wish to express colostrum for your baby before they are born, we suggest you start at around 36-37 weeks of pregnancy. If you are in hospital being induced, the process can take some time. This can be a perfect time to hand express, and staff can store your milk for you.

If no risk factors for premature labour have been identified during your pregnancy, then there is no evidence that daily hand expression of colostrum can trigger labour.

However, if you have any of the following conditions, antenatal expressing is not advised:

A short cervix
A cervical suture

If you experience any uterine contractions during expressing, you should stop. If these continue, please contact your midwife.

How to hand express while pregnant

Start by making sure that your hands are clean and that you have a sterilised container or syringe before you start.
Get comfortable, ensuring that you are as relaxed as possible.
To help release colostrum, it can be useful to shower or bath before expressing. Alternatively, you can apply some warm cloths to the breasts prior to expressing.
Use a few minutes of gentle breast massage before expressing. This can be kneading massage, stroking towards the nipple, or whatever feels comfortable for you. Nipple stimulation is also helpful.
Cup your breast with one hand making a ‘C’ shape with your thumb and the rest of your fingers, about 2-3 cm behind the nipple. Sometimes pressing inwards back towards your chest wall as you compress, may help.
Slowly and firmly compress your breast and then release the pressure, building up your rhythm. Avoid sliding your fingers over the skin. Because colostrum is very concentrated, it is thick, and will come out of your breast drop by drop. It does not matter what colour your colostrum is, this will vary.
If you cannot see any colostrum, try moving your fingers slightly towards the nipple or further away. Find the spot that works best for you.
Keep your hands in one position until the colostrum stops coming. Then you should move your hands around to a different position, ensuring that all lobes are drained.
Aim to use both breasts, at least twice each session.
Collect your colostrum a few times per day.
It can take time to start to be able to express. Play around with the position of your fingers and keep trying regularly. Some mums may find it helpful to use a breast pump for extra stimulation. If you’re not able to express colostrum before birth, don’t worry! This has no bearing on milk production once baby is here.

Ask your midwife for more syringes and bungs if needed, or bottles to express into. The same syringe / bottle can be used for a few expressions on the same day ensuring that it is stored in the fridge between expressions. In your hand held notes you will have sticky labels with your details on. Apply a sticker to the syringe or bottle and add the date and time. Your midwife can print you more labels if needed.

If you are expecting to deliver within 24-48 hours, you can keep your colostrum in a fridge. Otherwise, it is best to freeze it.
At the end of the day the containers of colostrum can be placed in a sandwich bag and then in a freezer (minimum temperature of -18°C). If you are in hospital, milk can be stored in a freezer.
When you are admitted to hospital for the birth of your baby, you can bring your frozen colostrum into hospital in a cool bag with freezer blocks. The colostrum should be handed to staff as soon as you are admitted so that it can be stored in a freezer.
Defrosted colostrum should be used as soon as possible, and always within 24 hours of thawing.

How much will I get?

The amount of breast milk you get will vary from a few drops to a few mls or more. This amount is perfect for your baby’s small stomach, as colostrum is very concentrated in nutrients and helps your baby fight infections.

Ensure that the midwives caring for you (or the neonatal team caring for your baby) are aware that you have collected your milk antenatally should it be needed by your baby.

If your baby is in special care

Antenatal expression of colostrum can be extremely useful for preterm or unwell babies in helping them to avoid the need for intravenous fluids, central (‘long’) lines or formula supplementation.

Further information about feeding your baby

If you are having difficulty breastfeeding after your baby is born, please ask staff for assistance.