Expressing or Harvesting Prenatal Colostrum

You may have heard or read about expressing or harvesting your colostrum while you are pregnant. Congratulations on taking the first steps to increase your chances for good milk production, comfort in expressing your milk and achieving exclusivity in breastfeeding!

More and more mothers are committing to the importance of exclusive breastfeeding. Did you know more than 80% of mothers are breastfeeding during the first day after birth, but by the second day only 60-ish % are still exclusively breastfeeding? It is hard to say "NO, thanks"" to. forced formula supplementation. Your doctor, with many more years of education and thousands of babies more experience than you, is recommending it. Really, WHO can say no?

Now, there is an alternative if you do a little planning and research and then practice prenatal colostrum expression. It is not for everyone, but it is widely accepted in hospitals. It solves the problem of supplementing a baby who has low blood sugar or dramatic weight loss, and when mother and baby are separated.

This strategy is useful if you are in the last month of pregnancy. You don't need approval from your OB or midwife, but I do recommend it. While it's technically possible to go into labor, it is highly unlikely. If all we needed to trigger labor was a few minutes of nipple stimulation, who in their right mind would choose a Pitocin induction?

You may already have colostrum leaking, but that's not necessary to be successful.

To start:

1. Wash your hands, have a syringe or milk tube ready and a soft cloth for wiping drips and spills.
2. Look at your nipple and areola in the mirror. You may notice the tip of your nipple looks a little like the surface of a raspberry. Milk will come out of the cracks in the surface of your nipple. You have between 4 and 8 pores that milk comes out of. Your areola is pigmented skin with tiny bumps on it. It can be extra large, large, medium or small. It can be light or dark. None of that matters for breastfeeding. The areola is a target your baby can see and smell when locating your nipple. The tiny bumps on your areola are Montgomery glands that secrete a fluid to clean and lubricate your areola and nipple.
3. Think of a traffic light. Your nipple is going to be the yellow light. Place your thumb on the red light position and your pointer finger in the green light position.
4. Just like for Goldilocks, there is a spot that's too close to the nipple, one that's too far from the nipple, and a "just right spot." For most of moms I have helped, the "just right spot" is about 1"-1.5" distance from the base of your nipple. For those with a 2" areola, that's on the edge of the pigment, For those with a 4" areola, that's in the middle of the pigment. Pigment doesn't matter. Seeing milk drops forming on your nipple is the only thing that matters.
5. Gently and firmly press your thumb and fingers together. Hold for two seconds: "one-one-thousand, two-one-thousand." and release.
6. Repeat the compression and release process three times. If you don't see any drops, move your fingers 1/4" away from your nipple and repeat step 5. 
7. Continue compressing your areola/breast in different places until you see a drop of milk forming. When you see a drop, stop changing your finger position, and keep compressing your areola/breast in a pleasurable rhythm. You will probably see one drop, then another and another.
8. Sometimes you only see one drop on the first practice. If you see zero drops, check your finger positions and try again. If after 5 minutes you have no results, try again another time.

When you do express your colostrum, you should label it and freeze it right away. Label everything with your name and date. Set your freezer on the coldest setting possible.

Store colostrum syringes in a cooler type lunch bag, with an ice pack, in the back of your freezer.

Bring the cooler bag to the hospital. They will store it in the freezer or fridge until you need or want it. You might use it if your milk is slow to come in, or your baby has hypoglycemia or jaundice. If you and your baby are separated for any reason, your colostrum can help keep them from needing supplementation with formula.

If you think of your colostrum as medicine, which it is, you get a sense of how valuable you are in your baby's life. Your colostrum moves out meconium and seeds your baby's intestines with prebiotics, probiotics and immune factors like IgA. Colostrum forms the building blocks of the human gut biome and your milk feeds that biome. Formula doesn't do any of this.

Right after birth, keep your naked baby on your bare chest as much as possible so baby has unlimited access to your breasts and breastfeeding. Continue this unlimited skin to skin contact regularly for the first two weeks, and as often as you desire for the first two months.

Good Luck! I'm here if you need help. Request an appointment in the bar above.