Colostrum: When should I express it?

Colostrum is the first milk your breasts produce. Often called "liquid gold", it is thick, nutrient-dense, and rich in antibodies, proteins, and growth factors that protect your baby from infection and support gut and immune development.

Your body begins producing colostrum during late pregnancy, and it continues in the first few days after birth before mature breast milk comes in.

Most mothers will breastfeed and provide colostrum naturally after birth. However, in some situations, expressing colostrum before birth (called antenatal expressing) can be helpful.

What is Antenatal Expressing?

Antenatal expressing means hand-expressing and collecting colostrum during late pregnancy (recommended from 36 weeks onwards) to store for your baby after birth. This can be reassuring and build confidence in some families, especially if there is a chance your baby may need extra feeding support in the first 24–48 hours. Having your own colostrum available may also reduce the need for formula supplementation.

When might it be recommended?

Your midwife and/or obstetrician might suggest antenatal expressing if:

• You have diabetes during pregnancy — babies can have low blood sugar after birth and the extra colostrum can help keep their blood sugar stable.

• Your baby has a condition that might make feeding more difficult – this could include a tongue tie, cleft lip/palate, or certain heart or neurological conditions. If your baby is diagnosed with one of these conditions before birth, having colostrum on hand can be helpful.

The large Australian DAME study found that women with diabetes in otherwise low-risk pregnancy could safely express colostrum from 36 weeks, with no harm to their babies. Some babies were also less likely to require formula in the first 24 hours.

When should you avoid it?

Always speak to your midwife or doctor before starting antenatal expressing. Antenatal expressing may not be recommended if you:

• Are at risk of premature labour

• Have placenta praevia

• Have been advised to avoid nipple stimulation*

*Nipple stimulation can release oxytocin, which may trigger uterine contractions – which is also why it is generally only recommended from 36 weeks onwards in low-risk pregnancies.

Things to know before you start

1. Start no earlier than 36 weeks, unless advised otherwise.

2. Colostrum is thick and produced in small amounts – drops are normal.

3. Hand expressing works best, compared to alternative techniques like a pump, at this stage.

4. Not collecting much (or anything at all) is common and not a predictor of future milk supply.

5. If collected*, store in sterile syringes or containers, labelled with your name, date, and time, and freeze.

*Collect it onto a spoon, into a small cup, or use a syringe to draw up drops straight from the nipple.

How to Hand Express

1. Wash your hands thoroughly.

2. You may find it easier after a warm shower or gentle breast massage.

3. You may prefer to ask your midwife or follow the instructions and image below:

4. Place the pads of your thumb and forefinger opposite each other at the outer edge of your areola.

5. Gently press back into your breast tissue (toward your chest wall) and compress your fingers together rhythmically.

6. Rotate finger positions around the areola if needed.

7. Express for up to 5 minutes per side, then switch breasts.

*Swap hands, have your partner help you, or have a rest if needed.

Remember – do not worry if there is little or no breastmilk, and if you feel uncertain about expressing or it is causing any discomfort or contractions, stop and seek advice from your midwife or doctor.

Currently in Australia, each hospital will have different protocols and suggestions on antenatal expressing. So, if you're unsure, your midwife or doctor is the best person to guide you. And whether you collect drops, millilitres, or nothing at all – trust and believe in your own body that it is preparing in its own unique way!