Colostrum harvesting seems to get more and more fashionable - and that for several good reasons. By writing this article I hope to empower more women to give it a go.
Colostrum, also called drinkable gold, has a thick consistency, due to its high cell count and a yellowy colour due to its high consistency of ß - carotin. It contains a large amount of protein, for example immunoglobulins and stem cells, which are very important for the newborn’s immature immune system. There are also higher counts of Vitamin. A, Vitamin. E, lactose and minerals in the colostrum, then in mature breast milk. In spite of its small amount it not only has shown to have a stabilising effect on the newborn’s blood glucose level but the small amount of colostrum does have a function. It aims to provide a low volume, to help the newborn establish a suck, swallow and breathing cycle during a feed (1).
A woman's body starts to produce milk already during pregnancy. The first stage of milk production is called mammogenesis. At this stage, the colostrum is produced and this production is regulated by hormones. Due to rinsing hormones in the mother’s blood, which are additionally produced by the placenta, the alveoli in the pregnant woman’s breasts convert their cells from epithelial cells to secretory cells. These hormones are called prolactin, relaxin and HPL (Human Placental Lactogen). The mammogenesis starts from approximately week 12–16 of pregnancy and ends most likely on the second day after the newborn’s birth. Due to oestrogen and progesterone, which are the hormones that keep the pregnancy going, the lactogenesis (milk production after birth) is inhibited, which means only a small amount of colostrum can be produced during pregnancy (2).
Benefits for the baby
The colostrum which has been harvested during pregnancy can be a great energy source for the newborn after birth. Birth is not only exhausting for the mother but also for the baby. The process of labor and birth uses up a lot of the baby’s energy. After birth the baby is no longer provided with energy by the mother so it has to obtain it from the breastmilk. However suckling on the mothers breast also requires energy and therefore the harvested colostrum can be a great energy boost for the newborn. One can often witness a better blood circulation in the newborn's skin and increased activity after it has been fed with the harvested colostrum. Studies have shown that the first hour after birth is crucial for the long-term breastfeeding outcome (2). However it not only has benefits for the newborn, but also for the mother. By giving the newborn a little energy boost one promotes productive suckling on the breast, which then releases oxytocin which in return encourages uterus contraction. The more productive suckling the newborn is able to achieve, the higher the oxytocin release is. The higher the oxytocin levels in the blood are, the more effective the uterus contractions are, which then resolves in a decreased chance of postpartum haemorrhage.
It is widely known that colostrum has a stabilising effect on the newborn's blood glucose level. This is especially important when a mother has gestational diabetes. Some newborns struggle with hypoglycemia after birth, due to the imbalance between insulin and blood sugar level. Most newborns need more milk to compensate for this gap. Therefore a study has shown that harvesting colostrum and feeding it to the baby after birth reduces the need for formula consumption (3).
Learning to express colostrum before birth has also shown to reduce stress in the immediate postpartum period over breast milk supply & increases confidence of your own body’s ability to produce enough milk. In addition, it enables the establishment of “full lactation” more quickly & supports familiarity with one's own breast and their functionality.
Another benefit of harvesting colostrum is that the partner is able to feed it to the newborn if the mother for example is still in the operating theater due to a cesarean section. It is a great way of bonding or caring for the newborn when the mother has to undergo other treatments after birth. The colostrum can either be fed via syringe or FingerFeeder.
One of the main benefits is that it will also help to learn how to express milk without the added pressure of a hungry baby. The learned massage can also help after the milk “comes in”, for example, with blocked milk ducts, full breasts which make it harder for your newborn to latch on, or one can feed it to a sleepy baby who needs a little convincing to suckle effectively on the breast.
When to start harvesting colostrum
Nipple stimulation releases oxytocin and can therefore start premature labour. This is why it is not recommended to start colostrum expression before pregnancy week 37. However, if you leak colostrum before, you can collect it with our set. Please do not express it by hand. You can follow the steps below 2 - 3 times a day, while each session can take 5 - 10 minutes.
How to harvest colostrum during pregnancy
When expressing colostrum during pregnancy you will notice that only a few drops will appear at a time. After birth this will change since your hormonal blood composition will change and your breast will produce enough milk to feed your hungry baby.
We have developed a kit which includes everything you need for collecting plus two video tutorials to show how to express and feed the colostrum.
- Make sure to wash your hands before starting.
- Find a nice and relaxing place at home & warm your breasts a little either by showering beforehand, massaging the breast tissue, or with the help of a wet warm flannel /cloth. If you have showered make sure your breasts are free of soap.
- Make sure you have a clean surface and open one syringe at the beginning to keep the remaining syringes sterile.
- Always use the same hand to express the colostrum as the breast (left breast - left hand).
- Shape your hand into a C shape by using your thumb and middle or index finger
- Place your fingers 2-3 centimetres from your areola.
- Press the tissue slightly against your chest while lightly stretching the tissue with your thumb and middle or index finger.
- Squeeze the tissue between your fingers and lightly push the nipple forward.
- Release the pressure and repeat building up a rhythm.
- Please note that the colostrum expression should never hurt!
- When no more colostrum can be expressed, repeat this motion by circling the position of your fingers so that all the breast tissue has been mobilised once.
- Collect the colostrum with the syringe & close it with the sterile lid once you have massaged both breasts or the syringe is full.
- If you have not collected enough colostrum after massaging both breast, you can try again later the same day. It is important to keep the syringe in the fridge in between each expression. Please note, colostrum can only be mixed when expressed on the same day. At the end of the day it has to be frozen
- Write your name, date and time on the label and stick it onto the syringe.
- Then place the syringe into the freezer until you leave for the hospital or birthing house.
Did you know?
If you have trouble expressing colostrum you may want to try it between 22:00 - 07:00, since prolactin - the hormone designed to support milk production- is at its highest (4). It is also produced when massaging and expressing the breast. This is why you may notice not as much colostrum drops at the beginning but they will increase over time.
Feeding
When leaving for the hospital or birthing house, place the silicone bag into a cool bag / or add ice cubes into it. Give it to the midwife or nurse in charge and kindly ask them to place it in the freezer. The World Health Organisation recommends starting exclusive breastfeeding within the first hour after birth. When your baby is born and the OB or midwife has assessed how your baby is doing you can ask them to bring you the expressed colostrum & feed it. To warm the frozen syringes, place them in 37°C warm water. It will take about 5 - 10 minutes for them to defrost. If one has not used all of it after birth, one can use it up to 6 month after freezing it. Since it contains a high amount of immunoglobulins, antibodies, vitamins & minerals it can be used when your baby has a cold or diarrhoea.
Important
Please consult your midwife/OB before expressing colostrum to make sure it is safe for you and your baby. Please keep in mind once the milk is defrosted it should be used within 24 hours. Please do not refreeze it.
Additional Sources
1. Anatomy / Colostrum, J. Bryant & J. Thistle, NCBI Nov. 2020
2. Amboss - Postpartum Period • World Health Organisation - Breastfeeding
3. Hand expressing in pregnancy and colostrum harvesting - preparation for successful breastfeeding, Kamila Wszolek British Journal of Midwifery, April 2015
4. Twenty-four hour patterns of prolactin secretion during lactation and the relationship to suckling and the resumption of fertility hi breast-feeding women / Human Reproduction vol.11 no.5 pp.950-955, 1996 / C.C.K Tay , A F. Glasier, A.S.McNeilly
