At Yeovil District Hospital we are committed to supporting exclusive breastfeeding for all babies as it is recognised as the healthiest way to feed your infant. Exclusive breastfeeding has many benefits and early introduction of formula milk increases the risk of allergies and impacts on the duration of breastfeeding.

Some infants are at risk of developing low blood sugar (hypoglycaemia) which increases the likelihood of formula supplementation in the first few hours/days after birth. Antenatal colostrum harvesting can help to decrease the need for formula supplementation.

Why you might consider antenatal colostrum harvesting

Colostrum is the first milk you make when your baby is born. It provides perfect nutrition and protection for new-born babies.

Antenatal colostrum harvesting is recommended if you have been told that your baby will need to have the level of sugar monitored in their blood after birth or there is reason to believe that that breastfeeding may be particularly difficult.

Reasons for this can include:

  • Diabetic in pregnancy (pre-existing or gestational);
  • Planned LSCS (lower segment Caesarean section);
  • Planned Induction of labour;
  • Breast hypoplasia;
  • Taking Beta-blockers (e.g. Labetalol);
  • Hormonal disorders (e.g. PCOS, hypothyroidism);
  • Previous breast surgery;
  • Multiple sclerosis;
  • BMI over 37;
  • Strong family history of dairy intolerance or inflammatory bowel disease;
  • Diagnosed cleft palate;
  • Congenital conditions (e.g. Trisomy 21);
  • Twin or triplet pregnancy with a stable lie;
  • Small for gestational age (SGA);
  • Inevitable premature birth (in labour prior to 36 weeks);  

We do not recommend antenatal colostrum harvesting in the following circumstances

  • Cervical suture insitu;
  • Placenta covering the cervix
  • Multiple pregnancy with unstable lie;
  • Before 36 weeks unless inevitable premature birth is imminent;

Breastfeeding and Diabetes

Diabetic mothers are encouraged to express colostrum in the late antenatal period as their babies are at increased risk of developing low blood sugar in the first hours after birth. Babies who are unable to feed after birth or have low blood sugar will require colostrum. If colostrum is not available then it is likely that the baby will need to be given formula milk which research has demonstrated can trigger an autoimmune response in the infant and increase the risk of the baby subsequently becoming diabetic.

The 2017 DAME study found “No harm in advising women with diabetes in pregnancy at low risk of complications to express breastmilk from 36 weeks gestation” and highlighted the benefit such as an increase of exclusive breastfeeding and a reduction in formula supplementation.

If you decide that you wish to harvest colostrum antenatally please do so from 36 weeks.

It is best to collect colostrum by hand expressing, this is a skill that can take a little practice to master so you may need to try a few times before you see any results.

How to hand express and store colostrum in the antenatal period?

  • Wash your hands and ensure that you have a clean container or syringe.
  • Get comfortable ensuring that you are as relaxed as possible.
  • To help the milk flow it can be useful to shower or have a bath before expressing; alternatively you can use some warm cloths and gentle massage prior to expressing.
  • Cup your breast with one hand making a ‘C’ shape (your thumb at the top of your breast your fingers below) approximately 2-3 cm back from the base of the nipple.
  • Gently squeeze your breast and then release the pressure. Find your rhythm. Avoid sliding your fingers over the skin. Milk should start to flow. Colostrum is very concentrated so it is thick and will come out of your breast drop by drop.
  • If the milk does not flow, try moving your fingers slightly either towards the nipple or further away, find the spot that works best for you.
  • Keep your hands in one position until the milk flow slows. Then you should move your hands around to a different position, ensuring that all areas are drained.
  • Aim to use both breasts in each session.
  • You can collect your colostrum straight into the syringe or pot 2-3 times a day.

You can find a video demonstrating hand expressing here www.unicef.org.uk/BabyFriendly/Resources/AudioVideo/Hand-expression/

Or use the QR code here:

Storage

You can collect your colostrum 2-3 times in 24 hours and store in the same syringe. The end of the syringe should be capped off with the bung provided and kept in the back of the fridge between collections. At the end of the day your syringe of colostrum should be placed in the freezer in a zip lock bag. Ensure that each syringe is labelled with your name, hospital number and the expressing date. Syringes can be obtained from your midwife.

Breastmilk can be stored in the freezer for:

  • 2 weeks in a freezer compartment of a fridge;
  • 6 months in the deep freeze (-18oC).

When you are come into hospital bring 5-6 frozen syringes of colostrum with you this avoids unnecessary wastage. If your breast milk is frozen then the best way to transport it is in a cool bag with an ice pack alongside it. You should give your labelled, expressed milk to the ward staff on admission for storage in the milk freezer on the SCBU, if it has defrosted then it can only be stored for 24 hours in the milk fridge on Freya ward.

The staff will check your colostrum is clearly labelled with your name and hospital number.

Considerations

There is no evidence that short episodes of antenatal colostrum harvesting will induce labour many women breastfeed throughout a pregnancy.

Some women do experience mild tightening/Braxton hicks during nipple stimulation so in recognition of this we recommend that you only begin antenatal colostrum harvesting at 36 weeks gestation and for short periods of time (up to 5 minutes initially increasing to 10 minutes once you have become skilled at harvesting.)

How much breast milk will I get?

The amount of breast milk you get will vary from a glisten on the end of your nipple to a teaspoon full. This small amount is perfect for your baby as colostrum is very concentrated in nutrients and helps your baby fight infections.

Do not be concerned if you are unable to express any colostrum as this does not mean that you will not be able to breastfeed.

Contacts/Further information

If you require further information or support please contact the Infant feeding team on InfantFeedingTeam@YDH.NHS.UK

Ref: 14/22/186
Review: 02/24