Colostrum Harvesting or Antenatal Hand Expression is a topic that isn’t talked about as much as it should be. So many moms with high risk pregnancy situations are unaware of how colostrum storing during pregnancy can actually help their babies after they are born.

The amazing qualities of our breastmilk are still majorly unnoticed. This plays a part in many hardships breastfeeding moms face; often alone due to the stigmas that affect support, and capitalistic push of formula in situations breast milk could have rectified.

If you are diabetic, run the risk of a NICU stay, susceptible to Gestational Diabetes or prenatal genetic testing shows concerns for baby this is definitely vital information for you to have.

WHAT IS ANTENATAL HAND EXPRESSION?

This technique involves expressing colostrum in the final few weeks of pregnancy. It can also be referred to as “colostrum harvesting.” Mothers are normally advised to wait until around 37 weeks before starting antenatal expression. Moms who are having multiple births may sometimes start sooner as giving birth earlier is more likely.

Why is it done?

For some mothers, it can be a useful tool that helps ensure their baby will start life without the need for formula supplementation. The importance of exclusive breastfeeding for all babies has been well-established by scientific research.

Colostrum contains vital immunological properties and helps to colonize the baby’s gut with healthy bacteria that protect against allergy and disease.

It also contains the perfect balance of proteins, fats and micronutrients needed for human babies as well as acting as a laxative to help the passing of the first tarry meconium stools.

Some babies may experience difficulties with feeding or maintaining their blood sugar levels during the first few days after birth and therefore may require supplementary feeds.

These include babies:

  • whose mother had diabetes in pregnancy or -who has a history of diabetes – to have on hand in case baby is born prematurely to curve formula pushing
  • with a cleft lip or palate identified during pregnancy.
  • with congenital conditions – Down syndrome or cardiac complications.
  • diagnosed with intrauterine growth restriction.
  • whose mother is taking beta blockers to control high blood pressure.
  • who are twins or triplets
  • who have breast hypoplasia (limited breast development).
  • who have had previous breast surgery.

It’s important for a mother to discuss her plans to express antenatally with her healthcare provider.

Note: This may not be recommended if you’ve been at risk of preterm labor in previous pregnancies, or have a surgical stitch.

The most common concern is that antenatal expression could potentially trigger premature labor resulting in complications from early birth.

Providers who support antenatal expression usually recommend doing so after 37 weeks gestation for this reason; as long as there are no risk factors present for premature birth.

You don’t need nor is it recommended to harvest if you have a pregnancy with none of the correlation risks/concerns listed above.

Antenatal expression of colostrum is ​never recommended before 36-37 weeks gestation, nor if you previously had a premature baby, have cervical incompetence or a cervical stitch in place, have noticed contractions while expressing or have had any vaginal bleeding or premature rupture of membranes during pregnancy.

HOW TO EXPRESS FOR HARVESTING

Hand expressing rather than pumping is the best and SAFEST way to collect colostrum as there will only be drops to collect at first and colostrum is thicker and stickier than mature breast milk. Labor is also more likely to be induced with high-frequency pumping than gentle hand expression therefore pumping is not recommended. The drops of expressed colostrum can be collected with a blunt-ended sterile syringe or expressed onto a spoon or into a small cup and then drawn into a syringe for storage.

You can start to express anywhere from once a day to at least four times a day. Gradually build up to gently expressing for about five to ten minutes at a time, two to five times a day, and then as often as necessary in the first few days after you give birth.

Click below for a video on hand expression:

Storing Harvested Colostrum

Harvested milk can be stored in a freezer until thawed for usage.

Expressed colostrum can be stored in the fridge (however not in the door of the fridge) for 48 hours (2–4°C). It can be stored in the freezer for:

2 weeks in a freezer compartment of a fridge

3 months in a freezer section of a fridge with a separate door 6 months in the deep freeze (-18°C)

HARVESTING DUE TO DIABETES

Some babies born to diabetic mothers can have low blood sugar levels due to high levels of insulin still circulating in their bodies. If the baby’s blood sugar levels drop too low, this is known as ​neonatal hypoglycemia​ and can be dangerous for your baby.

Breastfeeding as much as possible after birth is a good way to raise a baby’s blood sugar levels and prevent hypoglycemia. Some diabetic mothers find their milk comes in later than usual and others find their baby isn’t ready to breastfeed, so harvesting colostrum antenatally can ensure a supplement is available as needed. There are benefits for the mother too. Breastfeeding can help protect a mother with gestational diabetes from developing diabetes in later life and reduce the insulin a diabetic mother needs.

Often in these situations, mom is immediately told she will need to introduce formula to her baby. Formula isn’t the only option for hypoglycemia – they can also receive glucose through an IV, NG tube or receive sugar water.

Treatment usually depends on overall health and gestational age. If the baby is full-term they don’t need glucose supplementation (be it formula, IV OR sugar water).

In the event of a premature birth, formula is rightfully chosen as a fast action choice to prevent potential brain injury that can result from low blood sugars in preemies with low screening scores for sugars or preemies babies born to mothers with diabetes or gestational diabetes – which can make baby more susceptible to diabetes as well. Even if formula is needed due to premature birth, you can still supplement with breastmilk during formula feeds.

In many cases, many hospitals don’t have the patience to work with a breastfeeding gestationally diabetic mom and/or her full term hypoglycemic baby; and opt for formula to speed things up because births are viewed as a medical event and not a life event. This is a situation often requiring advocacy from Mom, especially if formula is being pushed and mom is excessively breastfeeding and also giving harvested colostrum to raise levels.

If baby is born to a diabetic mother or has low blood sugars and is not born premature, breastfeeding is the better option over introducing formula to raise sugars. Babies have homeostatic mechanism established enough to help them regulate their levels on their own at full term to transition successfully from intrauterine dependency to their new extrauterine environment.

“Healthy, full-term infants are functionally and metabolically programmed to make the transition from their intrauterine dependent environment to their extrauterine existence without the need for metabolic monitoring or interference with the natural breastfeeding process.”

(Peer Study Source: https://www.ncbi.nlm.nih.gov/m/pubmed/11339158/) Formula pushing is often done unnecessarily for full-term babies with low sugars.

Formula will raise blood sugar levels, however, research suggests that breastfeeding colostrum has a better effect on raising blood sugar levels than formula. Formula also is packed detrimentally with corn syrup and sugars that aren’t beneficial to the health of a newborn.

What if my baby is a preemie and I have to introduce formula to raise their blood sugar? What is a recommended formula to choose?

Unfortunately, FDA doesn’t regulate or mandate sugar content regulation with formula cans many formulas (including organic) have corn syrup or sugar in them. Actually, better formula for babies has low content of sugar but it’s hard to regulate – excessive sugar can cause health issues with babies.

It’s best to use formula that increases sugar with ​lactose​. For babies who can’t tolerate lactose – goat milk formula is a better option.

Once your preemie baby’s levels have increased, you can most certainly stop formula use if you want to breastfeed and reintroduce your baby to your breast.

BENEFITS OF ANTENATAL EXPRESSION

One of the main benefits is it provides a human milk supplement for after birth. Stored colostrum provides the perfect complete food a baby needs if for any reason s/he has difficulty breastfeeding or needs a supplement before his mother’s milk has “come in”.

It also prevents the need for industrially made formula and its associated disadvantages. It helps establish a full milk supply more quickly and get breastfeeding off to a good start. It also increases a mother’s confidence in hand expressing.

Even if the drops of colostrum are not saved, once the technique of hand expression is learned, a mother can start hand expressing straight after the birth if her baby isn’t able to latch.

This is definitely a conversation all moms should have during prenatal care to see if this is something that can be incorporated into baby’s first weeks of life. Always ask your provider for resources of local IBCLC or LC’s in your area as well. Lactation Consultants are very beneficial with concise education and information on all things breastfeeding relate and can provide the optimal support you need.

Have you ever harvested your colostrum?

Thanks for reading! Hope this was helpful.

Mommi Amber

Amber Oliver is a married stay at home mom of 2 and resides in Maryland. She is also an IBCLC and the mom blogger behind Look What Love Made, focusing on breastfeeding support, Minority & Maternal Mental Health Awareness and Parenting styles. Her own struggles with breastfeeding is what sparked her certifcation interest; and she enjoys being a clinical and peer support to breastfeeding moms.