Colostrum is the first milk produced by the breast, often referred to as “liquid gold” due to its concentrated nutritional and protective properties. This thick, yellowish substance is packed with antibodies and immunological factors that help colonize the newborn’s gut with healthy bacteria, supporting immunity and protecting against disease. Colostrum also acts as a natural laxative, assisting the baby in passing their first meconium stools. Because this initial milk is produced in small, highly concentrated quantities, hand expression is considered the gentlest and most effective method for collection compared to using a mechanical pump.
When and Why Hand Expression is Necessary
Hand expression serves important purposes both before and after birth. Antenatal colostrum harvesting, or collecting milk during the final weeks of pregnancy, is often recommended starting around 36 to 37 weeks gestation, but only after consultation with a healthcare provider. This practice allows a parent to build a reserve of colostrum, which is invaluable if the baby needs extra feeds immediately after birth. Stored milk helps avoid formula supplementation, particularly for babies at higher risk of low blood sugar, such as those whose mothers have diabetes or who are born prematurely.
Breast stimulation releases the hormone oxytocin, which can potentially trigger uterine contractions. Therefore, antenatal expression is not advised for individuals with a history of threatened preterm labor, cervical issues, or placenta previa. Postpartum, hand expression is useful when a baby is too sleepy, premature, or separated and cannot yet latch effectively. It is also used to manage early breast engorgement by softening the areola, or to clear a clogged milk duct.
Step-by-Step Guide to Hand Expressing
Begin by washing your hands thoroughly with soap and water before touching the breast. Finding a quiet, comfortable, and relaxed position is helpful, as stress can inhibit the let-down reflex. Gently massaging the breast in circular motions, moving from the chest wall toward the nipple, stimulates the milk ducts and encourages colostrum flow.
Next, position your thumb above the areola and your first two fingers below it, forming a ‘C’ shape two to three centimeters back from the nipple. Avoid placing fingers directly on the nipple tissue. Press your thumb and fingers straight back toward the chest wall, then gently compress and roll them forward in a rhythmic motion. This action mimics the baby’s suckling and compresses the milk sinuses beneath the areola to release the colostrum.
Press, compress, and release repeatedly, establishing a gentle rhythm without causing pain or sliding your fingers uncomfortably over the skin. Once the flow slows, rotate your fingers to a different position around the areola (e.g., moving from 12 and 6 o’clock to 11 and 5 o’clock) to drain different sections of the breast. Colostrum often appears as small, sticky drops, and it is normal to yield only a few drops to a few milliliters (0.5 to 3 ml) per session, especially in the beginning.
Safe Collection, Storage, and Administration
For collection, use a sterile, small-volume container, such as a one-milliliter or three-milliliter syringe with a cap, or a small, clean cup. The colostrum is easily drawn up from the cup into the syringe, or collected directly onto the syringe tip. Label the container immediately with the date and time of expression to track freshness.
Fresh colostrum can be stored at room temperature up to 77°F (25°C) for four hours or in the refrigerator at 40°F (4°C) for up to four days. For longer storage, colostrum should be frozen promptly, ideally at -4°F (-20°C) or colder, where it maintains its properties for six to twelve months. Always store containers in the back of the refrigerator or freezer, as this area maintains the most consistent temperature.
When needed, frozen colostrum should be thawed gradually in the refrigerator overnight or under warm running water. Once thawed, it must be used within 24 hours and never refrozen. The collected amounts are typically administered to the baby using a syringe, dropper, or small spoon. This delivery method is preferred over an early bottle, as it avoids introducing an artificial nipple that could interfere with the baby’s ability to latch onto the breast.