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The Magic of Colostrum


A newborn baby in the hospital being fed colostrum through a tiny cup by the mother and a nurse

As pregnancy progresses and you start to make feeding plans for your baby, you may hear about your “first milk” or colostrum. You may even start to leak some from your breasts as you reach the later stages of the third trimester and your breasts are preparing for breastfeeding. You hear about how special it is, that it is all the baby needs, perfect nutrition. You may hear other pregnant women talk about collecting and saving their colostrum. This may cause you to wonder, “What is colostrum anyway, and should I be collecting it?


What is Colostrum?


Colostrum is the baby's initial food source and provides a concentrated early source of nutrition and immune protection. It is the first thing they consume as they transition from being fully reliant on the placenta for nutrition to requiring enteral or consumed nutrition. It is a rich, thick, golden liquid excreted from the breasts in late pregnancy and the first few days after birth, before stage II lactogenesis or the onset of copious milk production. It is higher in protein and immune properties. It helps to get the baby's immune system fired up. It also supports healthy gut colonization and acts as a laxative to clear out the baby's first poop, meconium. 


Babies do not need a high quantity to get the nutrients that they need at first, which is good because their tummies start out small – only about 5 ml in size. Early and frequent expression of the colostrum from the breasts via infant suckling or maternal expression (hand expression usually works best with colostrum) will get the baby what they need at the beginning, in addition to helping bring your full milk in more quickly. 


Frequently Asked Questions About Colostrum


My baby won’t latch! What should I be doing to get my baby colostrum?


Learning to breastfeed and properly latch the baby can be a struggle. It takes practice, help, and time to master it. If the latch isn’t going well or you are having nipple pain in the first few days, seek out help immediately. Talk to the lactation consultant at the hospital or work with the experienced nurses. If you are home already, seek out help from your baby’s pediatrician or a community IBCLC. But in the meantime, express the colostrum regularly via hand expression and give it to the baby. Baby should be latching or feeding 8-12 times in 24 hours, so continue to mimic this pattern with hand expression or pumping if you are not latching the baby. Any colostrum or milk you get can then be provided to the baby through spoon, cup, or bottle feeding. Any amount of colostrum a baby gets is hugely beneficial to them. Plus your feeding and expression efforts can help bring in your milk, which typically arrives 2 - 5 days postpartum. 


I have started to leak some colostrum in pregnancy…should I be collecting it?


I get this question regularly, and I know it is a popular topic among mom groups! I usually answer, “Sure.” What I mean is that if you would like to collect it, great, but if you don’t, that is great too. For most women with healthy, full-term deliveries, previously expressed and frozen colostrum will not be necessary. After delivery, their bodies will continue to produce and they will feed the baby at the breast, with no stashed colostrum needed. There are, however, some cases in which you can consider collection:


  • Preterm Delivery: If you know that you will deliver early (e.g. twins) or your baby will be in the NICU for any reason (e.g. congenital heart disease), you may want to collect some colostrum via hand expression the week before you plan to deliver. Premature and medically fragile babies hugely benefit from breastmilk. It helps to better support their immune systems and gut development. If you know you will be utilizing the NICU, talk to them about their breastmilk policies to make sure you store colostrum in a way that your baby will be able to use. It is also good to learn hand expression and make plans for pumping since you know that will most likely be a part of your early breastfeeding journey.

 

  • Gestational Diabetes: You have diabetes. Babies of women who experienced diabetes in their pregnancies will have their blood sugar monitored as they transition to post-placenta life. Early and frequent breastfeeding and consumption of colostrum can help keep their blood sugar levels stable in those first few days. Some women like to have some extra colostrum on hand in case they are struggling to keep their blood glucose stable to prevent the baby from needing supplementation with formula. Just make sure that the colostrum is expressed and stored properly (as discussed below).


  • It makes you feel confident! If collecting your colostrum makes you feel more confident heading into your breastfeeding journey or if you previously struggled and want some just in case, go for it! Hand expression is always a great skill to have, and early colostrum expression can set you up well for a robust supply. Early and frequent latching and expression of colostrum/milk can be one of the best ways to establish your supply. So practicing hand expression of colostrum during pregnancy can be a great way to prepare for a better subsequent nursing experience. 


*Always remember to check and honor your hospital’s policies. Some have systems in place for colostrum storage and use, while others cannot accept previously expressed and stored colostrum.


If I want to collect my colostrum during pregnancy (37 weeks+), how do I do it?


Step 1: Wash your hands! Any and all milk expression or breastfeeding should be done with clean hands. 


Step 2: Prepare your collection container. People will often use small medicine syringes or collection container kits that can also be used to feed the colostrum to the baby. You can also use a spoon or small bowl to catch your hand expression. 


Step 3: Hand express the colostrum. Here is how if you aren’t sure of the technique. Using a double electric breast pump is not recommended during pregnancy. 


Step 4: Label and store colostrum appropriately. Mark the day and time of expression and store the container (typically in the freezer), so that you can safely use it as desired after your baby’s arrival. Make sure to check your hospital's policies before bringing it to the hospital for the baby. 


When should I expect colostrum to transition to milk?


You will have colostrum until lactogenesis II or the copious onset of breast milk production. On average, this occurs 3 days postpartum, but anytime between days 2 - 8 is considered normal. Often there will be a little mix of colostrum and milk or transitional milk that will look more like regular milk with a yellow tinge at first. Continued latching and hand expression both help encourage milk production. Have patience and try to trust the process.


The human body is incredible, especially the female body during pregnancy and breastfeeding. How special is it that our bodies can make a special substance designed perfectly to transition our offspring from intrauterine to extrauterine life? Colostrum has incredible value and nutrition, but there is a little mystery when it comes to knowing what to do with it. Hopefully, this helps to guide you about its use and if collecting colostrum makes sense for you.


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