Antenatal colostrum harvesting
- Sally Goodwin
- 1 day ago
- 6 min read
What it is, why it matters, and how to get started from 37 weeks
What is colostrum?
Colostrum is the first milk produced during pregnancy. It is thick, highly concentrated, and nutritionally distinct from mature breast milk. Often referred to as liquid gold, it is produced in small volumes that are precisely matched to a newborn’s stomach capacity, which at birth is approximately the size of a marble.
Colostrum contains:
Immunoglobulins and antibodies – providing passive immunity and infection protection from birth
White blood cells – supporting the development of the newborn immune system
Growth factors – promoting gut maturation and function
Concentrated protein and nutrients – in an easily digestible form suited to a newborn’s gut
A natural laxative effect – facilitating the passage of meconium and reducing the risk of neonatal jaundice
Even 1 to 5ml per feed in the first hours of life is clinically significant. Every drop of colostrum has value.
What is antenatal colostrum harvesting?
Antenatal colostrum harvesting is the process of hand expressing and collecting colostrum before birth, typically from 37 weeks of pregnancy. It is performed by hand rather than with a breast pump at this stage, and the colostrum collected is stored in small sterile syringes and frozen until needed.
It is a skill that most people can learn with practice, and small or absent volumes in the early days of expressing are entirely normal and not indicative of future milk supply.
Who may benefit?
Antenatal colostrum harvesting is appropriate for many families and is particularly recommended in the following circumstances:
Diabetes in pregnancy (gestational or pre-existing), where the newborn is at higher risk of hypoglycaemia after birth
A known fetal condition such as cleft palate or congenital cardiac anomaly, where feeding may require additional support from birth
Previous breast surgery or known concerns regarding milk supply
Planned induction of labour or elective caesarean section, where the onset of lactation may be delayed
A history of low milk supply or breastfeeding difficulties with a previous baby
A personal wish to have a colostrum reserve as a precautionary measure
In the absence of contraindications, harvesting from 37 weeks is safe in a straightforward, low-risk pregnancy and can be considered by any family who wishes to do so.
When is it not recommended?
Antenatal expressing should be avoided, or discussed with a midwife before commencing, in the following situations:
Known risk of preterm labour
Low-lying placenta or placenta praevia
Multiple pregnancy
Unexplained bleeding in the current pregnancy
If there is any uncertainty about whether harvesting is appropriate, please seek individual clinical advice before starting.
Creating the right environment
The environment in which expressing takes place can have a meaningful impact. Conditions that promote relaxation and a sense of safety helps.
When preparing to express, consideration should be given to the following:
Privacy – choose a space where there is no risk of interruption or feeling observed
Quiet and calm – a low-stimulation environment, free from noise or distraction where possible
Comfort – being physically comfortable and warm supports relaxation
Time – expressing without time pressure reduces anxiety and allows the body to respond naturally
There is no single correct environment, and what feels relaxed and private will differ from person to person. The key principle is to treat expressing as dedicated, unhurried time and to create conditions that feel safe and undisturbed.
How to hand express colostrum
Hand expression is the recommended method during pregnancy. The following steps provide a guide to the technique:
1. Wash hands thoroughly before beginning.
2. Apply warmth to the breasts using a warm flannel or by expressing after a warm shower, or some light massage will help too.
3. Position the fingers in a C shape, placing the thumb and first two fingers approximately 2 to 3cm back from the nipple on the areola.
4. Use a rhythmic press, compress, release motion: press back towards the chest wall, compress the fingers gently together, then release. Repeat this motion, rotating the fingers around the areola to cover all areas of the breast.
5. Collect the colostrum using the plunger of a sterile syringe, drawing it into a labelled sterile syringe.
6. Repeat on the opposite breast and aim to express 2 to 3 times daily for approximately 5 minutes per side.
Sterile syringes are available from many maternity units free of charge. It is worth confirming this with your maternity team in advance.
How much colostrum should be collected?
Volumes vary significantly between individuals and from session to session. In the early days of antenatal expressing, it is common to see only drops, or nothing at all. As expressing continues, many people find that volumes increase gradually.
A typical session may yield between 0.5ml and 2ml per breast, though this varies widely.
The volume collected antenatally does not reflect future milk production. Milk supply after birth is driven by frequent, effective feeding and is not determined by antenatal expressing volumes.
Storage and transport
Colostrum should be collected into a sterile, labelled syringe and stored in a household freezer. Frozen colostrum can be kept for up to six months. Each syringe should be clearly labelled with the mother’s name and the date of expression.
When attending hospital or preparing for a home birth, frozen syringes should be transported in a cool bag or insulated container. Most maternity units will store frozen colostrum during an inpatient stay. It is advisable to inform the admitting midwife that colostrum is available.
Once thawed, colostrum should be used within 24 hours if refrigerated, or as soon as possible if brought to room temperature.
Benefits of antenatal colostrum harvesting
Provides a colostrum reserve for the early postnatal period - in the hours immediately following birth, particularly after caesarean section or induction, colostrum let-down may take a little longer to establish. Having a frozen reserve means that if top-up feeds are clinically indicated, the family has their own colostrum available, avoiding the need for formula supplementation where this is not preferred.
Supports early milk supply establishment - antenatal expressing provides gentle stimulation of the hormonal pathways involved in milk production. While it does not significantly increase antenatal supply, it begins to prime the acini cells ahead of birth.
Reduces pressure around early feeding - having a colostrum reserve available in the early postnatal period can reduce anxiety around newborn intake and weight, providing a practical safety net.
Builds familiarity with hand expression - hand expression is a valuable and transferable skill in the postnatal period. Practising antenatally means families arrive at birth already confident in the technique.
Important considerations
Antenatal colostrum harvesting is not a predictor of breastfeeding success, and the volume collected does not indicate future milk supply. It is one element of antenatal preparation and works best alongside good postnatal support, early skin-to-skin contact, and access to specialist lactation support where needed.
If expressing becomes stressful or is not possible, this is not a cause for concern. There are many effective ways to support infant feeding, and individual support is always available.
Sally x
Sally Goodwin RM, MSc, IBCLC | Sally Goodwin Private Midwifery | North East Derbyshire, South Yorkshire and the East Midlands
References
Forster DA, et al. (2017). Advising women with diabetes in pregnancy to express breastmilk in late pregnancy (Diabetes and Antenatal Milk Expressing [DAME]): a multicentre, unblinded, randomised controlled trial. The Lancet, 389(10085), 2204–2213.
World Health Organization (2022). Breastfeeding. www.who.int
NICE (2021). Postnatal care. NICE guideline NG194. www.nice.org.uk
Unicef UK Baby Friendly Initiative. Guidance on antenatal expressing. www.unicef.org.uk/babyfriendly
This blog is written for the families in my care and for information purposes only. It does not replace individual clinical advice. If you have any concerns please contact your midwife or maternity unit, or reach out to me directly.
About The Author
Sally Goodwin is an award winning Midwife and founder of Sally Goodwin Private Midwifery Services. With over 18 years of experience as a midwife, Sally has had the privilege of supporting countless women and families through their pregnancy, birth, and early parenthood journeys.
Sally offers a compassionate and holistic private midwifery service, offering tailored care for parents-to-be in the East Midlands and South Yorkshire. From single appointments to full birth packages, providing expert support for pregnancy, birth, and beyond. Plus specialist care in lactation & tongue-tie release. Sally also runs the Mama & Baby Café in Chesterfield.
When she's not helping new parents and their babies, she's often found walking the Rupert the dog (and recording reels), being Mum to three grown up kids and Nana to two Grandies!
