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Antenatal Expression of Colostrum: Do you really have to do It?

Hand expressing before birth can feel like just another thing to add to an already long pregnancy to-do list.
Do you need to do this?
Cathy McCormick HolisticBaby
Published on
 

 

So let's clear this up right away: antenatal expression of colostrum is completely optional.

For some parents, it's unnecessary. For others, particularly when feeding challenges are expected, it can be a helpful, confidence-building step before birth. As lactation consultants we often explain to our expecting parents and in our antenatal classes, it's not about pressure or perfection, but about having information and options.

What Is Antenatal Expression of Colostrum?

Antenatal expressing involves hand expressing small amounts of colostrum (your first milk) during late pregnancy, usually from 36–37 weeks onwards, and storing it for use after birth if needed.

Colostrum is rich in nutrients, antibodies, and energy — and even very small amounts can make a difference in the early days.

When Might Antenatal Expressing Be Recommended?
A lactation consultant or maternity care provider may suggest antenatal expressing if your baby is expected to need extra feeding support after birth, including in situations such as:
  • Diabetes in pregnancy, where baby may need blood sugar monitoring
  • A planned early birth or more medicalised delivery (such as an elective caesarean)
  • Babies with a known congenital condition (e.g. cleft palate)
  • A history of low milk supply in previous breastfeeding journeys
  • Polycystic Ovarian Syndrome (PCOS)
  • Previous breast surgery
  • Limited breast development

In these cases, having stored colostrum available can reduce stress and support early feeding.

Why Consider Antenatal Expressing?

Even when there are no medical risk factors, some parents choose to antenatally express because:

  • Human milk is the recommended nutrition for all babies, especially those with additional health needs
  • Stored colostrum may reduce the likelihood of formula supplementation in hospital
  • It can support exclusive breastfeeding in the early days
  • Exclusive breastfeeding supports healthy gut development and beneficial gut bacteria
  • Learning hand expression before birth can increase confidence and familiarity with your body

Our lactation consultants also note from anecdotal experience that antenatal expressing can help parents feel more prepared, even if they end up not using the stored milk.

When Should You Start?

Current research suggests beginning from 37 weeks of pregnancy, unless advised otherwise by your midwife, doctor, or lactation consultant.

How to Hand Express Colostrum?

Here's a gentle, evidence-based approach commonly taught in antenatal classes and lactation consultant sessions in Auckland:

  1. Wash your hands
  2. Prepare a clean container or syringe for collection — you can collect over 1–2 days, label, date, freeze, then start again
  3. Warm your breasts using gentle touch, massage, or a warm shower
  4. Take a few moments to relax — calm breathing helps milk flow
  5. Place your fingers back on the areola
  6. Push back gently, compress fingers together, then release
  7. When flow slows, reposition your hand and repeat
  8. Express for 3–5 minutes on each breast, a few times a day

Expressing should never be painful. Avoid squeezing, pulling, or dragging the skin.

How Much Colostrum Is Normal?

A large study (the DAME trial) looked at women who hand expressed for 10 minutes, morning and night, over four weeks:

  • 25% collected 0–1ml total
  • 50% collected around 5.5ml total
  • 25% collected more than this

The amount of colostrum collected antenatally has no relationship to how much milk you will produce once your baby is born.

Small amounts are normal. This is not a test of your breastfeeding ability.

Support Makes a Difference!

Antenatal expressing is not a requirement. It's simply one option. What matters most is feeling informed, supported, and confident.

In our Antenatal classes at Birthcare Auckland or Titirangi or (pre recorded) On Line you receive Breastfeeding Class (pre recorded) On- Line Class and Taking Baby Home Class (pre recorded) On- Line. We cover topics like hand expressing in a practical, non-judgemental way, alongside guidance you'd expect from an experienced midwife and lactation consultant. Whether you attend in person or online, our goal is to help you understand your choices so you can make the decisions that feel right for you and your baby.

Book at Lactation Consultant at HolisticBaby Clinic Birthcare Auckland

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