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What is Prenatal Hand Expression? A 3-Minute Explanation of Colostrum Harvesting

Published in Birthing Services, For the Health of It Author: Certified Lactation Consultant Jeanne Friebe, RN, BSN, IBCLC, RNC-LRN

Your baby’s first milk is called colostrum. Known as “liquid gold,” this yellowish, thick milk is packed with protein and nutrients. This baby superfood:

  • Colonizes your baby’s gut with healthy bacteria to protect against allergies and disease
  • Contains the perfect balance of proteins, fats and micronutrients
  • Helps pass meconium, a baby’s first stools, which can be very sticky

Overall, colostrum helps your baby stay healthy!

If colostrum is so good for a baby, should I begin to collect colostrum while still pregnant?

All parents should consider the prenatal collection of colostrum. However, it might be especially important if you want to:

  • Ensure some colostrum is on hand if you have risk factors like diabetes, high blood pressure, endocrine disorders, polycystic ovarian syndrome, obesity, breast surgeries or limited breast development
  • Avoid formula use when supplementing for medical reasons, such as high bilirubin (studies show people using formula to supplement within the hospital are more than twice as likely to quit breastfeeding)
  • Avoid early weaning
  • Learn how to do hand expression so when baby is born you can remove milk from the breast in instances of a plugged milk duct, or not having access to an electric breast pump.
  • Feel more confident, motivated and prepared for breastfeeding
  • Increase your amount of early breast milk.

What is prenatal hand expression?

Hand expression means you are using your hands to compress your breasts in a way that colostrum comes out. Hand expressing before your baby is born is called prenatal hand expression.

Is hand expressing safe during pregnancy?

Yes, for many mothers it is OK to hand express colostrum before birth. However, please discuss with your prenatal care clinician before starting. The practice is not recommended for those at risk of preterm labor or other risk factors such as placenta previa.

When should I start hand expressing colostrum during pregnancy?

We advise mothers to wait until 37 weeks before starting to express colostrum – once the risk of preterm labor has passed.

Does hand expressing bring on labor?

Hand expression could possibly stimulate contractions. During hand expression, nipple stimulation releases the hormone oxytocin in the body and can lead to contractions. It is also the hormone of milk let down. The leaking of colostrum does not mean labor is near. Some women leak colostrum early in pregnancy as it can be found in the breasts as early as 16 weeks of pregnancy. Increased colostrum does not mean you will be going into labor soon.

Does hand expressing colostrum hurt?

If done properly, prenatal hand expression should not hurt. After getting the go-ahead from your clinician for prenatal hand expression, you will want to meet with a lactation consultant. The consultant will provide instruction on best practice and provide you materials for milk collection.

How often should I hand express before birth?

Often moms start by doing 5 minutes per breast, 2-3 times a day.

How much colostrum should I hand express?

The amount of colostrum a mom can express varies. Collecting colostrum ahead of time does not deplete what you have after delivery. You will still have colostrum for a few days after delivery.

Should I pump colostrum?

No. A pump is too aggressive for the amount of colostrum you will collect. Hand expression is a gentler way to accomplish milk removal. You will be able to collect most of what is hand expressed in a cup and then store in a syringe. If a breast pump is used, the small drops of colostrum would become trapped in the pump parts without a way to remove them – wasting your time, effort and a precious resource.

How long can I store expressed colostrum?

Your lactation consultant will provide information on collecting, storing and warming colostrum. Expiration varies depending on if stored at room temperature, refrigerator or frozen. Generally, we recommend you put colostrum in the freezer, labeled with the collection date.

How can I schedule a prenatal hand expression appointment with a lactation consultant?

Take the first step in providing the gift of colostrum to your baby. Schedule a 30-minute, in-person, prenatal hand expression appointment with a CentraCare lactation consultant at around 36 weeks of pregnancy.

  • Monticello: 763-271-2218
  • St. Cloud: 320-654-3630

Often these appointments are part of a bundled package of prenatal care with no additional charge. However, health plans vary. It is a good idea to check with your insurance company before scheduling an appointment.