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Expressing colostrum, also called antenatal colostrum collection or harvesting, is not necessary for everyone but can benefit some mothers and babies significantly. It can give peace of mind and reassurance that your baby will be able to have the best start in life and avoid the use of formula after birth.

• Colostrum starts being made between 16-22 weeks during pregnancy. 
• It is your baby's first milk after birth and for the first 2-4 days as your milk transitions.
• Colostrum is highly concentrated compared to mature breast milk.
• It is thick and sticky, typically golden in color from its high beta carotene and vitamin A content; compared to mature milk with a creamy white color, it is less thick.
• Colostrum is rich in antibodies like IgA and Lactoferrin, white blood cells, and epidermal growth factors. 
• Babies drink between 2-20mL of colostrum per feed. (1) Their stomach is just the size of a marble at birth and the size of a walnut by day 3.
• On day 1 after birth, they drink about ½-2 teaspoons of colostrum per feeding, increasing to 1 tsp-½ ounce by 48 hours old. (2)
• It is higher in protein and lower in fat and lactose than mature milk. It has about two times the amount of protein and four times the amount of zinc as mature milk.
• Colostrum has a laxative effect, helping the newborn baby pass meconium and preventing jaundice.

• Moms with gestational, type 1, or type 2 diabetes - babies born by a mother with diabetes are at a higher risk for having low blood sugar after birth. Colostrum will be able to raise the baby's blood sugar. It is also shown to reduce the time it takes for milk production to increase and become well-established. (3) It can help increase a mom’s confidence in being able to feed her baby and lead to longer overall breastfeeding duration.
• Prior breast surgery - having colostrum saved to provide your baby in case your supply proves to be affected by breast surgery. Keep in mind good breastfeeding management to ensure the best outcomes. Practice skin-to-skin with your baby and nurse your baby about every 2 hours, both day and night.
• If you have breast hypoplasia - if you do not experience changes to your breasts during pregnancy or breast growth or have other signs of hypoplasia, you may be at higher risk of low supply. It is not guaranteed, as some people with hypoplasia produce a full supply for their baby. 
• History of low milk supply - if you experienced low supply previously, collecting colostrum may be beneficial to have milk for your baby and help get breastfeeding off to a good start.

• If your baby has been identified as having a cleft lip or palate during pregnancy - there can be feeding challenges for babies with cleft lip or palate. Having colostrum to give your baby if needed is reassuring to parents and nutritionally best for the baby.
• Mothers expecting twins or multiples - collecting colostrum in the last few weeks can be helpful when there is a higher chance of delivering early. Babies born prematurely can have a more challenging time with feeding, and the expressed colostrum can help protect them against illness and the calories they need to thrive.
• Planned cesarean birth - Sometimes, mothers and babies are separated after cesarean delivery. If this happens, your baby will be able to have your saved colostrum until you are reunited and able to begin skin-to-skin and breastfeeding.
• If you take beta blockers for high blood pressure - you may experience a lower milk supply after giving birth.

• Talking with your care providers is always a good idea since they know your unique and complete health history before you begin.
• If you decide to collect colostrum to save for your baby, it is safe to begin at 36-37 weeks pregnant. 
• If you are expecting twins or multiples, you may consider collecting colostrum slightly sooner because there is a chance you will deliver your babies earlier.
• Hand express for a few minutes once a day and build up to hand expressing for 5-10 minutes each session 2-5 times per day.

• Colostrum can be stored in a clean container, like a syringe. 
• Colostrum collected from the same day can be stored in the same syringe, but keep it in the fridge between use.
• Once you have collected your colostrum for the day in your syringe, it can be capped, labeled, put into a ziplock bag, and stored in the freezer.
• Label each syringe with your name, the date, and the time you expressed the colostrum.
• Colostrum can be stored for up to 2 weeks in the fridge's freezer compartment or up to 6 months in a deep freezer. (4) 
• Use colostrum within 24 hours once it is thawed.

Hand expression is an important skill for any expecting parent to learn. Not only can you express colostrum before giving birth, but if you have any challenges after giving birth, you will have already practiced this skill and be comfortable with how to do it. 

• Wash your hands and the containers you will use to collect and store your colostrum in hot, soapy water.
• Apply a heat pack to help you relax and encourage milk flow. Heat can help release oxytocin, the hormone responsible for milk letdown.
• Gently massage or stroke your breast from the top of your breast toward the nipple and from underneath your breast toward the nipple.
• Make sure you are relaxed and comfortable.
• Place your thumb and index finger at the edge of your areola. Press your thumb and finger into the chest wall, squeezing gently. If you are too far away from the nipple, you will not get any colostrum. If you are too close to the nipple, you cannot express any colostrum; experiment and find where to place your fingers for your best results.
• After a few minutes, rotate your fingers to a different spot at the edge of the areola and express your colostrum again. 
• As drops of colostrum are expressed, collect them into your clean syringe or container.

Colostrum is a complete food that meets all your baby's needs in their first days of life. Before collecting your colostrum, talk with your care providers and IBCLC (International Board Certified Lactation Consultant) or SACLC (South African Certified Lactation Consultant). Each person’s situation is different, and together, you can devise the best plan to meet your and your baby’s needs. Although collecting colostrum is recognized as safe, if you are experiencing early contractions, be sure to contact your team to discuss whether it is safe to continue. 

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