Guidance on how to express colostrum during pregnancy

A brief overview of hand expression
The first milk in the breast is called colostrum. It is normal to start producing small amounts of colostrum in the middle of pregnancy. You may not always see the colostrum. There can be different reasons why we recommend hand expression of breast milk before childbirth.
Colostrum stabilizes the baby's blood sugar more effectively than formula does. Therefore, we recommend some pregnant women to hand express during pregnancy, typically 1-3 weeks before their due date. Consult with your midwife to determine when you can start.
Hand expressing colostrum during pregnancy does not negatively affect the amount of milk you produce immediately after childbirth. Instead, it prepares your breast for breastfeeding.
The time it takes to hand express, and the amount of colostrum collected can vary individually. Initially, it is normal to have little or no milk coming out. The amount can range from less than 1 ml to over 5 ml. Even if you only collect a small amount of colostrum, it is important for your baby.

You can stop hand expression at any time if you do not wish to continue.

How to do it

How to hand express breastmilk

Wash your hands before hand expressing. Colostrum can be expressed into a small, sterilized container, such as a small glass or a syringe.

Sit or stand comfortably. Express one breast at a time, holding the container with your other hand:

• Stimulate the flow of milk by gently massaging or stroking towards the nipple with a flat hand. Taking a warm bath or applying a warm cloth or heating pad to the breast can also help stimulate milk flow.
• Lean forward. Place your hand under the breast to support it. Position your thumb over the nipple and your index and middle fingers below the nipple at the edge of the darker area.
• Gently press your fingers into the breast towards the chest wall.

• Express milk by alternately squeezing your fingers together and releasing. Try to mimic the sucking rhythm of a baby. It may take several minutes before milk starts flowing from the breast.
• Feel for areas in the breast where there is a lot of milk and move your fingers around to stimulate all sides.
• Repeat the squeezing and releasing motion until no more milk comes out.

It should not be painful when hand expressing.

Colostrum can be transparent, whitish, yellowish, or bluish in colour. This does not have any significance.

 Store colostrum in small portions in your freezer
You should store the expressed milk in small portions in your freezer, such as small, sterilized glass containers or a syringe. The milk can be kept in the freezer for 6 months. You can collect milk from several expressing sessions in one container. Put the first milk in the freezer and pour subsequent expressions (up to 3 days in a row) into the same container.

Label all portions of colostrum with your name, CPR number, date, and time of expression.

 Bring the colostrum to the birth
When you are about to give birth, bring the frozen colostrum to the hospital in a cooler bag with ice packs. We will assist in placing the colostrum in a freezer in the maternity ward.

Things to be aware of

Contact us if you experience Braxton Hicks contractions or breast pain
If you experience discomfort in the form of frequent or long-lasting Braxton Hicks contractions or breast pain, stop expressing or skip the next session. If the contractions continue, contact the Delivery Reception. See the contact information for the phone number.

We will guide you on how to feed the colostrum to your baby
After you have given birth, we will guide you in how to thaw the colostrum and how to give it to the baby.

Gain more knowledge
In the Birth and Beyond app, you can find useful videos about hand expression.