Antenatal Colostrum Expression: When, Why, and How — Plus Safe Storage of Expressed Breast Milk (EBM)
Preparing to feed your baby can start even before birth. One helpful option for some pregnant people is antenatal colostrum expression—the gentle hand-expression of the first milk (colostrum) in late pregnancy. Knowing how to express safely and how to store expressed breast milk can help you feel confident and prepared for your baby’s arrival.
What Is Colostrum and Why Is It Important?
Colostrum is the first milk your body produces, usually from around 16–20 weeks of pregnancy, although visible drops often appear later. It is thick, golden, sticky, and produced in small amounts—but it’s incredibly powerful.
Colostrum is rich in:
Antibodies and immune factors
Protein
Vitamins and minerals
Gut-protective factors
It acts as your baby’s first natural immunisation, helping protect against infection and supporting early digestion.
What Is Antenatal Colostrum Expression?
Antenatal colostrum expression involves hand-expressing colostrum during pregnancy, usually from around 36 weeks gestation, and storing it to use after birth if needed.
It can be particularly helpful if:
Your baby is likely to need extra support after birth
You have diabetes (gestational or pre-existing) or taking medication that can impact on your baby’s blood sugar levels
You’re expecting twins or higher-order multiples
There’s a possibility of separation from your baby after birth
You want to build confidence with hand-expression before your baby arrives
You want a little extra EBM on hand to help with night 2 cluster feeding
Important: Antenatal expressing is not recommended for everyone. It should only be started after discussion with your midwife or doctor, especially if you have risk factors for preterm labour or some pregnancy complications.
When Is It Safe to Start?
For most people who are advised to express antenatally, it begins at:
36 weeks of pregnancy
Once or twice daily
For short periods (5–10 minutes)
Your midwife will guide you if this is appropriate for you.
How to Hand-Express Colostrum
Antenatal expression is done by hand, not with a pump.
Step-by-Step Guide
Wash your hands thoroughly.
Find a comfortable, relaxed position.
Gently massage the breast to stimulate milk flow.
Place your thumb and fingers in a “C” shape about 2–3 cm back from the nipple (generally on the edge of the areola).
Press back towards the chest wall, then gently roll forward like you are performing a massage. Do not pinch the nipple
Rotate finger placement around the breast.
Collect droplets of colostrum into a sterile syringe or container.
At first you may see only a few drops—this is normal. Every drop counts.
Helpful Tips
Warmth (a warm shower or compress) can help.
Stay relaxed—stress can inhibit milk flow.
Stop if you feel uterine tightening or discomfort and seek advice.
How to Store Expressed Colostrum and Breast Milk Safely
Because colostrum is usually collected in tiny volumes, small sterile syringes (1–3 mL) are often used antenatally.
Labelling
Always label with:
Date and time of expression
Your name (and baby’s name if known)
Storage Guidelines (General Recommendations)
Colostrum
Freeze as soon as possible after expressing, do not mix warm and cold EBM
Store at the back of the freezer, not in the door
Transport to hospital frozen (in an insulated container with ice bricks)
Always follow your local hospital or maternity service guidelines if they differ.
Freshly Expressed Breast Milk
Room temperature (≤26°C): up to 6–8 hours
Refrigerator (≤4°C): up to 72 hours (some guidelines allow up to 5 days)
Freezer (–18°C or colder): up to 3–6 months (longer in a deep freezer)
Thawing and Using Stored Milk
Thaw in the refrigerator or using warm water, once warmed the milk must be used immediately for a feed
Do not microwave breast milk
Do not refreeze thawed milk
Discard any leftover warmed milk after a feed
Bringing Expressed Colostrum to Hospital
If you plan to bring antenatally expressed colostrum with you:
Keep it frozen
Transport it in a cooler bag with ice packs
Hand it directly to staff on arrival so it can be stored safely
A Final Word of Reassurance
Not everyone can—or needs to—express colostrum before birth. Producing only a few drops, or none at all, does not predict breastfeeding success. Your body will make what your baby needs after birth.
Antenatal colostrum expression is simply one tool to support feeding and confidence, used when appropriate and with guidance.
If you’re interested, talk with your midwife or doctor—they can help you decide what’s right for you and show you how to express safely.
Written by Johanna Quigley (RN/RM/IBCLC)