Intermountain Health Lactation Consultant Addresses Trend of Expressing Colostrum Before Birth

Breastfeeding has been around as long as there have been babies, and August is a time to draw attention to how much it benefits mom and little ones. According to the CDC and Intermountain Health, infants who are breastfed have a lower risk of:

• Asthma and severe lower respiratory diseases.
• Obesity.
• Type 1 diabetes.
• Ear infections.
• Sudden unexpected infant death (SUID).
• Gastrointestinal infections (diarrhea or vomiting).

And mothers who breastfeed their infants have a lower risk of:

• Breast cancer.
• Ovarian cancer.
• Type 2 diabetes.
• High blood pressure.

The American Academy of Pediatrics and the World Health Organization recommend continued breastfeeding along with introducing appropriate complementary foods for up to two years or longer. Breastfeeding is also convenient, inexpensive and is good for the environment.

Women are encouraged to breastfeed their children for at least one year. The longer an infant is breastfed, the greater the protection from certain illnesses and long-term diseases. If mutually desired by the mom and baby, the longer a woman breastfeeds, the greater the benefits to her health as well.

Colostrum is Baby’s First Milk

If you’re pregnant and planning to breastfeed your baby, you may have heard about colostrum. Colostrum is known as baby’s “first milk.” It is available just before and in the first few days after giving birth, before breastmilk comes in. It is often more yellow in color and can be thicker than the more mature breastmilk that comes in afterward.

Colostrum has been nicknamed “liquid gold,” because compared with more mature human milk, colostrum is also higher in protein, slightly lower in sugar, and significantly lower in fat. It provides all the nutrients and fluid that your newborn needs in the early days and helps support their developing immune system and fight disease.

During pregnancy, the breasts begin producing colostrum in small amounts. Sometimes there are no outward signs of this, but sometimes colostrum leaks onto a person’s bra or other clothing.

“There is a current trend on social media to express your colostrum prior to delivery and freeze it, so when the baby is born if you need to supplement, you can give your baby your own milk instead of formula or donated breast milk. But if you are going to express colostrum, it’s important to do it safely,” said Laura Rowbury, RN, IBCLC, a nurse and certified lactation consultant at Intermountain Health American Fork Hospital.

According to Rowbury, most babies don’t need extra colostrum, but babies with certain medical conditions are helped by extra colostrum feedings in their first week of life.

Babies most likely to need supplemental feedings include:

• A baby born to a mom with type 1 diabetes or gestational diabetes diagnosed during pregnancy are at an increased risk for needing supplementation because they struggle to maintain healthy blood sugar levels.
• A baby born with increased bilirubin levels which leads to jaundice may require supplementation to help lower the bilirubin levels and prevent further weight loss, because they tend to sleep more.
• A baby who is small for gestational age (below the 10% in weight for their age) and large for gestational age or above 90% in weight for their age.
• A baby who is born premature or needs to be in a neonatal ICU.
• A baby with weight loss greater than 10% in the first two days of life.
• Babies born as multiple births (twins, triplets etc.)

“Although we do have donated breastmilk in our hospitals, many moms prefer to use their own milk and so do we. However, knowing when to start expressing colostrum and how much is needed will help to alleviate preterm labor and ensure we can use your colostrum,” said Rowbury.

“Expressing before birth improves your ability to exclusively breastfeed your baby during the first three months and improves breastfeeding success overall. The newborn stomach is small and only needs 1/2 tsp to 2 tsp of colostrum at each feeding,” she added.

Tips for safe expression of colostrum

• It’s not recommended to express colostrum prior to 37 weeks
• Hand expression is the most common way to collect colostrum.
• Ask your provider for instructions or videos on how to express colostrum.
• If you experience any cramping or abdominal (belly pains), stop right away.

Tips to store and use colostrum safely

• Check with your hospital to see if you can bring frozen colostrum.
• Colostrum needs to be kept frozen prior to delivery.
• It’s best to store colostrum in a syringe with a cap and leave space for expansion during freezing.
• Label each container with the date and time the colostrum was expressed.
• Bring frozen, expressed colostrum to the hospital in a cooler with blue ice to be used after delivery and let the hospital staff know you have frozen colostrum when you arrive.
• Once colostrum is thawed it must be used within 24 hours.

Intermountain Health hospitals and clinics offer in-person lactation consultations and telehealth lactation consultations. Visit the breastfeeding support page on Intermountainhealth.org for tips and videos and check with your local hospital’s labor and delivery department for specific local breastfeeding resources.

About Intermountain Health

Headquartered in Utah with locations in six states and additional operations across the western U.S., Intermountain Health is a nonprofit system of 33 hospitals, over 400 clinics, medical groups with some 4,600 employed physicians and advanced care providers, a health plans division called Select Health with more than one million members, and other health services. Helping people live the healthiest lives possible, Intermountain is committed to improving community health and is widely recognized as a leader in transforming healthcare by using evidence-based best practices to consistently deliver high-quality outcomes at sustainable costs. For up-to-date information and announcements, please see the Intermountain Health newsroom at https://news.intermountainhealth.org/.