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Somewhere in your ninth month, alongside the nesting and the hospital bag, you may have come across a practice that sounds almost too simple to be useful: hand-expressing tiny drops of colostrum from your breasts before your baby is even born, and freezing them in syringes for later. It’s called antenatal colostrum expression, and it’s gone from a niche recommendation for a small group of high-risk pregnancies to something a lot of expectant mothers now ask about directly. So is it actually worth doing, is it safe, and does it genuinely help with breastfeeding? Here’s what the research actually says, not just what’s trending in prenatal classes.
Colostrum is the first milk your body produces, thick, concentrated, and rich in antibodies and immune-supportive compounds, typically available in only very small quantities in the first few days after birth. Antenatal colostrum expression is the practice of hand-expressing and collecting this colostrum during the final weeks of pregnancy, usually starting around 36 weeks, so that a small stored supply is ready if your baby needs it in the early hours or days after delivery.
It was originally developed specifically for mothers with diabetes in pregnancy, since their babies face a higher risk of low blood sugar (hypoglycaemia) after birth and may need supplementation quickly. Over the past several years, the practice has expanded well beyond that original group, driven partly by genuine clinical interest and partly by social media and prenatal class popularity, which is exactly why it’s worth separating the established evidence from the general enthusiasm.
This is a rare area of maternity care with a genuinely well-designed trial behind it. The DAME trial (Diabetes and Antenatal Milk Expressing), a large randomised controlled trial conducted in Australia, followed pregnant women with diabetes who expressed colostrum twice a day for up to 10 minutes from 36 weeks. The results were reassuring on safety: no increase in preterm birth, and no difference in NICU admission rates or gestational age at birth between women who expressed and those who didn’t.
More recent research has built on this. The GAME trial (Gestational Diabetes Antenatal Milk Expression), a 2024-2025 randomised controlled trial conducted across two centres in Hong Kong with 246 women, evaluated a structured antenatal expression programme specifically for women with gestational diabetes, looking not just at breastfeeding outcomes but maternal mental health too, recognising that this group often experiences lower breastfeeding confidence and higher rates of postpartum depressive symptoms.
Here’s the honest, nuanced part, and it’s worth knowing before you start: a comprehensive 2025 narrative review concluded that while antenatal colostrum expression is well-established as safe for low-risk women from around 36 weeks, it does not appear to improve long-term breastfeeding rates on a population level. What it does reliably do is increase maternal confidence around breastfeeding and reduce reliance on formula supplementation during the hospital stay, since a baby who needs a top-up in the first day or two can be given their own mother’s colostrum rather than formula, which can help protect exclusive breastfeeding in the earliest, most fragile window.
In short: the evidence doesn’t support it as a guarantee of long-term breastfeeding success, but it does support it as a genuinely useful backup plan and a real confidence-builder, particularly for mothers who are anxious about their supply or who have a higher chance of needing supplementation in hospital.
This is the part that matters most, and it’s not something to work out alone from an Instagram tutorial. Antenatal colostrum expression is not recommended for women with:
The reasoning is straightforward: expressing releases of oxytocin, the hormone involved in triggering contractions, and while research in low-risk pregnancies hasn’t shown this to meaningfully increase preterm birth risk, that reassurance doesn’t extend to pregnancies that already carry a higher risk of early labour.
This is exactly why it’s essential to discuss your plans with your doctor or hospital before starting or a lactation specialist/consultant or a midwife., who knows your specific risk factors, scan results, and history. If you get the go-ahead, starting from around 36 weeks (some guidance allows from 37) is the generally recommended window, since starting earlier hasn’t been studied for safety and isn’t currently recommended.
If you ever feel cramping or tightening in your uterus while expressing, stop immediately. If it continues, contact your hospital or doctor promptly, rather than waiting to see if it settles.
Hand expression, not a pump. Colostrum is produced in extremely small amounts, most mothers collect somewhere between 1 and 3ml per session, and often nothing at all in a given attempt, which is completely normal. A breast pump at this stage tends to be uncomfortable and inefficient for such small volumes, and colostrum can stick to pump parts and be harder to collect. Gentle hand expression is the recommended technique.
Keep sessions short and low-pressure. A few minutes, two to three times a day, is a reasonable starting point. There’s no benefit to forcing longer sessions, and if nothing comes out on a given day, that’s not a sign anything is wrong, a newborn’s stomach is roughly the size of a marble, so even a few drops matter far more than the number might suggest.
What you’ll need:
Storage, step by step:
Getting it to the hospital. When labour starts, transport your frozen syringes in an insulated cooler bag with an ice pack, and ask hospital staff to move them into a medical freezer as soon as you arrive.
Even setting aside the stored colostrum itself, the process of learning hand expression during pregnancy has real value on its own. It’s a skill that remains genuinely useful after birth too, regardless of whether you managed to collect much colostrum antenatally, knowing how to hand express helps enormously in the first days if your baby is sleepy, struggling to latch, or if your breasts become overly full before your milk properly regulates.
For mothers with diabetes specifically, or anyone anxious about whether their baby might need supplementation, having your own colostrum ready removes a layer of stress from an already overwhelming first day, rather than a rushed decision about formula in the middle of the night, there’s already a small, familiar answer in the freezer.
This is exactly the kind of preparation that benefits from proper guidance rather than a YouTube video and guesswork. As independent midwives, our role isn’t to clear you medically for this, that conversation belongs with your doctor or hospital, who know your specific pregnancy and risk factors. What we can do is walk you through the technique properly, help you feel confident with hand expression, talk you through safe storage and labelling, and be a steady, knowledgeable presence to ask questions as you prepare, alongside whatever your hospital team has advised for your specific situation.
If you’re approaching 36 weeks in Abu Dhabi and want proper, hands-on guidance through this and the rest of your birth preparation, our breastfeeding support covers exactly this kind of practical, evidence-based preparation.
When should I start harvesting colostrum before birth?
Most guidance recommends starting no earlier than 36 weeks of pregnancy, and only after discussing it with your doctor or hospital, since starting earlier hasn’t been studied for safety.
Is it safe to hand-express colostrum during pregnancy?
Research, including the DAME trial, has found antenatal colostrum expression from 36 weeks to be safe for low-risk pregnancies and pregnancies affected by diabetes, without increasing rates of preterm birth. It is not recommended for women with a history of preterm labour, cervical insufficiency, placenta praevia, or certain other risk factors, so medical clearance is essential first.
Does harvesting colostrum improve long-term breastfeeding success?
Current evidence doesn’t show a clear improvement in long-term breastfeeding rates at a population level, but it does reliably increase maternal confidence and reduce the need for formula supplementation in the first days after birth if a baby needs a top-up.
How much colostrum should I expect to collect?
Most mothers collect around 1 to 3ml per session, and about 40ml in total by the time they give birth. Producing very little or nothing on a given day is completely normal and not a sign of a problem.
How long can harvested colostrum be stored?
Colostrum can generally be kept in the fridge for up to 4 days, or frozen for 6 to 12 months. Once thawed, it should be used within 24 hours and never refrozen.
Preparing properly for breastfeeding starts well before your baby arrives, and it deserves guidance you can trust. Our midwife services in Abu Dhabi are here to walk you through exactly this kind of preparation, alongside whatever your hospital team has advised for your pregnancy.
Approaching 36 weeks and want proper guidance on colostrum harvesting? Book a consultation and let’s get you ready.
Nativacare is your trusted support system led by experienced community midwives for your extraordinary motherhood journey. We at NativaCare believe that the positive motherhood outcome is not a probability but a possibility. Unlock your potential and change your attitude to change your altitude.
YES YOU CAN DO IT.
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