Colostrum Collection During Pregnancy: Is It Right for Everyone?

There’s a lot of information on social media about collecting colostrum before your baby is born. Some parents are encouraged to do it, while others are left wondering if they should be doing it too. It can quickly feel like one more thing to add to an already overwhelming pregnancy checklist.

At the South African Certified Lactation Consultant Association (SACLC), our approach is simple: we do not routinely recommend antenatal colostrum collection for every pregnant woman. Instead, we believe every family deserves balanced, evidence-based information so they can make an informed decision together with their healthcare provider.

Let's unpack what colostrum collection is, who it may benefit, and why it isn't necessary for most pregnancies.

What is colostrum?

Colostrum is often called your baby's "first milk". It is the thick, golden milk your breasts produce during pregnancy and in the first few days after birth.

Although only small amounts are produced, colostrum is packed with everything a newborn needs:

• Antibodies to help protect against infection

• Growth factors that support the developing gut

• Nutrients perfectly suited to a newborn's tiny stomach

• White blood cells that help strengthen your baby's immune system

Even a few drops can be incredibly valuable.

What is antenatal colostrum collection?

Antenatal colostrum collection (sometimes called colostrum harvesting) means expressing colostrum by hand during the last few weeks of pregnancy, usually from around 36 weeks, collecting it in sterile syringes and freezing it for use after birth if needed.

It is important to note that hand expression is recommended rather than using a breast pump during pregnancy.

Why do some parents consider collecting colostrum?

For certain pregnancies, having stored colostrum available after birth may be helpful.

Examples include:

• Mothers with diabetes during pregnancy

• Babies expected to have low blood sugar after birth

• Some babies who may require admission to the neonatal unit

• Situations where temporary separation between mother and baby is expected

In these circumstances, having expressed colostrum available may reduce the need for formula supplementation if the baby requires additional feeds.

However, this decision should always be made together with the healthcare team caring for the pregnancy.

Why isn't it recommended for everyone?

While antenatal colostrum collection has become increasingly popular online, current evidence does not support routine colostrum collection for every pregnant woman.

Research has shown that, for women with uncomplicated pregnancies, routinely expressing colostrum before birth has not been proven to improve breastfeeding outcomes or increase milk supply after delivery.

Like many areas of maternity care, the decision should be individualised rather than becoming a standard expectation.

Things to consider before deciding

There are several reasons why routine antenatal expression may not be the right choice for everyone.

Breastfeeding works best at the breast

One of the most important parts of establishing breastfeeding is allowing your baby to feed directly from the breast as soon as possible after birth.

This skin-to-skin contact and frequent feeding help stimulate milk production while also allowing baby to practice attaching and feeding effectively. Expressed colostrum can sometimes have a place, but it should never replace opportunities for direct breastfeeding unless there is a medical reason.

Measuring milk can create unnecessary pressure

Pregnancy already comes with enough expectations.

When parents begin collecting colostrum before birth, it's easy to compare volumes or worry if only a few drops are expressed. The truth is that every body is different, and the amount collected before birth does not predict how much milk you will make once your baby arrives.

A few drops are completely normal.

Breastfeeding isn't measured in milliliters

One of the biggest misconceptions is that successful breastfeeding is about how much milk you can express.

In reality, babies are often far more effective at removing milk than expressing by hand ever will be. Many mothers who struggle to express during pregnancy go on to exclusively breastfeed successfully.

What does the evidence say?

One of the best-known studies, the DAME Trial, looked at women with diabetes during pregnancy.

The researchers found that hand expressing colostrum from around 36 weeks in low-risk pregnancies did not increase harm or trigger labour when appropriately supervised. However, it also wasn't recommended as something every pregnant woman should automatically do.

More recent research continues to suggest that antenatal colostrum collection should be considered only in selected situations, rather than becoming routine practice.

If you do choose to collect colostrum

If you and your healthcare provider decide that antenatal colostrum collection is appropriate for your pregnancy, it should be done safely.

General recommendations include:

• Discuss it first with your obstetrician, midwife or healthcare provider.

• Begin only if you have been advised it is safe to do so.

• Use hand expression, not a breast pump.

• Collect into sterile syringes or approved containers.

• Label and freeze the colostrum according to your healthcare team's guidance.

• Stop and seek medical advice if you experience contractions, bleeding or any concerning symptoms.

Every breastfeeding journey is different

The most important thing to remember is that collecting colostrum before birth is not a requirement for successful breastfeeding.

Many mothers never express a single drop before delivery and go on to enjoy a healthy, rewarding breastfeeding journey. Others may benefit from antenatal colostrum collection because of specific medical circumstances.

Neither choice is "better". What matters is that the decision is informed, evidence-based and appropriate for your individual pregnancy.

We're here to support you

Preparing for breastfeeding involves much more than collecting milk. It includes understanding how breastfeeding works, learning about baby's feeding cues, knowing what to expect in the first few days, and having the right support when challenges arise.

SACLC's Certified Lactation Consultants are trained to provide evidence-based guidance tailored to your unique situation. Whether you're wondering if antenatal colostrum collection is appropriate, preparing for birth, or navigating the early days with your newborn, we're here to help you make informed choices with confidence.

Because every mother deserves support that is compassionate, personalised and rooted in the latest evidence.

Your breastfeeding journey doesn't have to look like anyone else's. It simply needs to be right for you and your baby. 🤍