This blog is written by Lauren Brenton from One Mama Midwife
You’ve probably heard someone say, “Should I collect colostrum before birth?”. Sometimes it’s framed as a must-do. Sometimes it’s dismissed. The truth (as usual) is more complicated.
Antenatal colostrum collection can be helpful for some pregnancies, but it’s not recommended for everyone, and it needs to be done safely.
What is colostrum?
Colostrum is the first milk your breasts make (yes, it’s still breastmilk) and it actually starts being produced between weeks 16-18 of pregnancy. It’s thick, concentrated, and produced in small volumes – those small volumes are normal and all that most healthy babies need for the first few days of life.
Colostrum is high in antibodies, lines baby’s digestive system, is high in protein and low in fat and sugar – it’s often termed liquid gold because of its amazing properties.
Does colostrum run out if you express during pregnancy?
No, this is a common myth that if you express the colostrum out during pregnancy then there will be none left for the baby to drink. Your body will continue producing colostrum until after your baby is born; the more often your baby feeds in the first few days will allow the body to increase the volume and change the composition of the colostrum into what’s said to be “breastmilk”.
What is “collecting colostrum” in pregnancy?
Collecting colostrum in pregnancy usually means hand expressing small amounts in late pregnancy (after 37 weeks) and storing it (typically frozen) to use after birth if needed.
It’s often called:
• antenatal expressing,
• antenatal colostrum harvesting,
• antenatal hand expression.
It is recommended in Australia to start hand expressing after 37 weeks of pregnancy and stopping if you feel contractions or have any bleeding. When we express colostrum or breastmilk during pregnancy and after birth, it releases the hormone oxytocin. Oxytocin is also responsible for our labour contractions, so that is why it isn’t recommended to express colostrum prior to 37 weeks, just in case you accidentally put yourself into labour. Always check with your healthcare provider before expressing colostrum in pregnancy.
Can I express colostrum with a pump?
It is typically recommended to hand express rather than using a pump, as the drops are so small they might all get lost in the pump parts. Plus, if you use a pump, then you don’t get the confidence from hand expressing.
Why might someone collect colostrum before birth?
Most babies breastfeed without needing extra “top-ups”, but there are situations where having your own stored colostrum can be genuinely helpful, including:
• diabetes in pregnancy (because babies can be at risk of low blood sugar),
• anticipated feeding challenges (for example, certain congenital conditions),
• likelihood of separation after birth (NICU/special care),
• planned caesarean where you want extra reassurance (not because you must, but because it can support confidence and reduce reliance on formula if a top-up is clinically needed).
Now, let’s talk about the study everyone references…
What does the DAME study actually say? (and who it applies to)
The DAME trial is the best-known Australian study on antenatal expressing in pregnancy complicated by diabetes.
Study design (DAME)
DAME was a multicentre, unblinded, randomised controlled trial across six hospitals in Australia. It recruited women with gestational or pre-existing diabetes in singleton pregnancies at 34–37 weeks, and compared:
• antenatal expressing twice per day from 36 weeks, versus
• standard care.
What the study found about the benefits of expressing colostrum in pregnancy
1. No evidence of harm
One of the first and most important conclusions from the DAME trial is that advising low-risk women with diabetes to express breastmilk from ~36 weeks did not cause harm to mother or baby.
Specifically: The rate of neonatal intensive care unit (NICU) admission was not significantly different between the expressing group and the standard care group.
2. Increase in Early Exclusive Breastmilk Feeding in Hospital
While the study was not designed to prove large clinical effects, it did find moderate evidence that a greater proportion of infants in the expressing group received exclusive breastmilk in the first 24 hours after birth compared with those who did not express. Women advised to express had higher exclusive breastmilk rates in the first day of life. There was also some evidence (though less strong statistically) that exclusive breastmilk feeding during the entire hospital stay was higher in the expressing group compared with standard care.
This suggests that antenatal expressing may support early initiation of exclusive breastmilk feeding before formula supplementation is considered, particularly relevant for babies at risk of early hypoglycaemia, such as those of mothers with diabetes.
When is antenatal expressing NOT recommended?
Different hospitals list slightly different exclusions, but common “don’t do this without specialist advice” situations include:
• threatened/actual preterm labour history,
• cervical stitch/short cervix,
• placenta praevia,
• bleeding in pregnancy,
• any contractions triggered by expressing.
If you’re unsure, the safest rule is to ask your midwife or Obstetrician first.
How to collect colostrum safely (step-by-step)
It is commonly recommended to start off expressing 2–3 times per day, starting with a few minutes each side (often 3–5 minutes), and stopping if you get any contractions.
Method: hand expression (not pumping)
• Wash hands thoroughly.
• Warmth helps before starting (warm shower/compress can help the reflex).
• Place thumb and finger about 2–3cm back from the nipple (on the areola line), press back toward the chest, compress gently, then release. Rotate around the areola. It’s important to note that we do not slide our fingers when we are hand expressing.
• Collect drops into Haakaa Silicone Colostrum Collectors.
• Stop immediately if you have pain, bleeding, or contractions.
• Clearly label colostrum collector with date and time that you expressed.
• Transport frozen to hospital in an esky/cool bag with ice bricks.
For breastmilk storage times, the Australian Breastfeeding Association advises:
• Room temperature 6-8 hours;
• Fridge ≤72 hours;
• Freezer storage (3 months or 6-12 months) depending on freezer type;
• Follow your hospital’s policy for antenatal colostrum storage.
Where Haakaa fits in (practical tools)
If you’re collecting colostrum, you need something that suits tiny volumes and safe storage.
Haakaa’s Silicone Colostrum Collectors are designed for collecting and storing small amounts, are made from medical-grade silicone, and come pre-sterilised in some packs.
This can be especially helpful because colostrum is thick, comes in drops, and can be fiddly to handle with larger containers or traditional syringes.
The most important takeaway
Antenatal colostrum collection can be a great option when it’s recommended for your pregnancy and done safely.
The DAME trial gives reassuring safety evidence for women with diabetes in pregnancy who are low risk, expressing from 36 weeks with no increase in NICU admissions compared to standard care.
But it’s not a universal rule, and it’s not compulsory if you do not want to do it. The goal is preparation not pressure.
Written by Lauren Brenton
Endorsed Midwife, Founder One Mama Midwife Pty Ltd