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Is it advisable to extract colostrum before delivery? In which cases would it be indicated

Colostrum is the milk that a newborn takes in the first days of life. However, its production begins already in pregnancy. Therefore, it is possible to produce and extract colostrum in the days / weeks before delivery. But is it really necessary to extract it? In which cases would it be indicated?

What is colostrum?

Colostrum is the first food a breastfed newborn receives. It is the name given to the breast milk that we secrete during the first 2-3 days of life; Later we produce transitional milk and, finally, mature milk, which will be the one that lasts throughout lactation.

Colostrum is also known as “liquid gold”, because it has a composition that makes it very special, and it is just what the newborn needs during those first days of life . Colostrum is yellowish in color, due to its high content of carotenoids. It is very rich in immunoglobulins, lactoferrin, oligosaccharides and defensive cells, which is why some say that colostrum is “the first vaccine”. It is secreted in very small amounts, between 2-20 ml per dose, but it is enough for the baby that has just been born.

Although colostrum is the milk secreted by women during the first days of life, it is produced already in the last months of pregnancy; in fact, some women notice that their breasts leak weeks before delivery. Thus, all women, even those who choose not to breastfeed their babies, have colostrum.

What is prenatal colostrum extraction?

As we have mentioned, colostrum begins to be produced in the later stages of pregnancy. Thus, we could extract colostrum before delivery and store it . In the event that the baby, due to different circumstances, cannot be breastfed initially, he can be fed with his mother’s colostrum without the need to resort to artificial milk.

Which women can benefit from extracting colostrum?

Although there are authors who recommend that all women do it, since it brings benefits to all women (such as self-confidence and better preparation for breastfeeding), there are specific groups that especially benefit from it.

  • Women with diabetes

We include here both women with diabetes prior to pregnancy and those with gestational diabetes (which develops during pregnancy).

In these cases, the rise in milk (phase II of lactogenesis) may be delayed . In addition, maternal diabetes is associated with low levels of prolactin (the hormone most involved in breastfeeding) and a lack of milk supply. On the other hand, mothers with diabetes have caesarean section more frequently and their children have more frequency of suffering certain complications (prematurity, respiratory distress …) that can cause mother and child to be separated for the first hours or days of life.

In addition, children of diabetic mothers are at higher risk of hypoglycemia . For this reason, these babies often need supplements or artificial milk and prenatal extraction of colostrum can be an alternative to this. On the other hand, it would favor the initiation of breastfeeding, which is especially beneficial in these mothers, since it reduces the risk of developing type 2 diabetes in women who have suffered from gestational diabetes and decreases the frequency of diabetes in childhood.

The prenatal extraction of colostrum in women with diabetes has been widely studied and is a practice recommended by many authors.

  • Women likely to have hypogalactia

Primary or true hypogalactia (inability of the mother to produce enough milk to exclusively breastfeed her baby) is fortunately rare.

However, there are some situations in which it is likely to occur, for example in breast hypoplasia. Women with mammary hypoplasia have breasts with a small mammary gland; They are breasts that are widely separated from each other, shaped like a drop (” tea drop ” in English) or tube and with an areola that is large compared to the breast. In these cases, hypogalactia is very likely. For this reason, it may be beneficial to have colostrum extracted from before the pregnancy . In this way they will stimulate more milk production and, if needed, the newborn can receive breast milk supplements the first hours or days of life.

Women with PCOS may also have difficulties breastfeeding and may benefit from prenatal colostrum extraction.

  • Situations in which mother and child are likely to be separated for the first hours of life

Until recently, and it still happens in some hospitals, babies born by cesarean section were separated from their mothers during the first hours of life, until the mother recovered from the intervention. The current trend is for both to stay together, but if you have a scheduled cesarean section in a hospital where this does not happen, prenatal colostrum extraction can prevent artificial milk from being administered to your baby.

  • Babies with retarded intrauterine growth

As with the children of diabetic mothers, babies with delayed intrauterine growth are more likely to develop hypoglycemia after delivery. In addition, they usually lose a lot of weight in the first days. For this reason, prenatal extraction of colostrum could prevent them from being given artificial milk supplements in the first hours or days of life.

  • Babies with congenital malformations

These newborns are also frequently separated from their mothers , as they may require hospital admission. In addition, in some cases, they cannot be attached directly to the chest in the initial moments. Thus, mothers whose babies have already been diagnosed with a malformation in the uterus, such as a cleft or palatal lip, for example, can extract colostrum before delivery and thus ensure that their breast milk will be the first food they receive.

How to perform the colostrum extraction?

Colostrum extraction should be manual and just one or two times a day is enough. Starting before 36 or 37 weeks gestational age is not recommended. Colostrum is produced in very small amounts, but that shouldn’t worry us. The first few times it is likely that we will barely get a few drops.

Before starting, good hand hygiene is essential. We will massage the breast first and then we will begin with the manual extraction, placing the fingers in a C shape about 2-3 cm from the base of the nipple. When the dripping stops, we will move on to the next breast. We can collect the colostrum in a spoon or a small container and later transfer it to a small syringe (remember that the quantities that we will collect each time are small, but they will be enough for our newborn).

It is important to label each syringe (or we can put it in a bag and label it) with the date of extraction and the baby’s name. Later we will freeze it . To transport the milk, if necessary, we will take it to the hospital in a cooler with ice sheets.

What are the risks?

Prenatal colostrum extraction releases oxytocin, and some may think that this could trigger labor. However, oxytocin is also released in other situations, such as sexual intercourse or if another baby is breastfed during pregnancy; and both situations are perfectly compatible with a normal course pregnancy.

The latest studies indicate that prenatal colostrum extraction is safe and beneficial in normal pregnancies. It is important to note, however, that it should be guided by a healthcare professional and that, in the event of noticing contractions or pain, we should stop performing it .

Cover photo | pvproductions – www.freepik.es
In Babies and more | Eleven Breastfeeding Problems And How To Fix Them, According To A Lactation Consultant, Do Women Who Breastfeed During Pregnancy Produce Colostrum For The New Baby?

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