What are the guidelines for harvesting and storing colostrum (first milk)?

Guidelines for Harvesting and Storing Colostrum

Colostrum should be harvested as early as possible after birth, stored in clean containers, refrigerated or frozen promptly, and properly labeled with date and time of collection to ensure optimal quality and safety for infant feeding.

Harvesting Colostrum

Antenatal Colostrum Expression (ACE)

• ACE is safe for low-risk pregnant women when performed from around 36 weeks' gestation 1
• Benefits of antenatal colostrum collection:
  • Helps avoid formula use in hospital if supplementation is needed
  • May have positive effects on infant immune function
  • Increases maternal confidence around breastfeeding
  • Provides valuable hand expression skills that will be useful postpartum

Postpartum Colostrum Collection

• Colostrum is the first fluid produced by mammary glands immediately after birth 2
• Contains high concentrations of:
  • Essential nutrients (proteins, lipids, carbohydrates, micronutrients)
  • Immunologic factors
  • Growth factors
  • Signaling peptides
  • Commensal bacteria (including Lactobacillus and Bifidobacterium species)
• Harvest colostrum as soon as possible after birth, as quality diminishes over time

Storage Guidelines

Containers

• Use clean, sterile containers specifically designed for human milk storage
• Internally screw-threaded containers with silicone O-rings are recommended to prevent contamination 2
• Containers should be labeled with:
  • Date and time of collection
  • Mother's name and infant's name (if in hospital setting)

Temperature Control

• Fresh colostrum:

  • Refrigerate within 1 hour of collection to minimize bacterial growth
  • Store at 4°C (refrigerator temperature)
  • Use within 24-48 hours if refrigerated

• Frozen colostrum:

  • Freeze promptly if not being used within 24-48 hours
  • Store at -20°C or lower
  • Can be stored for up to 6 months in a regular freezer compartment
  • Can be stored for up to 12 months in a deep freezer (-20°C or lower)

Thawing and Warming

• Thaw frozen colostrum gradually:
  • Place in refrigerator overnight, or
  • Use warm water bath (temperature not exceeding 40°C)
• Never use a microwave to thaw or warm colostrum
• Once thawed, use within 24 hours and do not refreeze

Quality Control and Hygiene

Preventing Contamination

• Wash hands thoroughly before expressing or handling colostrum
• Clean breast surfaces before expression
• Use clean or sterile collection equipment
• Avoid touching the inside of collection containers
• Refrigerate or freeze promptly after collection

Special Considerations

• Breastfeeding is safe for mothers with hepatitis C virus (HCV) infection, unless nipples are cracked or bleeding 2
• If nipples are cracked or bleeding in HCV-positive mothers, breast milk should be expressed and discarded 2
• For mothers with hepatitis E virus (HEV) infection who are asymptomatic, breastfeeding should not be discouraged 2

Common Pitfalls to Avoid

1. Delayed storage: Storing colostrum at ambient temperature leads to rapid bacterial growth. Refrigerate within 1 hour of collection.

2. Improper thawing: Thawing at high temperatures can damage bioactive components. Use gradual thawing methods.

3. Inadequate labeling: Failure to properly label containers can lead to confusion and potential waste of valuable colostrum.

4. Poor hygiene during collection: Bacterial contamination can occur during the harvesting process. Maintain strict hygiene practices.

5. Inappropriate containers: Using containers not designed for human milk storage can lead to contamination or leakage.

By following these guidelines, mothers can successfully harvest and store colostrum to provide optimal nutrition and immune protection for their infants, particularly in situations where direct breastfeeding may be delayed or supplementation is needed.