Colostrum is indeed the natural number 1 feed for your baby as it is the first nutritious liquid produced by the milk-production system of the mother’s breasts. So precious is this yellow colored ‘first breastmilk’ in terms of baby’s nutrition and health, that it is called ‘Liquid Gold’. Yet, in many cultures and societies, it is still not considered as ‘real’ or ‘proper’ breastmilk and that’s why they avoid giving it to the newborn, instead replacing it with other types of liquid feeds- the ‘Prelacteal feeds’.
In this article we will try and understand the importance of colostrum in breastfeeding, while also learning about the different stages of breastmilk production and the risks of offering prelacteal feeds, instead of colostrum.
Table of Contents
What is Colostrum? How does it differ from Transitional and Mature breast milk?
Colostrum is the first nutritious liquid produced by mother’s breasts from the second trimester of pregnancy onwards till around 3rd day after the baby’s birth. Colostrum thus is the first breast milk, which gives way to Transitional Milk till about 2 weeks after the baby’s birth. Only after that maternal breasts start producing Mature Milk. Each of these breast milk types differs in quantity, color, content and qualities.
Mature Milk has further two subtypes- Foremilk coming from milk sacs in the front portion of breast during the beginning of feeding, and Hindmilk coming from milk sacs in the back portion of breast, during later part of feeding, as the breast is closer to being empty.
| Type of breast milk | When available | Quantity | Appearance | Content |
| Colostrum | 2nd trimester to 3rd day after baby’s birth | Small | Thick, sticky (viscous) and dark yellow | Low in lactose, calories and fat; rich in proteins and minerals |
| Transitional | 3rd – 14th day after baby’s birth | Increases | Thin, liquid and light yellow | Increased calories, water, fats and carbs compared to colostrum but lesser than mature milk |
| Mature | After 14 days of baby’s birth | Further increases | Thinner, liquid and bluish grey | Lower protein; Higher water, calories, lactose and fat. Foremilk is thinner and richer in lactose. Hindmilk is thicker, creamier and richer in fat. |
Why should we feed Colostrum to the baby? (Colostrum benefits for baby)
Colostrum is produced in small quantities (few ml at a time). It is sticky or viscous and has an egg-yolk-like dark yellow colour. This has made many cultures and communities disregard and discard it, rather than feeding it to the newborn baby. This misconception deprives the new baby of multiple advantages.
- Colostrum is an adequate and appropriate nutrition for the new baby.
The new baby’s stomach capacity is hardly few milliliters (5-7 ml per feed on Day 1). The small quantity of colostrum with its unique content rich in proteins, minerals, essential fatty acids and fat-soluble vitamins, and low quantities of lactose and fat, provides enough proper nutrition for the newborn. It helps prevent hypoglycemia.
- It provides added immune protection to baby.
Colostrum is rich in antibodies (IgA, IgG and IgM), white blood cells and lactoferrin.
The antibodies and leucocytes (lymphocytes and macrophages) aid the new baby’s immature immune system in warding off different infections.
Lactoferrin is an iron-binding protein, which prevents growth of harmful bacteria and other pathogens. It also has anti-inflammatory and immune modulatory properties.
With its immunity-boosting properties, colostrum helps protect the newborn baby’s vulnerable health.
- It improves gut health.
IgA antibodies in colostrum line up the intestinal epithelium to provide local immunity. The prebiotics in colostrum help in development of healthy bacterial flora in the gut.
Colostrum also acts as a natural laxative, helping the baby pass meconium (the first stool), which clears excess bilirubin and reduces the risk of jaundice.
These nutritional and immune advantages of colostrum are so valuable that it is often called ‘Liquid Gold’, of course its deep yellow color playing an equally important role in this name!
What are Prelacteal Feeds?
Prelacteal feeding refer to the practice of providing a newborn baby with feeds other than breast milk in the first few days after birth, before the mother’s milk fully comes in. These feeds are typically given in addition to, or instead of, colostrum and early breast milk. Prelacteal feeds examples may include water, sugar water, glucose water, honey, herbal concoctions, or infant formula.
Historically, prelacteal feeding has been a common cultural practice in some societies and communities. It was believed that these pre-lacteal feeds had beneficial effects on the baby’s health or helped to clear meconium from the baby’s system. However, the practice of pre-lacteal feeding is not recommended by leading health organizations and can have negative consequences for both the baby and the mother.
Why giving Prelacteal Feeds instead of Colostrum is risky? (Risks of Prelacteal Feeding)
- Colostrum Suppression:
Giving pre-lacteal feeds may lead to the baby consuming less colostrum, which is essential for the baby’s early nutrition, immune protection and gut health.
- Delayed Onset of Mature Milk:
Breast milk production works on a supply-and-demand basis. If the baby receives pre-lacteal feeds instead of frequent breastfeeding, it may delay the onset of mature milk production in the mother, as breastfeeding is the primary stimulus for milk production.
- Risk of Infections:
Pre-lacteal feeds, especially if prepared in unhygienic conditions, can pose a risk of infection to the newborn, as their immune system is still developing, and their gut is more vulnerable.
- Difficulty in Latching:
Introducing artificial teats or bottles for pre-lacteal feeds may cause nipple confusion and difficulty latching during breastfeeding, leading to breastfeeding challenges.
- Hypoglycemia Risk:
In some cases, giving water or glucose water as a pre-lacteal feed may lead to a drop in the baby’s blood sugar levels (hypoglycemia).
What is Colostrum Harvesting?
Feeding colostrum to the newborn baby directly from the mother’s breast is the preferred way. But there are certain situations where this may not be possible, and in such cases Colostrum Harvesting can be considered.
Colostrum Harvesting is a practice of expressing and storing colostrum in the final 2-3 weeks of pregnancy. This stored colostrum then can be fed through a syringe or a bottle to the newborn baby.
What are the Indications for Colostrum Harvesting?
The indications for Colostrum Harvesting are conditions in baby or mother where the normal breastfeeding is expected to be difficult, delayed or not possible.
- In Baby:
Prematurity
Cleft Lip or Palate
Congenital anomalies
Small or Large babies - In mother:
Maternal health problems like diabetes, hypertension or heart disease
Breast hypoplasia or Breast surgery
Past history of problems in breastfeeding
How is Colostrum Harvesting done?
- The decision is taken after the doctor’s advice.
- Colostrum expression can begin in the last weeks of pregnancy- typically 37 – 39 weeks.
- Only Hand Expression of colostrum prior to delivery; no use of breast pump.
- With sterile precautions, the colostrum is expressed by hands, and collected in syringes or cups, which are labelled to identify name- date- time.
- The collected colostrum in syringes or cups is stored in refrigerator (up to 3 days) or freezer (up to 3 months) according to when it is planned to be used.
What is the potential Risk of Colostrum Harvesting?
The stimulation of the breasts during colostrum harvesting may cause the release of oxytocin, a hormone that can cause the uterus to contract. In a pregnant woman near the end of her pregnancy, these contractions could potentially trigger premature labor if they become strong and regular.
To reduce the risk of premature labor, the following precautions are needed.
- Undertaking the procedure only after medical guidance
- Gentle breast stimulation for expression, avoiding overstimulation
- Watching for signs of premature labor such as regular contractions, abdominal pain, back pain, or vaginal bleeding
- To stop expression and consult the doctor if such signs are present.
Summary
- Colostrum is the first breast milk produced by mother’s breast by 2nd trimester of pregnancy till 3-5 days after the baby’s birth.
- Colostrum gives way to Transitional Milk by 3rd to 5th day after baby’s birth and Mature Milk by the 2nd week of baby’s life.
- Colostrum is thick, sticky, dark yellow fluid produced in small quantities.
- Feeding colostrum offers adequate appropriate nutrition, boosts baby’s immunity, and improves baby’s gut health.
- The practice of replacing colostrum with other types of feeds (Pre-lacteal feeds) is unhealthy and to be avoided.
- In certain situations, the colostrum can be expressed, stored, and fed through syringe or cup- a practice that is called Colostrum Harvesting.
