Guidelines for expressing primary breast milk (colostrum) in the Department of Neonatology & Neonatal Intensive Care Unit - N.I.C.U.

Dear Mother, congratulations!

We are happy to be partners in your new path and wish you good health and success.

Breast milk is the best treatment for any newborn born on time and all the more when premature. Expressing and pumping milk is your way of being part of the treatment that promotes and heals your baby. The decision to breastfeed and express milk is yours. We are here to assist you in this process.

For any question or requests, you can always contact the nursing team and lactation consultants in the N.I.C.U and Maternity Department.

The first milk your body produces is called colostrum. 

It is recommended to start squeezing the first drops of colostrum manually immediately after birth.

Benefits of breast milk in premature babies:

Colostrum is the primary milk produced starting at week 16 of pregnancy and begins to appear after birth. Colostrum is a liquid rich in protective substances, immunization and has a perfect nutritional composition for your baby's needs. The texture of colostrum is very thick and its quantity is small compared to the mature milk. In the first few days, there are between a few drops and a few ml of colostrum in each pumping. 

When the colostrum changes to mature milk, the amount of milk increases.

It is important to start expressing milk as early as possible, preferably within an hour of birth.

Massage the breasts again and repeat steps 2 to 5.

Try to avoid friction and pain while squeezing.

Milk should be expressed 8-12 times a day (every two-three hours) in order to establish and maintain milk production.

Positioning the fingers on the breast, step 1, 2, 3, getting a syringe and stopper, removing the plunger and assembling the stopper, squeezing drops of milk from the breast into the syringe, returning the plunger, removing excess air and screwing the stopper, sticking a sticker with the details of the milk and the newborn.

The Ministry of Health in Israel is  promoting the administration of colostrum to the mucous membranes of the oral cavity for local absorption of the milk components (Administration Buccal Colostrum). 

Studies show that this protects the digestive system and helps the optimal absorption of the milk, reduces the risk of prematurity complications (NEC) and generally promotes the health of the premature baby. This should be done within 8-10 hours of birth.

We will be happy if you are able to transfer even a few drops of colostrum to us within this time frame from birth.

The collected colostrum should preferably be transferred to the N.I.C.U  as close as possible to the time of squeezing with the purple syringes that are in the kit.

 An identification sticker of the baby must be affixed to the vessel before transferring it to the delivery room.

 Later, the marked milk (an orange sticker with the date and time and a purple sticker identifying the child) must be transferred to the N.I.C.U and given to the nurse.

During the first week you will feel fuller in your breasts, and at this stage you will be able to switch from manual expressing to a milk pump (usually two to three days after giving birth).

In the N.I.C.U, you can get a sterile pumping kit for use with milk pumps located in the  "Milky Way" - the pumping rooms in the N.I.C.U.

We wish you success, good health for both you and the newborn baby.

The lactation consultants' team – 

Department of Neonatology & Neonatal Intensive Care Unit