Unlocking the Power of Colostrum: Early Initiation Solution Capturing Every Drop

Every drop counts.  This phrase takes on a whole new meaning when considering the immense benefits of colostrum for infants. Colostrum, the first milk produced, is rich in immune factors, bioactive proteins, and nutrients, particularly vitamin A, which gives it a golden color and the nickname “liquid gold.”

The breasts begin making colostrum during pregnancy as the mammary gland forms milk-producing cells (lactocytes).1  In the first 24 hours after birth, mothers produce between 10-50 ml of colostrum.  Volumes increase in the coming days as secretory activation takes place.2

Many components of human milk are at their peak concentrations in colostrum.3, 4 These elevated levels are currently thought to serve as “initial loading doses,” offering additional protection against infection as the infant’s immune system transitions from being passive in utero to becoming immunogenic after birth.5

Purpose and Function of Colostrum

  • Immunity
  • Nutrition
  • Develop gut microbiota, aiding in digestion

So you may be asking yourself, “What components in colostrum make it so good for infants?”

Colostrum is rich in essential bioactive components that promote the health of infants:

  • Maternal Immune Cells & Antibodies: Provides passive immunity with immediate and tailored protection against pathogens6.
  • Probiotics: Health-promoting bacteria that protect against pathogens.7, 8
  • Human Milk Oligosaccharides (HMOs): Indigestible oligosaccharides that serve as food or “prebiotics” and decoys for pathogenic bacteria.9, 10
  • Bioactive Proteins: These include lactoferrin and lysozyme, which have antimicrobial properties.11–13

Colostrum can act as a bridge to extrauterine life as it aids the infant in adapting to life outside the womb by:

  • Protecting Mucosal Surfaces: As it is swallowed, colostrum coats the mucosal surfaces in the mouth, esophagus and intestine with maternal immune cells and antibodies. These components help establish a protective barrier preventing pathogens from crossing the mucosal surface, thus preventing infection.3
  • Furthermore, growth factors in colostrum help in closing the large gap junctions present in infants’ gastrointestinal epithelial cells, reducing the permeability of the gut.3
  • Promoting a Favorable Microbiome: Provides probiotic bacteria a competitive advantage over pathogens.13 High concentrations of iron-sequestering proteins, such as lactoferrin and transferrin, reduce the ability of pathogenic bacteria to acquire iron needed to proliferate and cause infection4.
  • Educating the Immune System: Initially, infants have limited capabilities to defend themselves against pathogens. Colostrum provides antigens and cytokines to help train infant’s antigen-presenting cells to bind and carry them to lymphoid tissues, aiding a major shift in immune response as infants adapt to extrauterine life.3, 14, 15

Colostrum can be used as immune therapy for infants born prematurely and has been associated with reduced incidence of late-onset sepsis, NEC and ventilator associated pneumonia in very low birth weight (VLBW) infants.15  This method, oral immune therapy, consists of administering a small volume of 0.1-0.2 ml of colostrum inside the infant’s cheeks until oral feeds begin16–18 and has been shown to be safe even for the smallest and most fragile infants, including those born weighing less than 1,000 grams.17, 18

Colostrum’s rich composition not only aids in the infant’s immediate health but also plays a crucial role in promoting long-term well-being.

  • Reduces Jaundice: Acts as a laxative to clear meconium, reducing bilirubin buildup.19
  • Protects Against Infections: Provides immune protection.3 Active and passive immunity protects the infant because it is rich in immunoglobulins, lactoferrin, lysozyme, cytokines, and numerous other immunologic factors, including maternal leukocytes.9, 20
  • Minimizes hypoglycemia: Contains nutrients that help to balance insulin production, which helps to decrease risk of low blood glucose.21
  • Initiates Breastfeeding: Decreases the need for additional medical interventions during the hospital stay.21

Did you Know?

  • sIgA, is a protein, and is the most abundant immunoglobulin in colostrum.22
  • sIgA inhibits pathogens from attaching to the gut lining and neutralizes viruses and toxins, including E. coli and Clostridium difficile.3
  • Lactoferrin, a bioactive protein, has antimicrobial and anti-inflammatory properties that help reduce the incidence of lower respiratory tract infections, the duration of dehydrating diarrhea, and the severity of rotavirus infection.3
  • Lactoferrin works by binding to iron, preventing pathogenic organisms from accessing the iron they need to survive.15

But what about mothers who are separated from their infant or if their infant cannot effectively stimulate the breasts and remove colostrum?

Effective ACTIVATION of milk-producing cells in the first hours and days after birth is critical for establishing long-term milk production due to the postpartum hormonal shifts that trigger milk production.

When direct breastfeeding isn’t possible, Medela offers an innovative solution: the Colostrum Protector. It is designed to collect colostrum efficiently, reducing loss during pumping. It connects seamlessly to the Symphony® pump without compromising performance, ensuring that colostrum is collected before it reaches the pump components, thereby minimizing any loss in the breast pump parts.

The Colostrum Protector features a convenient snap-on lid for safe storage and transport, significantly reducing the risk of contamination. A 2022 survey revealed that 95% of nurses who trialed the product felt it supported best practices, and 89% would recommend it to their facility (colostrum protector evaluation).

Medela is enhancing our most popular sterile breast pump kits to include the Colostrum Protector. This enhancement has the unique capability to support the activation of milk-producing cells and protect colostrum from loss and contamination.

Learn more: Symphony Sterile Kit Enhancements (medela.com)

Want to learn more about colostrum?
Watch the recorded Colostrum Mastery: Bridging Science & Practice ┃ Dr. Sarah Reyes, PhD, Jenny Murray, BSN, RN, IBCLC (youtube.com) to learn more about how you can adopt practical applications to support your patients.

References

  1. Hassiotou F, Geddes D. Clin Anat. 2013; 26(1):29–48.
  2. Kato I et al. Breastfeed Med. 2022 [cited 2022 Jan 17]; 17(1):52–58.
  3. Ballard O, Morrow AL. Pediatr Clin North Am. 2013; 60(1):49–74.
  4. Ames SR et al. Gut Microbes. 2023; 15(1):2190305.
  5. Levy O. Nat Rev Immunol. 2007; 7(5):379–390.
  6. Hassiotou F et al. Clin Transl Immunology. 2013; 2(4):e3.
  7. McGuire MK, McGuire MA. Adv Nutr. 2015; 6(1):112–123.
  8. Boix-Amorós A et al. Nutr Rev. 2019; 77(8):541–556.
  9. Bode L. Glycobiology. 2012; 22(9):1147–1162.
  10. Cortez RV et al. Nutrients. 2021; 13(12).
  11. Brockway MM et al. Adv Nutr. 2024; 15(1):100127.
  12. Lönnerdal B, Lien EL. Nutr Rev. 2003; 61(9):295–305.
  1. Donovan SM. J Pediatr. 2016; 173 Suppl:S16-28.
  2. Newburg DS, Walker WA. Pediatr Res. 2007; 61(1):2–8.
  3. Reyes SM. Medela AG. 2024:1–8.
  4. McQuigg M et al. Obes Res Clin Pract. 2008; 2(1):I–II.
  5. Snyder R et al. Pediatr Neonatol. 2017; 58(6):534–540.
  6. Lee J et al. Pediatrics. 2015; 135(2):e357-66.
  7. Mitra S, Rennie J. Br J Hosp Med (Lond). 2017; 78(12):699–704.
  8. Hassiotou F, Geddes DT. Adv Nutr. 2015; 6(3):267–275.
  9. Giouleka S et al. Children (Basel). 2023; 10(7).
  10. Pribylova J et al. J Clin Immunol. 2012; 32(6):1372–1380.
  11. Medela. 2022

Learn more about Medela

Explore Medela University and its extensive LMS modules, access upcoming webinars, or review past offerings. If you are motivated to enhance your nursing team’s foundational support for breastfeeding, email the Medela team at education@medela.com.

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The material presented in this blog represents the opinion of the author(s) and not necessarily the views of Synova Associates. Synova Associates does not endorse any specific products or organizations but strives to connect its industry partners with leaders interested in product/educational innovation.

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