Questions parents Ask: If I'm Pregnant and Leaking milk, Can I Collect It?

What can I do if I leak milk during pregnancy? Is it safe to pump?

Our breasts start making changes for feeding around 16 weeks of pregnancy. Every lactating person has a different experience, and it sounds like your body is leaking colostrum. Leaking or not leaking doesn't show how much milk we will have later. For example, leaking colostrum while pregnant doesn't mean you will have tons of milk, and not leaking doesn't mean you won't have enough. It is all about our individual responses.

You can collect milk before your baby is born. Generally it isn't recommended to actively express until you are 36 weeks pregnant. If you are leaking, you could do passive collection, which means providing a way for the milk to be collected as it leaks out. There are different ways to do this -- like breast shells, or Milkies Milk Savers.

At 36 weeks hand expression is recommended over pumping.

If a person is pregnant with multiples, has had preterm labor in the past, gets strong contractions from breast stimulation, or is on pelvic rest, actively removing colostrum (pumping or hand expression) is not recommended and can be dangerous as it could contribute to preterm labor. 

Otherwise, the way the body works is, we have these receptor sites that respond to oxytocin (the love hormone, released during orgasms, breast stimulation, and even while eating chocolate). During the majority of pregnancy, these receptors are closed -- they are not open to fully receive oxytocin when it is released in the body. Toward the end of pregnancy, the last few weeks, these receptor sites open up and become sensitive and ready for oxytocin -- this is because oxytocin is what creates the contractions in labor.

This is so why it is generally safe to have a toddler nursing through a pregnancy (same contraindications apply as above for special cases -- multiples, premature opening of the cervix, history of preterm labor, etc.).

Colostrum is the first milk. It will never become that whitish-blue, flowy milk we think of until the removal of the placenta -- the placenta tells us where the baby is and what the body should be doing. When the placenta is inside us, it tells the body we are growing a baby, so we don't need mature milk yet. When the placenta is removed, the body says, "Hey, the baby is outside now, so we better make milk!" The hormones in the placenta are what make those changes happen. That is why mature milk doesn't come until the placenta is out -- even then it takes a few days for those changes to happen.

This is why, even a tiny piece of the placenta accidentally left inside the body can interfere with how our bodies make mature milk. A small piece can still release enough hormones to confuse the body about where the baby is -- are we growing the baby? Or do we need to be making milk? It can also stop the uterus from involuting all the way (shrinking back to its normal size), as well as create a risk of uterine infection.

I had a doula client acting as a gestational surrogate who had enormous success collecting colostrum before birth. She  and the baby's parents decided this would be beneficial as the baby would get ample colostrum in addition to starting formula. There are many different reasons to start antenatal collection, and this resource from Association of Breastfeeding Mothers UK gives sound data and advice on how you can collect your baby's colostrum before birth. Of course talk to your medical provider about your specific situation, as they know you best.

Basically all that to say: if you use special collection cups to let the colostrum drip into, that is more than safe before 36 weeks as long as you don't try to stimulate the breasts -- remember, passive collection, passive meaning, you do no work (no hands, no pump). At 36 weeks you can hand express to actively collect colostrum.