If you’re thinking, “I don’t know what COLOSTRUM or JAUNDICE even are”, you are not alone. These are things that most people don’t learn about until they have a baby of their own. Even then, your baby might not ever have jaundice. One of the best ways to prevent it is by ensuring that your baby gets plenty of colostrum right from the beginning.
What is Colostrum?
Colostrum is the first milk that you produce. Your body is preparing to make milk from early on in the pregnancy, and by the end of the second trimester, your body is probably ready to feed a baby. This is how even babies born prematurely can often get breast milk. Colostrum is what comes out first. It’s very dense and nutritious and just what a newborn baby needs. It’s different from mature breast milk in a lot of ways.
- There is only a very small amount. You might only feed your baby a teaspoon at a time, or even just a few drops! This is actually a good thing. While a baby is learning to suck and swallow food, it’s helpful to only have a smaller amount to work with. This allows the baby to gradually build strength and coordination.
- It is thicker and more yellow.
- It’s higher in protein and lower in fat and carbohydrates so that a small amount is all they need.
- It is extra rich in immunoglobulin A. This is a substance that protects the baby from infections while their immune system is developing.
- Colostrum is also designed to feed the good bacteria that’s trying to get established in your baby’s gut. Babies are born with a sterile gut, but they need to colonize it with a great microbiome quickly so they can digest food and fight off infection. A microbiome is an army of microorganisms that inhabit your body or a particular part of the body. We need these armies to protect us against germs, break down food for energy, and help make the vitamins we need to stay healthy. The baby gets their first big dose of microorganisms from your vaginal microbiome during birth. Microorganisms are bacteria, bacteriophage, fungi, protozoa, viruses.It might sound bad to hear that the baby will be getting bacteria and viruses from you, but there are a lot of different species of these microorganisms. Some of them are bad and make us sick, but others are really good! Those are the ones you are passing to your baby. We need a big collection of the good ones in the gut to digest food well and stay healthy. Colostrum is designed to feed these new microorganisms in your baby’s gut so they reproduce and spread. Once this happens, your baby will be able to digest food better and will be even more protected from harmful bacteria and viruses.
- Colostrum is very important for so many reasons. Some people even collect colostrum before they go into labor just to make sure they have some on hand in case they have to be separated from their baby for any reason. See this recent blog post to find out more about collecting your own colostrum using hand expression.
What to Do Right After Birth
The best thing we can do for a great start at birth is to make sure your bare baby is placed directly onto your bare skin immediately after birth. This skin-to-skin contact (SSC) does many things. It helps your baby adjust to being outside the womb. Babies tend to breathe better and regulate their body temperature and blood sugar levels better. It’s also a signal to your body that the baby is here and it’s time to start making and releasing milk.
It’s also a great idea to delay any unnecessary procedures or assessment until you’ve had time to give your baby the first feeding. Some of the things that might be delayed include shots, ointments, weights and measurements. These things can come a little later and will give you and your baby the uninterrupted time you need to get a good start with feeding. It’s important to rest, relax, enjoy, and watch your baby for signs of readiness.
A baby might get very alert and start to seem restless. They might lift their head right up and start bobbing around looking for a nipple. A baby might try to eat their fist or open and close their mouth like a fish! When you can notice these signs and allow the baby to find a nipple quickly, the first feeding will usually be at just the right time and be successful.
If your baby doesn’t seem interested after 30 or 45 minutes have passed, it’s also ok to offer a nipple anyway. If your baby doesn’t want the nipple or seems especially sleepy, it’s a great idea to ask for help from a lactation consultant. They might offer some great suggestions to get your baby to latch on, or they might recommend that you hand express some colostrum to give your baby.
What is Jaundice?
Jaundice is a condition that happens when bilirubin levels in the blood are high. Bilirubin is basically just a waste product that our bodies make from the normal breakdown of red blood cells. Usually, our liver takes care of the waste and it’s removed from the body. When the liver isn’t functioning right, or when there is too much of this waste product to pass through completely, it can build up and be reabsorbed in the intestines. You may be able to see that a baby has jaundice because their skin color looks more orange or yellow in tone. Newborn babies are at a higher risk for jaundice for a number of reasons.
- Their livers are immature and slower to pass the bilirubin.
- They have more bilirubin because they have more red blood cells with a shorter lifespan. That means more broken down red blood cells to move out.
- Newborns are born with a substance called meconium (see this article about Newborn Poop!) in their intestines. Meconium is what we see in their diapers for the first couple of days. It’s the waste that has built up in their gut while they were in the womb. It’s not made of food, since they don’t actually eat while in the womb, but babies do swallow the amniotic fluid. So meconium is made from lots of little hairs and skin cells and fluid. If the baby is not passing the meconium quickly enough, the bilirubin stays trapped in the intestines and can be reabsorbed, causing jaundice.
How can colostrum help?
When a baby is getting plenty of colostrum from the beginning, it helps them pass the meconium. By quickly clearing out the meconium, the bilirubin is not able to build up and be reabsorbed in the intestines.
Later on, if a baby seems to be eating well and getting plenty of milk, jaundice can happen as a result of not getting quite enough milk. The baby is getting enough to grow and make dirty diapers, but not quite enough to keep the bilirubin flowing out. This is not uncommon, and is usually called breast milk jaundice. In most cases, breastfeeding should continue. The more a baby feeds at the breast, the more milk will be produced, and that can help flush the bilirubin out. Sometimes it just takes a little longer.
There are cases where a baby needs extra support for jaundice. When this happens, the most common therapy is with light. It’s not invasive and doesn’t even involve medication! The baby is put under special blue lights, like fluorescent lights. They get some tiny goggles to protect their eyes from the bright light and are kept warm but uncovered so their skin can absorb the light best. This particular light spectrum can break up the bilirubin so it can leave the body through dirty and wet diapers. Some settings can offer biliblankets instead. These can often be used for light therapy in your room or even at home!
National Library of Medicine – StatPearls article about the Anatomy of Colostrum
Dunn AB, Jordan S, Baker BJ, Carlson NS. The Maternal Infant Microbiome: Considerations for Labor and Birth. MCN Am J Matern Child Nurs. 2017 Nov/Dec;42(6):318-325. doi: 10.1097/NMC.0000000000000373. PMID: 28825919; PMCID: PMC5648605.
CDC Article about Jaundice