Expressing is a way of removing milk from your breast without your baby needing to suckle.
Why express breastmilk: There are lots of reasons why you might want to express milk. Your baby can still have the benefits of breastmilk if she’s not able to breastfeed directly due to issues like tongue ties, tight jaws, or if you can’t be with her all the time. For latch, ties, tight muscle jaws it is best to work on resolving the issue with a Lactation Professional before resorting to expressing
Expressing Breastmilk can be helpful when
1. Your partner or someone else is going to feed your baby in your absence
2. In case of truly low supply (after being assessed by a Lactation Professional) You want to produce more milk, as expressing can boost your supply by creating more demand on breasts. Expressing along with direct feeding can also lead up to oversupply related issues
3. You must be apart from your baby, for example, if she’s in special care, NICU, PICU or you go back to work.
4. Your breasts are uncomfortable and very full (engorged). If this happens, then hand expressing some milk can help you feel more comfortable.
5. If your baby can’t suckle well or can’t take milk straight from your breast at first. Or if you or your baby have a condition or illness that makes breastfeeding difficult for the time being.
How to express breastmilk
1. Whether you are hand expressing or using a pump, always wash your hands before you start and make sure any equipment you’re using has been sterilized
2. Please do not express breastmilk in a toilet or a bathroom.
3. It’s helpful to get in the right mood too. The more relaxed you are, the easier it will be. The hormone oxytocin is released in your body when you’re feeling happy and relaxed, and that’s what causes your milk to be released (let down). Sometimes that’s hard if your baby is ill or if you’re feeling rushed and stressed.
Start with the Massage – Stroke – Shake Method
- Massage the breast
- Stroke the breast from the chest wall to the nipple with a light tickle-like stroke. Continue this stroking motion from the chest wall to the nipple around the whole breast.
- Shake the breast gently while leaning forward
4. Holding your baby or sitting near her, looking at a picture of her, or holding and smelling her clothes can all help.
Different ways to express breastmilk are
1. By Hand
2. By Manual Pump
3. By Electric Pump
1. You’ll need a wide-mouthed container, such as a jug, to collect your milk in. Make sure it’s either well-cleaned and scalded with boiling water, or sterilized. You’ll also need some sterile bags, bottles or lidded containers to store your milk in.
2. Hand expressing does take a bit of getting used to, and you may need to practice for a while. These tips may help:
3. Gently massaging your breasts or applying a warm flannel to them before you start can help the milk to let down.
4. Cup your breast with one hand. With your other hand, make a “C” shape with your fingers and thumb. Squeeze the area around the nipple gently (rather than the nipple itself).
5. Squeeze and then release until you get into a rhythm. Your milk will start to appear as a few drops at first, increasing to a steadier flow. If it doesn’t, rotate your hand round your breast and try another area.
6. Keep going until the flow slows down and then move to a different part of your breast. When you’ve done one breast, move onto the other.
Using a Pump to Express Breastmilk
1. Some women find it easier to use a pump. Whether you use a manual or an electric pump will depend on what you’re comfortable with, how often you need to express and how much milk you need to produce. Some electric pumps allow you to express both breasts at the same time.
2. Most pumps work in a similar way. You put a suction cup and funnel attachment over your nipple and areola. This mimics how your baby suckles, stimulating your milk to flow. If you’re using a manual pump you repeatedly squeeze a handle to create the pumping action. If you’re using an electric pump, the machine does this for you.
3. Expressing shouldn’t be painful, but if you’re experiencing any pain, or you’re finding it difficult, speak to your Lactation Consultant
4. It can take anywhere between 15 minutes and 45 minutes to pump both your breasts. Don’t use time to guide you, though. Just pump for as long as your milk is flowing well. Change breasts when the flow slows down. Keep changing between breasts. Even if you’re only getting a small amount out, it all adds up.
5. If you only need to express the odd feed, expressing by hand or using a cheaper manual pump may work best. If you’d like to pump regularly at home, a standard electric pump may be the best choice for you.
6. If you need to produce lots of milk because your baby can’t feed from your breast, you may want a hospital-grade double electric pump. Many hospitals will have these pumps on the wards, and you can also hire them for use at home.
7. When using a breast pump, try these tips:
a. Sit comfortably, with your back straight.
b. Support your breast from underneath. Place your fingers flat on your ribs, with your first finger between your breast and your ribs.
c. Ease your nipple into the funnel, making sure that your nipple is in the center. It’s important to make sure you’ve got a good fit. If too much areola is pulled into the funnel it can make your nipples sore. A tight funnel can also inhibit your milk flow. Many pumps come with a selection of funnel sizes so choose one that’s right for you.
d. Keep the funnel close enough to maintain a seal with your skin, without forcing it on to your breast.
e. Be patient. It often takes a minute or two for your milk to flow well.
8. If you’re using an electric pump, you can sometimes change the force of the suction on it. If you can, start on a lower strength and build up. If you start with a high strength it can be painful and may damage your nipples.
Once a mother has expressed milk storage guidelines need to be followed to keep the milk optimum for child’s intake
By following recommended storage and preparation techniques, nursing mothers and caretakers of breastfed infants and children can maintain the safety and quality of expressed breast milk for the health of the baby.
- NEVER refreeze human milk after it has been thawed
- Leftover from a Feeding (baby did not finish the bottle)
- Use within 2 hours after the baby is finished feed
These are general guidelines for storing human milk at different temperatures. Various factors (milk volume, room temperature when milk is expressed, temperature fluctuations in the refrigerator and freezer, and cleanliness of the environment) can affect how long human milk can be stored safely.
Storage of Breastmilk after expressing
1. Use breast milk storage bags or clean food-grade containers with tight fitting lids made of glass or plastic to store expressed breast milk.
2. Avoid bottles with the recycle symbol number 7, which indicates that the container may be made of a BPA-containing plastic.
3. Never store breast milk in disposable bottle liners or plastic bags that are not intended for storing breast milk.
4. Freshly expressed or pumped milk can be stored:
a. At room temperature (77°F or colder) for up to 4 hours.
b. In the refrigerator for up to 4 days.
c. In the freezer for about 6 months is best; up to 12 months is acceptable. Although freezing keeps food safe almost indefinitely, recommended storage times are important to follow for best quality.
1. Clearly label the breast milk with the date it was expressed.
2. Do not store breast milk in the door of the refrigerator or freezer. This will help protect the breast milk from temperature changes from the door opening and closing.
3. If you don’t think you will use freshly expressed breast milk within 4 days, freeze it right away. This will help to protect the quality of the breast milk.
4. Freeze breast milk in small amounts of 2 to 4 ounces (or the amount that will be offered at one feeding) to avoid wasting breast milk that might not be finished.
5. When freezing breast milk, leave about an inch of space at the top of the container because breast milk expands as it freezes.
6. If you will be delivering breast milk to a childcare provider, clearly label the container with the child’s name and talk to your childcare provider about other requirements they might have for labeling and storing breast milk.
7. Breast milk can be stored in an insulated cooler bag with frozen ice packs for up to 24 hours when you are traveling. Once you arrive at your destination, milk should be used right away, stored in the refrigerator, or frozen.
8. Breast milk expressed at different times can be mixed only at same temperature.
9. When breast milk expressed at different times is mixed, the expiry date of the formerly expressed milk is applicable.
Safe Thawing for Breastmilk
1. Always thaw the oldest breast milk first. Remember first in, first out. Over time, the quality of breast milk can decrease.
2. There are several ways to thaw your breast milk:
3. In the refrigerator overnight.
4. Set in a container of warm or lukewarm water.
5. Under lukewarm running water.
6. Never thaw or heat breast milk in a microwave. Microwaving can destroy nutrients in breast milk and create hot spots, which can burn a baby’s mouth.
7. Use breast milk within 24 hours of thawing in the refrigerator (this means from the time it is no longer frozen or completely thawed, not from the time when you took it out of the freezer).
8. Once breast milk is brought to room temperature or warmed after storing in the refrigerator or freezer, it should be used within 2 hours.
9. Never refreeze breast milk once it has been thawed.
1. In an open cup/tonic cup
2. In a syringe for pre-term babies
3. Via Spoon
4. In a beaker with a simple valve/Paladai
5. Bottle with 0/Newborn teats (best avoided for development of baby’s jaw and to avoid nipple confusion, If offered should be offered via Paced bottle feeding method)