Expressing breast milk is when you use your hands or a breast pump to get the milk from your breasts. Whether you use your hands or a pump is dependant on how long you have been breastfeeding, the reason you are breastfeeding and how often you are going to express.
|
The first milk you produce after your baby is born is called colostrum. If you need to express milk at this stage it is best done by hand. During the first week, as your breasts feel fuller, you may choose whether you wish to continue expressing by hand or to use a pump.
|
The number of times you will need to express per day will depend on your circumstances. For example, if your newborn baby is not feeding from the breast at all then you need to express frequently to establish and maintain your supply (8-10 times a day), but once your supply is established you may be able to reduce the number of times you express. A lactation consultant can advise you on what you need to do.
|
Important points to remember
|
- Expressing should be done gently to avoid pain and discomfort.
|
- The use of gentle breast massage and nipple stimulation will help to encourage the milk flow (let-down reflex - see: Breastfeeding: Getting started fact sheet).
|
- Using relaxation techniques or thinking about your baby while expressing may also be helpful.
|
- Expressing frequently throughout a 24 hour period (including overnight) is more effective in stimulating your milk supply than expressing for a long period of time at one sitting.
|
|
Reasons for expressing
|
There are a number of reasons why you may need to express breastmilk, such as:
|
- your baby is unable to attach at the breast or is not sucking effectively
|
- you are separated from your baby e.g. baby is premature or sick, or you are unwell
|
- to soften full breasts to make it easier for your baby to attach
|
- to allow healing after nipple damage (this may not be necessary if attachment is improved)
|
- if your milk supply is low
|
- to clear blocked areas and prevent mastitis
|
- to maintain milk flow during mastitis
|
- you are returning to work or you are going out and will miss a feed
|
- you have chosen not to breastfeed but want to give your baby expressed milk.
|
|
(For further information on mastitis see: Breastfeeding: Mastitis fact sheet.)
|
Hand Expressing
|
It is important to learn how to express by hand before you go home from hospital. The midwives will help you with this. Some general points to remember are:
|
- hand expressing should be used for the first few days (before the milk comes in), but after this can be used at any time
|
- if your baby is not able to breastfeed, expressing should begin as soon as possible after the birth
|
- in the first few days after birth the amount of colostrum expressed may vary from a few drops to a few mls. As colostrum changes to more mature milk the volume will gradually increase
|
- expressing frequently (8 – 10 times in 24 hours, including overnight) will help establish and maintain your milk supply
|
- if your breasts become very full, hand express a little milk just before the feed to help your baby to latch on well
|
- if your nipples are damaged and sore then hand expression is the gentlest way of expressing breast milk. Electric pumps can also be used carefully if they can be set on a low suction level.
|
|
(For information about breast pumps also see the fact sheet: Breastfeeding: Using a breast pump.)
|
A general guide for hand expressing
|
Always wash your hands before you start to express. To begin, gently massage your breasts for a short time and stimulate your nipples to encourage the let-down or flow of milk, then:
|
| with your hand under your breast, place your thumb and index finger on either side of your areola, well back from the nipple
|
| | gently press your thumb and forefinger back into your breast and as you do this, press them towards each other behind the nipple. Press for about 2 seconds, then release
|
| | continue to compress and release and your milk will begin to appear
|
| | when the flow stops move your fingers to another position, around the edge of the areola, and start again
|
| | when the flow slows to drops of milk change to the other breast
|
| | massage both breasts again and repeat steps 1 – 5.
|
|
|
|
It is important not to cause pain or friction while expressing.
|
 |
|
How long does expressing take?
|
Breastmilk expression will probably take between 20 and 30 minutes in total.
|
The important thing is to express one breast until the flow slows to drips and then to switch to the other breast. Once that breast slows, if you are expressing because your supply is low, switch back to the first breast again. By switching back and forth, expressing each side 2 or 3 times, you will increase your supply over time.
|
Using “breast compression” will help to drain your breasts and therefore speed up the process as well as increasing the amount you obtain. Breast compression means squeezing your breast gently (i.e. where the breasts meet the ribs with your fingers on one side and thumb on the other).
|
How much milk should you get?
|
The amount of milk you obtain is dependant on individual circumstances and stage of breastfeeding.
|
In the first few days after birth between a few drops and a few mls of colostrum may be expressed each time. As colostrum changes to more mature milk, the amount increases. At day 4 or 5 this may be around 50–70 mls at each feed or expression increasing to 80–120mls by the end of the first week (these amounts are very variable from mother to mother). By about 6 weeks, you may produce around 600 – 800mls (sometimes more) over a 24 hour period.
|
If you feel your milk supply is not enough for your baby please seek expert assistance.
|
|
Guidelines for storage of breastmilk at home
|
| Room temperature
(26°C or lower)
|
| Refrigerator
(4°C or lower)
|
| |
|---|
Freshly expressed into container
|
| 6-8 hours
If refrigerator is available store milk there
|
| 3-5 days
Store at back where it is coldest
|
| 2 weeks in freezer compartment inside refrigerator
3 months in freezer section of refrigerator with separate door
6-12 months in deep freeze (-18°C or lower)
|
| Previously frozen thawed in refrigerator but not warmed
|
| 4 hours or less - that is, the next feeding
|
| | | Thawed outside refrigerator in warm water
|
| For completion of feeding
|
| 4 hours or until next feeding
|
| | | Only for completion of feeding
|
| | |
|
|
See also the fact sheet: Breastfeeding: Using a breast pump
|
Where to get more information
|
Your local Maternal & Child Health Nurse
|
Breastfeeding Service
|
Royal Women's Hospital
Level 4
Cnr Grattan St & Flemington Rd
Parkville VIC 3052
|
Tel: (03) 8345 2400
|
Maternal and Child Health Line
|
Tel: : 13 22 29 (24 hours)
|
Australian Breastfeeding Association
|
Tel: 1800 mum 2 mum (1800 686 2 686) Breastfeeding Helpline
|
Web: http://www.breastfeeding.asn.au
|
Breastfeeding NHS
|
Web: http://www.breastfeeding.nhs.uk
|
Disclaimer
|
The Royal Women’s Hospital does not accept any liability to any person for the information or advice (or use of such information or advice) which is provided in this fact sheet or incorporated into it by reference. We provide this information on the understanding that all persons accessing it take responsibility for assessing its relevance and accuracy. Women are encouraged to discuss their health needs with a health practitioner. If you have concerns about your health, you should seek advice from your health care provider or if you require urgent care you should go to the nearest Emergency Dept.
|
Published: Jan 2008
|
