Expressing breastmilk

Advice on the benefits of expressing breast milk, including information on expressing by hand and using breast pumps.

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Expressing allows you to continue to provide your baby with the nutritional benefits of breast milk when you are unable to breastfeed directly. It can be used to relieve engorged breasts, to provide your partner with the bonding opportunity of feeding your baby, to stimulate milk production and for storage if you are going out or returning to work.

Expressing involves the release of milk from your breasts, either by hand or using a pump, and storing it in a sterile container for your baby to feed on at a later date. It takes approximately three weeks for a breastfeeding routine to become established so you should wait until after this time before you start to express milk.

Some believe that feeding a young baby with a bottle can hinder direct breastfeeding as baby may prefer the faster flow of milk provided by a bottle. If you are concerned about this you should talk to your healthcare professional, however you may choose to feed your baby using a spoon or through a plastic beaker (this is only suitable for infants over the age of 4 months) as an alternative.

Expressing can take some practice, so don't be put off if things don't go to plan right away. Before you begin you should wash your hands thoroughly, ensure all equipment is sterile, go somewhere you are unlikely to be disturbed and try and relax. Although it differs between individuals, many find that the best time to express is in the morning when milk production is at its highest. However, after, or when you are practiced, during a feed can also be a good time to express as your let-down reflex (the reflex that encourages milk to flow towards the milk ducts and nipple) will already be stimulated.

Expressing by hand

The only pieces of equipment you will need to express by hand are a sterile container and a warm towel, this makes it the most economical and flexible option, especially if you don't intend on expressing milk regularly. You should warm the breasts using heated towels or by taking a shower or bath and then massage the breasts in a downwards motion towards the nipples for several minutes before you begin.

To stimulate milk production you need to compress the milk ducts surrounding the nipple rather than the nipple itself. Place your thumb and index finger on either side of your areola (you will feel small lumps under the skin, these are the milk ducts) and compress your breast back towards your chest whilst squeezing your fingers together gently. If your hands are placed correctly a stream of milk should be produced. Release the pressure and rhythmically repeat, working your fingers around the whole of your nipple area so as to release milk from all of the ducts. Once milk production has ceased on one breast you should repeat the process on the other.

You shouldn't find the process of expressing milk painful, if you do experience some discomfort you should try moving your fingers upwards away from your nipple slightly. Additionally, if you find it difficult to stimulate the release of milk it may help to think about, or look at a picture of your baby.

Expressing by hand can take some practice and may be a bit messy to begin with, however once you get the hang of it it will provide a quick and flexible way of providing extra milk for your baby.

Expressing by pump

Breast pumps are designed to extract milk from the breast by creating a vacuum using a funnel placed over the nipple area and storing milk in an attached bottle. Hand, battery and electric varieties are all available.

Pumps can provide a quicker, simpler way to express milk (especially if you are not experienced at expressing by hand) and most pumps have the flexibility to adjust the sucking strength to one that is comfortable for you.

It is essential that each componenet of a breast pump is steralised regularly either by boiling or using a chemical or steam steraliser. Additionally, you should make sure that the funnel fits over the nipple properly and doesn't feel uncomfortable in any way.

If you find expressing milk difficult at first you should ask for help from your healthcare professional and pursue as the health benefits of breastilk for your baby are extensive. Once breast milks has been expressed it can be used straight away, stored in the back of the fridge for up to 48 hours or frozen for later use.