Expressing breast milk

There are many reasons why you may be considering expressing breast milk by pumping. These may includes:

  • To make a reserve so that your baby can have breast milk when you are at work or travelling
  • To stimulate milk production if your baby’s appetite is reduced
  • If your baby is born premature or has trouble latching on
  • To prevent or treat engorgement, mastitis or a plugged duct
  • If you are weaning and trying to alleviate some of the pressure in your breasts

Pumping does provide some freedom, since you don’t need to be around for every feeding – this means you could go back to work or take some time for yourself during the day. However, keep in mind that you shouldn’t offer a bottle to your baby until breastfeeding has been established – otherwise, you are risking nipple confusion and your baby rejecting the breast.

How often and when to pump?

If you are breastfeeding and your goal is to store some extra milk for when you’re not around, the best time of the day for pumping is in the morning when the amount of milk is the greatest. Wait for an hour after nursing to pump – this gives enough time to the milk glands to secrete milk for the next meal.

If you are pumping to prevent engorgement, try to stick to your baby’s feeding schedule. Making long breaks between feeding or pumping can lead to milk build-up and inflammation.

Breast pumping methods

Two options are a breast pump or hand expression methods.

Breast pumps can be manual or electric, the main difference being the ease of use and time spent pumping. Fully automatic pumps will allow you to multitask while pumping and it will only take 10-15 minutes, while manual pumps are more time and energy consuming (taking around 45 minutes). Of course, there is a difference in price as well, so when choosing a breast pump consider your priorities – if you plan on pumping on everyday basis, it may be a good idea to invest in a good automatic pump that will save time and energy. On the other hand, if you only plan to pump from time to time, a manual pump should do the trick.

Whichever pump you choose, make sure to choose the appropriate size of breast shields and position them properly so that they don’t cause any discomfort. Pumping can be slightly uncomfortable at first due to a strong sucking sensation, but it should not be painful.

You may decide to try hand expression. This method is time consuming, so it is not practical for everyday use, but if you only need to do it from time to time, it’s worth trying to do it properly. Ask your lactation consultant to show you the correct technique or follow the instructions below:

Position your thumb above the nipple and your first two fingers under the nipple. Your hand should form the letter C, but you shouldn’t be cupping the breast, squeezing it or pulling on the nipple. Without spreading your fingers apart, push straight into the chest wall and then roll your fingers forward simultaneously. This movement will massage the milk ducts and push the milk towards the nipple. Rotate your hand around your breast to express other reservoirs that are spread throughout the breast tissue. Repeat until the breast feels light.

If you are not around your baby when expressing, it may help if you could hear your baby over the phone, watch a video or go through some photos. Seeing your baby’s face or hearing their voice may help with letdown reflex, so try different techniques and don’t forget to relax.

Storing breast milk

Plastic or glass bottles with secure caps to ensure freshness, or plastic bags for milk storage are all appropriate ways to store freshly expressed breast milk. Plastic bags can also be used to freeze the milk if needed. Refrigerate the milk right after pumping – this way it can stay in the back of the fridge at 4˚C for up to five days. If you decide to freeze it for later use, keep in mind that freezing destroys antibodies in the breast milk, but the nutritious value remains the same. Frozen milk can be stored for up to 12 months at -20˚C in the deep freezer, but for the best quality and freshness, use it within 3 months. Remember to mark the dates on the containers prior to storing them.

How to warm the milk

If you decide to freeze the milk, you’ll need to thaw it by leaving it in the refrigerator overnight or by putting it under cool running water. Once thawed, milk should be refrigerated and used within 24 hours. Whether the milk was in the freezer or in the fridge, you should warm it up before offering it to your little one. Put the cold milk under warm running water for a few minutes or put a pan with water on the stove and place the container with milk inside of it. Do not heat the milk directly in the pan on the stove and don’t make it boil – just warm it up enough so that your baby will drink it. Also, avoid heating the milk up in the microwave since this can reduce some of the nutritive properties of the breast milk.