If you decide to breastfeed your baby, there may come a point where you need to consider expressing your breast milk. Expressing breast milk could help relieve engorgement when your breasts feel painful, boost your milk flow, allow you to feed twins or premature babies or keep milk levels up if your baby is struggling to feed. Expressing also means you can involve your partner more in feeding and continue breastfeeding once you return to work.
Knowing how to express breast milk and how long to store it for can be confusing, but it’s important to get it right. And once you’re in the know, it’s pretty simple.
Don’t let the word breast 'pump’ deter you from giving it a go. Expressing milk is nowhere near as scary as you may think. Plus being able to store in the fridge allows you to get a good night’s sleep while your hubby does the 2am feed!
With that in mind, Sharon Trotter, midwife, breastfeeding consultant and neonatal skincare advisor gives us her advice on how to express breast milk effectively.
When should I start expressing?
Unless your baby was premature or is ill it’s best to wait until your milk supply is established before starting to express. This is usually at around the six to eight weeks point.
‘Express often – after the first feed of the day is a good time,’ says midwife Sharon Trotter. ‘If you’re separated from your baby, use a photo, piece of clothing or even a video of your baby to stimulate your let-down.’
How to express milk:
When it comes to expressing breast milk, you have three options:
- Expressing milk by hand
- Expressing milk with a manual breast pump
- Expressing milk with an electric breast pump
Breast pumps create a suction to stimulate milk flow whereas expressing by hand is more like milking. However, both styles work effectively as they closely mimic your baby feeding. When expressing milk, it is important you relax as it takes practice and can be a difficult skill to master.
15 amazing breastfeeding facts:
If you are struggling to settle your baby, it might be because newborns have a strong sense of smell and know the unique scent of your breastmilk which could be distracting them and preventing them from falling asleep. Sometimes dads can feel left out if their partner is breastfeeding so this is the perfect time to get them involved! Dads are often better at settling their little ones because they don't give off hormones or the smell of breastmilk meaning the baby will find it easier to switch off and drift off to sleep.
1) Struggling to settle your newborn? Get Dad involved
When you have a baby there is always a strong urge to kiss their squishy little face. Turns out there is no need to resist that urge because kissing your newborn can boost their immune system. When you kiss them, you body is detecting the pathogens on their skin which are then transferred to your lymphatic system so that you can produce tailor-made milk featuring antibodies to fight any bugs.
2) Kissing your baby can change your breastmilk
The reflex which makes the breasts release milk is powered by the hormone oxytocin. This powerful hormone can improve wellbeing, lifts your mood and makes you feel happy and relaxed. Oxytocin is the marvellous hormone which also plays a role in orgasm, giving birth and helping your uterus shrink back its original size.
3) Breastfeeding can make you happier
These sugars are not the kind of sugar you have in your tea! These sugars are much more special and in breastmilk they are known as oligosaccharides. We still do not know the function of the majority of oligosaccharides. However, some prevent bacteria from sticking to the wall of your the baby's gut which helps fight pneumonia and sepsis. Other oligosaccharides feed the good bacteria which are important for a healthy microbiome.
4) Breastmilk contains more than 200 types of sugars
Breastfeeding has been shown to reduce the risk of breast and ovarian cancers in mothers. Even breastfeeding for a short time reduces the risk of breast cancer by 16-24%. Ovarian cancer risk is 24–30% lower in women who have breastfed. Women who breastfeed are less likely to develop type two diabetes, cardiovascular disease and postnatal depression. Breastfeeding mothers are even less likely to be obese later in life.
5) Breastfeeding reduces the risk of certain cancers in mothers
Certain antibodies in breastmilk have been found to prevent the transmission of the HIV virus. Not all HIV infected mothers were passing the virus to their children via breastmilk and researchers found antibodies and immune cells in breast milk were neutralising and inhibiting the HIV virus.
6) Breastfeeding can neutralise HIV
The composition of breastmilk (levels of fat, protein, vitamins, sugars, minerals and hormones) varies greatly. However, studies have shown that breast milk is consistently different for boys and girls. Differences in milk might change your baby's behaviour or influence their growth and development.
7) Breastmilk is different for boys and girls
We all know that breastfeeding can be painful and it can result in cracked or sore nipples. Breastmilk contains components that fight infection and reduce inflammation or swelling of the breast. If your breasts are sore, putting expressed milk on your breasts or nipples can soothe them and speed up recovery. If that fails, cabbage leaves are an old remedy for relieving swollen breasts.
8) Breastmilk has healing powers
Breastfeeding can lower the risk of ear infections, diarrhoea, and stomach problems. Children who are breastfed even have a lower chance of getting certain illnesses when they grow up such as asthma, diabetes, and childhood obesity.
9) Breastfed babies are less likely to get ill
Who needs the gym? Breastfeeding burns up to 500 calories a day. Not only that, but breastfeeding uses 25% of the body's energy whereas the brain only uses 20%.
10) Breastfeeding can burn up to 500 calories a day
Breastmilk contains the hormone Prolactin which helps induce sleep. When breastfeeding, mothers release this hormone into their own blood stream which means they fall asleep faster and easier after a nighttime feed. It might explain why you feel tired during the day after a feed.
11) Breastfeeding mothers get more sleep
Every newborn placed on their mother's skin after birth has the ability to find and make their way towards the breast by themselves. A baby's natural instincts help them locate, latch on and breastfeed if they are skin-to-skin with their mother. In an NCT class where the parents were told this fact, they started a competition to find out whose baby found the breast first!
12) Babies can find the breast
Breastfeeding could help get your baby used to certain flavours and tastes which might make it easier when weaning them in the future. As the flavour of breastmilk constantly changes, your baby is more likely to be used to variation in tastes. As well as this, continuing to breastfeed after they've started eating solid foods could help protect them against food allergies.
13) Breastfeeding can help your baby get used to certain tastes
The body produces very small quantities of the early milk, colostrum, because newborns only have the stomach size of a marble. New mothers might visualise feeding their child the kind of volume that would fill a bottle, however, in the early days only small amounts of milk are necessary.
14) Newborns have a very small stomach
Many people think they have to wake up their baby if they fall asleep while feeding. However, babies are still capable of latching onto the breast AND feeding even whilst asleep. Sometimes 'dream feeding' can be beneficial for conditions like reflux as in their sleep state they are less likely to suffer with this or spit the milk back up.
15) Babies do not have to be awake to breastfeed
Expressing milk by hand is particularly effective with a newborn, during the first days and weeks of being a new mum. Hand expressing means you can stimulate milk flow from a particular part of the breast so if one of your milk ducts becomes blocked, this style of expressing can be particularly useful.
Before you start expressing, place a sterilised bottle or container underneath the breast to catch the milk. The NHS gives steps on how to express by hand:
- "Wash your hands thoroughly with soap and warm water.
- Some mothers find gently massaging their breasts before expressing helps their milk to let down.
- Cup your breast with one hand then, with your other hand, form a "C" shape with your forefinger and thumb.
- Squeeze gently, keeping your finger and thumb near the darker area around your nipple (areola) but not on it (don't squeeze the nipple itself as you could make it sore). This shouldn't hurt.
- Release the pressure, then repeat, building up a rhythm. Try not to slide your fingers over the skin.
- Drops should start to appear, and then your milk usually starts to flow.
- If no drops appear, try moving your finger and thumb slightly, still avoiding the darker area.
- When the flow slows down, move your fingers round to a different section of your breast, and repeat.
- When the flow from one breast has slowed, swap to the other breast. Keep changing breasts until your milk drips very slowly or stops altogether."
A manual breast pump relies on you squeezing the handle to create suction to express the milk. The advantages of a manual breast pump are that they do not require an electricity supply, they are often smaller, cheaper, quieter and good if you pump infrequently or want to take it on holiday. With a manual pump, make sure the funnel isn’t too small when your nipple is brought into the narrow part, as this could be painful. Operate the handle as instructed on the packaging and swap breasts frequently.
Watch our video for more advice:
If you prefer an electric pump, the motor will operate the pumping action for you. The advantages of electric breast pumps are that they are often faster, better at producing larger volumes of milk and they allow you to adjust both speed and suction. It is important to build up slowly as setting the strength too high could be painful initially.
Advances in breast pump technology mean that electric breast pumps are becoming quieter and more discreet than previous models which often required mums to be plugged into an electricity supply. There are now hands-free wearable breast pumps that can sit in your nursing bra.
If you want to try an electric breast pump, the NHS notes the option of hiring a pump "Your midwife, health visitor or a local breastfeeding supporter can give you details of pump hire services near you."
How long can you store breast milk?
Don’t worry if you’re out and about as your expressed breast milk is fine to stay at room temperature for about six hours. However, any longer and it needs to be in a fridge.
Your milk can be stored in the fridge for up to five days at 4C or lower or for two weeks in the ice compartment of a fridge. You can buy a fridge thermometer from a kitchen shop if you are unsure of the temperature.
If you want to keep the milk for longer, you can freeze it for up to six months and use it up to 24 hours after defrosting. Refrigerate or freeze your milk in a sealed and sterilised container or specially designed milk storage bags. Always label and date expressed milk and ideally store it in small quantities to avoid waste and so it can warm or thaw quickly.
How to feed your baby expressed breast milk:
Your milk is best served fresh, as it’s perfect on the day it’s expressed. But, if you’re giving it to your baby after having been in the fridge or freezer, there are some things to watch out for.
Defrost your milk by placing it in the fridge to defrost slowly or try holding the container under cold running water. The NHS says: 'You can feed expressed milk straight from the fridge if your baby is happy to drink it cold. Or you can warm the milk to body temperature by putting the bottle in a jug of warm water'.
However, ‘Don’t microwave expressed breast milk,’ Sharon advises. ‘It will create dangerous hot spots that will burn your baby’s mouth and you also run the risk of milk break-down.’ Don’t shake the milk vigorously if it’s separated. Instead, gently swirl it.
If your baby refuses to take expressed breast milk from you, don't be disheartened. This is because they are so used to feeding on your breast. ‘Try offering it to them from a spoon, cup or bottle,’ Sharon suggests. ‘They might also accept it from their dad or another close carer.’
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