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 the different ways you can express 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 partner can do 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 long should I express for?
It's important to make sure you're sitting in a comfortable position before you start expressing. It's also important to focus on the flow of the milk rather than how long you express for, as the time it takes to express your milk will vary from mother to mother. While some may only take five minutes to produce milk, others may take longer. If you are struggling, you might want to express on one breast while feeding your baby on the other as this can help you produce oxytocin which can speed up the milk flow.
How to express milk
When it comes to expressing breast milk, you have three options:
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.
Expressing milk by hand
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."
Expressing milk with a manual breast pump
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:
Expressing milk with an electric breast pump
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."
Is it painful to express milk?
It shouldn't be painful to express your milk so if you're finding it difficult, you should talk to your midwife or call a breastfeeding counsellor from NCT on 0300 330 0700 for support.
Top tips to know when expressing milk
Angela Cartwright, a lactation consultant, midwife and mum of three, reveals her top tricks and tips which will speed you straight up the expressing learning curve and change your relationship with that pesky pump!
1) Harness your hormones
You’ll find it much, much easier to express your milk if you can see, hear or smell your baby. The reason for this is a hormone called oxytocin. Known as the love hormone, it is the same hormone which will have caused your uterus to contact and push your baby out if you had a vaginal birth.
‘Most mums think their babies suck milk out of their breast,’ says lactation consultant Angela Cartwright. ‘But actually when your baby suckles, your body produces oxytocin, which makes your breast push milk out to your baby.’
And this is a very physical process: the nerve cells in your nipple send a message to your brain to produce the hormone, which cause the muscles around your glands to contract, squeezing milk into the milk ducts.
This is called the let-down reflex and you may feel a tingling sensation when it happens.