Rashmi Hospital

Centre for Minimally Invasive Surgery & Maternity

190, Double Road, Indiranagar Bangalore 38

Tel: 25253311, 25251573, 25251139, 25200447

For Maternity, Gynaecology & ENT: 9880108844/9980015424

Keyhole surgeries performed

E-Mail: info@rashmihospital.com

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Expressed breast milk-techniques and storage

There may be times when you want to express your breast milk, such as when you are separated from your baby or if you are finding it difficult to establish direct breast feeding. There are many ways of expressing breast milk, either by hand or with a manual, electric, or battery operated breast pump.

Techniques of expressing milk

  • Manual [by hand]

Massage your breast to help your milk "let down," using one of the following techniques:

  1. Wash your hands thoroughly with soap and water
  2. Try to relax. The let-down reflex is delayed by anxiety, although it will eventually occur.
  3. With both hands, slide your hands from your chest toward your nipple. Massage your breasts with the flat of your hands, working towards each nipple. Imagine that you are 'pushing' the milk from the periphery of the breast towards the areola
  4. With your fingertips, massage in a circular motion all around your breast.
  5. Grasp the dark circle (areola) with your thumb above and two fingers below. Push in toward your chest wall, then squeeze gently, slowly rolling your fingers toward your nipple but not onto your nipple.
  6. Continuously press and squeeze the nipple and areola in a rhythmic massaging movement. The milk will soon begin to flow - sometimes even squirting out.
  7. After about five minutes, or once the milk dwindles to a few drops, express from the other breast.
  8. Repeat the technique on each breast for a total of 30 minutes. If you express each breast three times, for five minutes, it will not take more than half an hour.
  9. Even if you use a pump, it is a good idea to finish off the expressing session by hand to squeeze out the remaining drips. This 'hind milk' is rich in fats and is a valuable source of energy for your baby.

Manual expression is not really a long time solution as it is rather time consuming as well as difficult to express large volumes of milk. This method is okay to tide over a crisis or an emergency when you are not prepared with your breast pump.

  • Breast pumps

There are many breast pumps available on the market today. You could get either a manual pump with a bulb like a BP apparatus or you could get a battery operated pump. Both are good and you could expect to spend between Rs: 1000/- 2000/- for a good quality pump and it is important to use a good pump for this to work well. You could ask your doctor for suggestions as well as availability of these pumps.

Do not use any kind of pump until your breast milk has come in. Also, avoid using a pump if you have nipple damage.

A good pump must be

  1. Easy to use

  2. Comfortable

  3. Effective

  4. Safe-should not cause damage to nipples

An electric pump should have adjustable levels of suction as too high a suction can cause pain as well as damage to your nipples.

Even when you are using a pump to express milk you will need to follow a particular technique.

  • Stimulate the let-down reflex by hand. Once the milk has started flowing, switch to the pump.

  • Sit on a chair with a table in front of you such that you will be able to keep the pump on the table and it should be level with your nipples. If needed you could either adjust the height of your chair or the height of the pump by placing some books on the table

  • Massage your breasts from the periphery to the centre to encourage the milk let down as well as to fill the areola with milk

  • Follow the instructions of the pump and allow the nipple along with the areola to be sucked into the funnel of the pumps collecting device

  • Start with low pressure, and then slowly increase to your level of comfort. If it hurts, check that the mouthpiece of the pump is centred directly over your nipple and reduce the suction.

  • Build up the suction as per instructions

  • Once milk has started to flow keep on massaging the breast from the chest wall towards the nipples to increase the speed of flow

  • When you feel that the negative suction is gradually being lost build it up with the breast pump again

  • Finish expressing by hand to remove the last rich drops of milk.

When should you start expressing milk?

Your milk supply is being established in the first two to three weeks, so wait until your baby is about three weeks old before you use a breast pump, unless recommended for a specific reason.

In general, you express milk:

  • In between breastfeeding. (One hour before or one hour after a feeding.)

  • After your baby has finished breastfeeding.

  • In the early morning when your milk supply is usually at its highest. For most women, expressing in the morning will yield more milk than in the late afternoon or early evening

Will I Have Enough Milk for my Baby if I Am Also Expressing?

Breast milk production is a supply and demand system. The more the breast is stimulated, the more milk will be produced. Since the milk is made in response to the stimulation, either by breast pumping, expression or a baby nursing, you should not be concerned about not having enough milk.

Other things to keep in mind regarding expression of milk

 * Give yourself time to learn how to express milk properly; it's a skill like any other. Don't hesitate to ask your doctor for help
* Aim to express at least every four or five hours to avoid breast engorgement. This is an uncomfortable condition and engorged breasts are difficult to express.
* Express as often as you would breastfeed in order to maintain your milk supply. For example, if your baby feeds six times over a 24-hour period, you need to express at least six times.
* Express more often if you find you can't keep up with your baby's demands. You may need to express every two hours during the daytime for one to two days.
* Express at least once overnight to maintain your milk supply. There are very few women who can maintain a good milk supply over a prolonged period if their breasts do not have milk removed at least every four to five hours.
* Avoid using supplementary bottles of formula. Your breasts operate on a system of 'supply and demand'. If breast milk is removed, your body will make more; if you leave it in your breasts, they will stop making milk.
* Freeze excess breast milk if you produce more milk than your baby needs.

Storing breast milk