pregnancy questions answered
Expressed breast milk-techniques and
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
Massage your breast to help your milk "let
down," using one of the following techniques:
- Wash your hands thoroughly with soap and
- Try to relax. The let-down reflex is delayed
by anxiety, although it will eventually occur.
- 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
- With your fingertips, massage in a circular
motion all around your breast.
- 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
- Continuously press and squeeze the nipple and
areola in a rhythmic massaging movement. The milk will soon begin to flow -
sometimes even squirting out.
- After about five minutes, or once the milk
dwindles to a few drops, express from the other breast.
- 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.
- 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
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.
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
A good pump must be
Easy to use
Safe-should not cause damage
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
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
Build up the suction as per
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
Finish expressing by hand to
remove the last rich drops of milk.
When should you start
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
In general, you express milk:
In between breastfeeding. (One
hour before or one hour after a feeding.)
After your baby has finished
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
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 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