Breastfeeding Education

Expressing, Storing and Using Breast Milk

Expressing breast milk

Not every breastfeeding mom needs to express milk. You may want to express your breast milk to relieve your breasts if you are away from your baby, or to save milk for later use. For healthy, full-term babies, if you do need to express, it is best to wait until baby is at least three or four weeks old. By then, your milk supply is established. If your baby is premature or sick, you can get help in the hospital to express your early milk. The following sections tell you how to express breast milk.

Getting ready

When you need to express your breast milk, you can do it either by hand or with a pump. Both ways take patience and practice. Begin by following these steps:

  • Wash your hands.
  • Wash everything that will touch the milk in hot soapy water. Rinse well and air dry.
  • Choose a comfortable place where you can relax. Practice slow, easy breathing as you settle down.
  • Keep warm. Put a sweater around your shoulders or sit near a heat source. Warmth helps you relax and starts your milk flowing.
  • Allow enough time-don't rush.

Other ways to start your milk flowing:

  • Think about your baby.
  • Take a warm shower or splash warm water on your breasts.
  • Stroke your whole breast with light, tickle motions.
  • Roll and tug gently on your nipple using your thumb and forefinger.
  • Shake your breasts gently towards each other while leaning forward.
  • Massage your breasts using one of the methods shown below.
  • Breastfeed on one side while you express on the other.

Finger tip massage:

  • use two fingers
  • press fingertips lightly into breast
  • make small circles
  • start from the back and move towards the areola
  • cover the whole breast
  • massage firmly, but gently

Diamond hand position:

  • support breast with both hands thumbs on top, fingers below
  • press gently as you move towards the nipple

Parallel hand position:

  • place one hand above, one below
  • gently press towards nipple
  • rotate hands as they move forward

Warm washcloth massage:

  • wet washcloth with warm water
  • press firmly on breast, from back to nipple

Hand expressing

Hand expressing is more like breastfeeding than pumping is. When you use a pump, you draw the milk out of your breast. When you hand express, you compress your milk reservoirs, which is what your baby does while breastfeeding. It often takes some practice to get milk out at first, so be patient with yourself. Some women find hand expression better than any other method. It is also cheapest, because it requires no special equipment.

Remember that the milk must be gently squeezed from the back of the milk reservoirs.

Try this method for hand expressing:

  • Hold a wide-mouthed clean container under your nipple. Or place the container on a table in front of you.
  • Position your thumb on top and first two fingers under the areola, a few centimeters behind the nipple. That's 1 to 1 ½ inches
  • Press in straight toward your chest wall about 1 inch.
  • Roll your thumb and fingers forward toward the areola. Roll as if you were making a finger print. This action compresses and empties the milk reservoirs without damaging sensitive breast tissue.
  • Repeat rhythmically and collect the milk. When the stream of milk slows, vary the position of your hand. Rotate around the areola to reach more milk ducts. Change hands and repeat. After 5 to 7 minutes, change breasts. Massage, stroke, and shake your breasts. Express again for 3 to 5 minutes at each breast. Repeat once more. The whole procedure can take about 30 minutes.

Using a breast pump

Breast pumps come in three types: hand operated, battery-operated, and electric. If you use a breast pump, first follow the directions for getting ready to express your milk. Then follow the instructions included with the pump.

A few points about breast pumps:

  • If you have a premature baby or for some other reason your baby cannot feed at the breast, you may need to use an electric breast pump.
  • Pumping both breasts at the same time can stimulate more milk production and save time. This is called double pumping.
  • Remember to keep your breast pump clean. Before you choose one, you should find out if it can be cleaned easily.
  • You may be able to rent a pump instead of buying one. Check with your local hospital, drug store, or Public Health Services office.

Storing breast milk

Breast milk is a fresh, living substance, as well as a food. Store it carefully to preserve its nutritional and anti-infective properties.

Here are some tips:

  • Use glass or plastic containers with lids that fit well.
  • Use plastic bags made especially for storing breast milk. If you use disposable plastic nurser bags to store breast milk, double-bag to make them stronger, as they may break.
  • Store breast milk in small amounts to avoid waste.
  • Store breast milk in the refrigerator for up to 5 days, however, less than 72 hours is ideal.
  • Breast milk can also be frozen. While freezing destroys some of the good things in the milk, breast milk that has been frozen is still much better than formula.
  • If you will be freezing the breast milk, do so within 24 hours of collecting it.
  • When freezing breast milk, leave an inch of space in the container. The milk will expand as it freezes.
  • If you add fresh breast milk to a container of frozen milk, first chill the fresh breast milk. This stops the warm milk from thawing some of the frozen milk.
  • Label each container of milk with the date it was expressed. Use the oldest container of milk first, making sure that it has not passed the safe storage times given below.

Where / Temperature / Time

  • Room temperature / 18°C - 30°C / 3-4 hours
  • Refrigerator / 0°C - 4°C / 5 days, however, less than 72 hours is ideal (not previously frozen).
  • Freezer compartment inside a refrigerator / < 0°C / 2 weeks
  • Freezer compartment with separate door / < 0°C / 3-6 months
  • Deep freezer / -19°C / 6-12 months

 

Using stored breast milk

  • Breast milk will separate into layers when stored. Shake it gently before serving to mix in the cream.
  • Frozen breast milk can be thawed in the refrigerator or by placing the container in lukewarm water. Use thawed breast milk within 24 hours. Thawed milk should not be re-frozen.
  • Warm breast milk with care. Heat it gently by putting it in warm water. High temperatures can destroy some of its goodness.
  • Breast milk should not be heated in a microwave oven for three reasons. One, it is easy to overheat the milk, destroying its goodness. Two, microwaves heat the milk unevenly. Hot spots in the milk may scald your baby. Three, bags may burst.

If you plan to use a bottle to feed your breast milk to your baby, wait until baby is six weeks old. Offering a bottle before six weeks of age may cause nipple confusion. This happens because the mouth and tongue action needed to get milk from your breast is very different from that needed to get milk from a bottle. An infant may become confused and refuse the breast. Wait until your baby gets really good at breastfeeding before introducing a rubber nipple, including a soother.

There are other ways to feed expressed breast milk to your baby, such as cup feeding or finger feeding... contact Public Health, La Leche League or local breastfeeding support groups for more information.