In the first couple of days after you have had your baby the amount of milk (colostrum) that you will produce will be very small, therefore it is better to hand express and use a sterile syringe to store the colostrum. When you milk ‘comes in’ and there is an increase in volume, it is often easier to use a pump and store milk in a sterilised bottle.
There are several reasons why some mothers need to express milk such as:
- Baby is in the neonatal unit and is unable to feed from the breast, in this case it is recommended that you express about 8 times in 24 hours
- Later on when some mothers need to return to work but want to continue giving their baby breast milk.
- It can also be useful to help increase breast milk supply by expressing after feeds or pumping from the other breast whilst feeding to increase demand and stimulate the supply.
How to hand express:
- Wash your hands with soap and warm water
- Try to find a comfortable and supportive place to sit, you may need extra cushions or support especially behind your back
- If possible have some skin to skin time with your baby. If you cannot have any skin to skin then it can help to look at a photo of your baby.
- Gently but firmly massage your breast in a downward motion towards the nipple for a good couple of minutes
- Make a big ‘C’ shape with your thumb and first finger and place this around your breast , a few centimetres above your areola (the dark area around the nipple)
- Firmly bring together your thumb and finger, squeezing down towards the areola, then release.
- Keep repeating this motion, after a few times hopefully you will see some milk on your nipple. This can take a couple of minutes though so allow some time and keep going.
- When there is a drop of milk on the nipple this can be caught using a sterilised syringe. A second pair of hands to hold the syringe is very useful at this stage especially if this is the first time you have done this so either have a partner, friend or someone with you to help.
- Continue adjusting your hand position around the breast to put pressure on different areas of the breast. It can also help to do some more massage in between the squeezing.
- Keep going until the milk stops or you have enough. It can be quite challenging at the beginning, but the more you do it the easier it gets.
Once you have finished expressing the milk needs to be stored correctly. If you are in hospital ask the midwife or nurse where you can store it. If you are at home then you can place it in the fridge for up to five days at 4⁰C or lower or in the freezer for up to six months as long as it is in a sterile container.
- It is important to realise that the amount of milk expressed is not reflective of how good your supply is and should not be compared to quantities recommended for formula milk. It also does not show you how much the baby is getting when they feed directly from the breast as their sucking is very different from pumping and your body reacts differently having a baby breastfeeding directly; there is usually a change in hormones which affects milk production.
- It is important to remember that you need to be emptying your breasts regularly to avoid engorgement and mastitis. Through the night prolactin levels are high (the hormone that makes you produce milk) therefore emptying your breasts regularly overnight is just as, if not more important, than in the day. As a result it is not advised to rely on expressed breast milk produced in the day to feed the baby at night as this means the breasts will not be stimulated during this time.
It’s really hard to stay cheerful if you’re being woken up every couple of hours every night. Try to remember that it won’t last too long.
Imagine what it’s like for your baby, doing everything for the first time.
Your questions about formula feeding answered.
Sometimes, for various reasons, mothers use formula rather than breastfeeding.