Why express breastmilk?
There are several reasons you may want or need to express breast milk:
- Your baby may be sick or premature, and you need to establish and keep your milk supply going
- There may be breastfeeding problems, and expressing is part of your management plan
- You have returned to work and need to express while you are away from baby
- A need to relieve engorgement by releasing a little milk from your breasts
- You may want to go out with your friends or family and leave your breast milk for your babysitter to feed your baby.
Expressing your breasts is a useful skill to learn. Your midwife will show you how to do this, using either your hand or a special breast pump. Babies may be fed breastmilk by either a bottle, cup or spoon (depending on how much they need).
You will only have small amounts of colostrum for the first few days. Hand expressing is the best way to collect colostrum until your milk starts to increase (around day 2 or 3). Your midwife/nurse will show you how to hand express and provide written information on expressing and storing your breastmilk. If your baby is not feeding on the breast (e.g. preterm infants), you must start expressing as soon as possible after birth. If you cannot express in the first 1-2 hours, you should aim to do so within 6 hours of birth, and then every 2 – 3 hours until your milk “comes in”.
Stanford University hand expressing instruction video
Electric Breast Pump
You can start using a breast pump around day two or when you are getting around 5mls of colostrum by hand. You will need to express at least eight times in 24 hours to maintain a good milk supply until your baby starts to feed well at the breast. Your midwife/nurse will guide you throughout this process. It is best to use a hospital-grade electric pump while you are establishing your milk supply. Your midwife/nurse will assist you to use a breast pump, and answer any questions you may have.
Warming expressed milk
If you are using breast milk that you’ve previously expressed and stored in the fridge, follow these simple instructions for bringing it up to the right temperature for your baby.
- Remove stored milk from the fridge just before it is needed.
- Warm baby’s bottle in a jug of hot water (not freshly boiled) to heat it.
- Ensure you shake and twist the bottle while the heating is occurring; this ensures even heat distribution.
- Check the temperature EVERY time before you feed it to the baby. This check is done by dropping a few spots onto your inner wrist, make sure it is warm, NOT hot.
- Do not heat bottles in the microwave. This method is known to create hot spots which can burn your baby’s mouth.
Cleaning expressing equipment
Pumping equipment can be washed in warm, soapy water, rinsed and dried between uses. You should sterilise your equipment once every 24 hours.
Bottles and teats should be cleaned in hot soapy water and sterilised after each use with either a sterilising unit or boiling.
- Always wash your hands before cleaning bottles and equipment.
- Rinse straight after use in running water.
- Wash teats, bottles and lids in warm water and dishwashing liquid/detergent, use a bottle brush to ensure all traces of milk are gone.
- Always clean before sterilising.
- Re-sterilise if it has not used within 24 hours.
- Place equipment in a large saucepan, covering with water.
- Cover with the lid of saucepan and bring to boil, leaving instruments to simmer for 5 minutes.
- Remove from heat and allow to cool while the lid remains on the saucepan.
- Use clean tongs or clean hands to remove bottles etc.
- Allow drying on a clean surface.
- Add teats upside down in bottle cap, seal with disc and lid.
- Allow to cool and store in a clean container in the refrigerator.
Lyn Ahearn (BHScNurs, PGCertNeoNurs), Registered Nurse, Registered Midwife, IBC Lactation Consultant/ Dr Janelle McAlpine (PhD), Clinical Midwife
Photo by Elvira Koneva used under license from Shutterstock.com