Whatever your reasons for choosing to breastfeed, at some stage you might find you either need or want to give your baby a bottle. Expressing breast milk means you can do so without switching to formula.
Why do mums express their milk?
Sometimes it might be necessary to express – for example, if your baby is in the special care unit and you’re unable to breastfeed directly. Perhaps you’re going back to work and want your baby to carry on having your milk while you’re apart.
If your breasts are engorged, expressing will relieve the discomfort. It will also boost your milk supply – after all, your breasts will make more milk to meet the perceived demand.
Expressing means other people can feed your baby, whether it’s so your partner can get more involved or so grandparents or a babysitter can give you a break.
It’s up to you how often you express your milk, and how much you express. That will probably depend on why you’re doing it. You can express milk either by hand or with a breast pump.
What you will need
If you’re going to express your milk, you’ll need some equipment. You’ll need to choose a breast pump, if you plan to use one, and bottles and teats for feeding. If you plan to express a lot of milk, you might want to invest in some special breast milk storage pouches. You’ll also need to consider how you will sterilise all the equipment you use – will you cold-sterilise with tablets or fluid, or buy a microwave or steam sterilising unit?
Expressing by hand
Some women prefer to express by hand, especially when they’re just getting started. It can also be helpful if, for instance, you have a blocked milk duct. All you need is a sterilised bottle or container to collect the milk.
- Start by washing your hands with warm water and mild soap, and get your bottle or container ready.
- Use one hand to cup your breast and make a ‘C’ shape with the forefinger and thumb of the other. Use the ‘C’ to squeeze gently, keeping your finger and thumb a few centimetres from your nipple, just outside the areola. Don’t squeeze the nipple itself. Release the pressure then repeat, developing a steady rhythm. Your fingers shouldn’t slide over your skin.
- Milk should start to flow. When it slows, move your fingers to a different part of your breast and carry on. When the flow reduces to slow drips, or stops completely, swap to the other breast.
Expressing with a pump
There are two types of breast pump – manual (hand-operated) and electric – and many different sizes, shapes or kinds within those categories. Which you choose will depend on your own preference and what works best for you. Manual pumps tend to be cheaper, while electric ones are quicker and require less effort.
Ask other mums for recommendations, advice, and to share their experiences. Your medical centre, hospital or local post-natal support group may have one or several you can hire or borrow to help you decide what kind of breast pump is best for you.
Some pumps allow you to vary the amount of suction. Start with a low setting and build up. You may also find there are different sized funnels, so you can choose the one that best fits your nipples.
Remember the pump and its components, and the container you use for your milk, should be sterilised before you use them.
Storing your breast milk
You can store your collected breast milk in sterilised bottles or containers, or in special breast milk storage bags and pouches.
- In the fridge – up to eight days at 4°C (39.2°F) or lower, or three days if the temperature is higher.
- In the freezer – up to six months if the temperature is -18°C (-0.4°F) or lower
- In a cool-bag with ice packs – up to 24 hours.
Remember to label and date containers if you are storing it for more than 24 hours, especially if you are expressing regularly, to avoid confusion.
Defrosting and heating
If you can, it’s best to defrost frozen breast milk slowly in the fridge. If you’re in a hurry, though, it’s ok to put it in a jug of warm water (or hold it under warm running water).
Once thawed, shake the container gently as you may find the milk has separated. Use it straight away – let your baby have it cold, if she will drink it that way, or warm it in a jug of warm water or under the hot tap.
Be careful about defrosting or heating breast milk in the microwave as this can cause hot spots which will burn your baby’s mouth.
After an hour from the start of feeding, any unused milk should be thrown away. Never refreeze breast milk once it has thawed.
Some mothers find it hard to get their milk flowing when trying to express. Try to stay relaxed and choose a time when you’re feeling calm.
You might find it helps to gently massage your breasts first to encourage the milk to let down. Having your baby – or a picture of them – nearby can also make it easier. You could also try covering your breasts with a warm towel first or expressing after you’ve had a bath or shower.
If you continue to struggle, talk to your midwife or health visitor. They will be able to offer advice and suggest breastfeeding support groups in your area.