Once you and your baby are comfortable with breastfeeding, you may want to express milk so that someone else can feed your baby when you’re not there. This can be useful if you want to continue breastfeeding when you go back to work, or even if you just want to have a night out. You can express by hand or use a breast pump – these are often available to hire if you don’t want to buy one.
You might also need to express milk if your baby is unable to feed directly from the breast – for example, if he or she is ill or premature. In this case, it’s best to start off expressing by hand.
Hand expression of breastmilk is a handy skill for a breastfeeding mother to have. Reasons why you might want (or need) to hand express include:
- to express in the first few days for an ill baby
- to tempt your baby to attach and feed
- to help your baby attach to a full breast
- it may be more effective than a breast pump
- it doesn’t cost anythingDiagram showing milk-producing cells and milk-collecting ducts
- it’s more convenient
- you are in full control
- it helps you learn how your breasts work
To understand how to express it is good to understand a bit about what your breast looks like below your skin. Inside it is a bit like the segments in an orange with different sections. The milk travels from little milk-producing cells, down very narrow little tubes called milk-collecting ducts and then the milk is available to the baby at the front of your breast.
This diagram may help you understand.
How to do it
- Sterilise a container to collect the milk in. A small plastic bowl or other wide necked container is good.
- Give yourself plenty of time and privacy.
- Wash your hands.
- Start the milk flowing by relaxing and massaging your breasts gently (see the photo below).
- Feel your breast to see if you can find the spot where the milk-collecting ducts widen. This is usually well behind the nipple. It can feel as if there is a change in the texture of the breast tissue.
- Place your thumb above and finger below this point in a C-shape as shown in the picture below.
- Press your thumb and finger together, squeezing your breast between thumb and finger, then release and repeat in a rhythmic action. Milk will start to drip and then may squirt out in a spray.
- If you want to get as much milk as possible, rotate your fingers around the breast to empty all the breast segments (see diagram).
There are several different types of breast pump you can buy – both hand operated and electric pumps are available. It’s a good idea to think about how often you intend to use a breast pump before investing in an expensive model. If you are not sure what sort of pump you might need, ask another mother or your midwife or health visitor. Large electric pumps are available for loan or hire and these tend to be used by mothers who are expressing almost all their milk for an ill or premature baby. For details on pumps for loan or hire, you can contact the Northern Ireland Mother and Baby Appeal (NIMBA) on 028 9332 9933 or the National Childbirth Trust (NCT) on 0870 4448708.
Before you start to express, sterilise your breast pump equipment. Try to ensure that you give yourself plenty of time and that you don’t feel hassled.
Begin by massaging your breasts and hand expressing a few drops of milk. (See the previous section on hand expressing for how to do this.) This will help to start your milk flowing.
Then place the breast funnel of the pump over your breast, making sure your nipple is in the centre. It may take a few minutes for the milk to start flowing. Some mothers find it helps to get the milk flowing if they express with their baby near by or if they have something that helps them think about their baby, such as a photograph or piece of clothing.
Express from the first breast until the milk flow slows down or until you feel you have got enough milk. Then switch to the other breast and do the same. If you want to obtain as much milk as possible, massage your breasts before you switch sides and express until the milk flow stops completely.
If you are keeping your milk supply going for a baby in hospital, then you will need to begin expressing as soon as possible after the birth and then express frequently at least 6-8 times a day, including at least once at night. See the section on ill and premature babies for more information.
If you are going out and want to leave some expressed breastmilk for someone else to feed your baby, it is a good idea to plan in advance and express your milk at least the day before you go out. As a rough guide, a baby under 3 months old will need to be left 100-120 mls (3-4 ounces) of breastmilk per feed and an older baby would probably take 150-200mls (5-7 ounces) per feed. The breastmilk can then be stored in the fridge or freezer – see the section below for details.
Breastmilk can be stored in the fridge for up to five days and frozen for up to three months. Freeze it in small quantities, for example in ice cube trays, so that there is no waste if your baby only wants a little. Make sure you label and date your breastmilk before you put it in the fridge or freezer. Storage times may be shorter if you are expressing milk to feed an ill or premature baby, but the staff in the special care baby unit will be able to advise you about this.
Breastmilk should be defrosted overnight in the fridge or thawed by standing the container in a jug of warm water. Do not use the microwave – it may heat the milk unevenly and scald your baby. There is also some evidence that microwaving destroys some of the beneficial anti-immune factors in breastmilk.