Expressing Breast Milk
Expressing Breast Milk
Expressing breast milk by hand or by pump helps to establish and maintain your milk supply. Expressing milk can take some time to learn, if you are still under neonatal or midwifery care your nurse/midwife should be able to support you. There is also some information on expressing on this page.
Reasons expressing may be required
Your baby is not well enough or strong enough to breast feed straight away
Your baby is premature and too small to breastfeed straight away
Your baby is in hospital and you are not able to be with them for all feeds
You are not well enough to breastfeed straight away
Your baby has a medical condition that prevents breastfeeding
So that both parents can share feeding
You plan to feed using breastmilk in a bottle
So that you are able to return to work and continue giving your breast milk to your baby
When should I start expressing?
If your baby is in hospital and not able to breastfeed straight away, it is best to begin expressing as soon after birth as you can. The nurse or midwife looking after you and your baby will be able to support you with expressing.
If you are expressing because you are planning to return to work or have decided to introduce bottle feeds, it is a good idea to start expressing around six to eight weeks before so you can build a supply in the freezer.
How often should I express?
If your baby is in hospital and you are not able to breastfeed straight away then it is important to start expressing milk as soon as possible after your baby is born (ideally within 2 hours of birth). To ensure you can establish and maintain your milk supply its is recommended that your express frequently. To begin with, you should aim to express around eight to ten times in 24 hours, including at least one night time expression. Breast milk is produced on a demand and supply system, the higher the demand (number of expressions) the more milk you are likely to produce. It is also important to ensure there are no gaps longer than 5 hours between expressing. This is important to keep the hormone (prolactin) levels up and the milk supply maintained. After the first two weeks you can often reduce the frequency to eight times in 24 hours, with time you will find a routine that suits your and your baby's needs.
Evidence has shown that if you can express nearer ten times within the first ten to fourteen days then you can often increase your supply to where you are expressing about 750ml of breast milk in 24 hours. Producing this amount or more promotes healthy long term milk supply.
You do not need to express at regimented times, for instance every 3 hours. You can cluster express, which means express frequently over a short period of time, when it is most convenient for you. This may mean you choose to express every hour for a few hours, or every couple of hours. The main goal is to reach eight to ten expressions in 24 hours (ideally 10 in the first few weeks) and not have any gaps in expressing longer than 5 hours.
For the first few days after your baby is born, it is best to express the colostrum (first milk) by hand. Expressing by hand stimulates the hormone oxytocin which helps milk production.
In the first few days it is normal to only get small drops of milk, so expressing by hand means that you are able to catch these small but precious drops of colostrum for your baby.
Your midwife or nurse will be able to show you how to hand express. But there is more information here from UNICEF.
Expressing by Pump
Breast pumps are a useful way to express breast milk. Your hospital should be able to provide you with a breast pump to use during your stay on the maternity and neonatal units. The staff will show you how to use the pump effectively. Some units can also lend you a breast pump to use at home whilst your baby is in hospital, but if not, you can rent or buy one.
Electric pumps – There are several types of electric pump, and most can be adapted to allow single or double pumping (pumping both breasts at the same time). Hospital-grade, double electric breast pumps can be ideal if you need to establish and/or maintain your milk supply with a pump, or you have to express for a long time.
Hand pumps – Hand pumps are usually less expensive and are more widely available in shops. With hand pumps, suction is created by squeezing a handle. This can be quite tiring after a while, so using an electric pump can save time and energy. A hand pump is ideal for short-term or occasional use, or if you are travelling and cannot access an electric pump.
Preparing to Express Breast Milk
When expressing milk it is a good idea to give yourself time and make sure you have everything you need before you start. It is also important to wash your hands thoroughly before you begin. Things you may need:
1 or 2 expressing kits (for single or double pumping).
Pump and tubing, funnels and valves.
Bottles and lids for bottles.
Labels for bottles and a pen to write on them.
Water to drink whilst expressing.
A table to put the bottle on whilst you disconnect from the tubing.
Something to record when, how long for and how much you have expressed. Some units may provide expressing logs, you may also find it useful to use a notebook or a phone app for this.
A pumping bra can also be useful to free up your hands whilst you express.
When using a breast pump it is important to make sure you are using the correct size funnel- this will prevent you from making your nipples sore and can enhance your milk production.