Expressing and Storing Milk

You may want to express milk to relieve and soften engorged breasts, to provide your baby with a feed in your absence or because some problem prevents breastfeeding. If cracked or sore nipples or some other problem is making feeding temporarily impossible, a pump is not the answer and gently expressing by hand is best.

Expressing By Hand

Choose a time when you feel relaxed and unhurried, wash your hands and use a previously sterilised bottle or jar with a non-metal lid to collect the milk. After a bath is sometimes a good occasion for a first try, or you can help the let-down reflex by putting hot compresses on the breast before expressing. Start by stroking the breast with a light finger-tip touch from chest wall towards the nipple, moving all around the breast. Thinking about the baby and relaxing helps the milk to be released. The point at which you want to apply pressure is where the milk ducts open out into a wider reservoir which is usually where the dark skin of the areola merges into ordinary skin. Hold the breast between finger and thumb at this point using left hand to right breast and vice versa. Squeeze rhythmically inwards without letting your finger slide on the skin and without touching the nipple. Move around the breast to empty each of the reservoirs in turn and then swap to the opposite breast to give time for more milk to drain down.

You can also collect a certain amount of milk simply by holding a container to catch the drips which in the early days may leak from the breast the baby is not feeding from. Some people produce quite a lot when the let-down releases the main bulk of the milk. Usually this leaking tails off as feeding is established. But remember that drip milk is foremilk and therefore low in fat and calories. It is less satisfying when fed alone to your baby, and it is important to remember this if the baby is left for a babysitter to feed in your absence.

Expressing milk to relieve engorged breasts needs to be done very gently to avoid bruising skin which is already stretched and tender. If you have problems ask a midwife, breastfeeding counsellor or another breastfeeding mother to show you how to express milk. Some people get very adept and use this technique even when having to express full feeds for the baby if they have gone back to work because it saves taking a pump around with them.

Breast Pumps

'I didn’t like using the pump but it was the only way I could express enough for my baby who was eight weeks premature. I just used to switch off and imagine it was the baby sucking at the breast. I didn’t like it in the beginning, but once I got used to it I could read a magazine and forget what was happening.’

Hand pumps These can be useful if you regularly express milk for someone else to give your baby. There are very many different designs on the market. One mother’s ideal pump is another one’s agony, so look around and take advice from other mothers and breastfeeding counsellors. Most pumps tend to be one cylinder inside another with a funnel shape at the top to fit over the nipple. Drawing out the inner cylinder creates a vacuum which puts pressure on the areola in the way the baby’s sucking would. The exact shape and angle of the funnels, the ease with which they are operated and their ability to come to pieces to be sterilised vary quite a bit.

Breast relievers These are not the same as pumps. They consist of a glass funnel shape and a bulb and are not advised for expressing feeds. They are intended for expressing only a little milk to relieve pressure and are extremely difficult to clean and use.

Electric pumps Such pumps are expensive but can be hired from breastfeeding counsellors and are usually the only effective way of building up and maintaining a supply of milk if your baby is ill or premature and needs to be given expressed milk regularly by tube. In the beginning midwives will show you how to use one at the maternity hospital. As with all expressing it is important to relax. Hot compresses and stroking the breast in the same way as for hand expressing before you start can help the let-down reflex. Like the hand pumps, electric pumps have a funnel or cup which fits over the nipple and areola only; the rhythmic suction is provided by the machine. Milk collects in a sterilised bottle.

Containers and all detachable parts of pumps need to be cleaned and sterilised.

Storing Expressed Breast Milk

Milk can be kept for:

Always date milk if you plan to freeze it, and put it in a sterile container every time. Do not thaw frozen milk over direct heat on the stove because it will curdle and be unusable. You can stand the bottle in a jug of warm but not boiling water; or hold the bottle under the tap starting with cold, changing to tepid and then hand-hot water only as it begins to thaw. Do not allow it to thaw over a longer period at room temperature or leave it standing in the room once it has thawed.

Once thawed, breast milk should be used as soon as possible. Do not keep it for longer than four hours in a fridge before using it.

Never re-freeze milk that has been thawed.

Transporting expressed breast milk is best done in a freezer bag and this applies whether you are expressing milk at work to bring home to the baby or taking a bottle of expressed breast milk to give to a baby while you are out. Keep it as cold as possible by using more than one freezer pack and observe the storage times as if it were in the fridge.