Breastfeeding - Expressing Breastmilk
You can express milk manually with your hands or with a breast pump. Breast pumps are used to ease engorged breasts or to collect milk when you are away from your baby (for example, if you are ill or at work). Pumping enables you to continue to breastfeed by keeping your milk production stimulated. If milk is not emptied from the breast regularly, it sends a message back to your body to stop making milk.
To express milk manually:
- Make sure your hands are clean. Wash them well with soap and water.
- Put a clean cup or container under your breast.
- Massage the breasts gently toward the nipples.
- Place your thumb about 1 inch back from the tip of the nipple and your first finger opposite.
- Press back toward your chest, then gently press the areola between the thumb and finger and release with a rhythmic motion until the milk flows or squirts out.
- Rotate your thumb and finger around the areola to get milk from several positions.
- Transfer the milk into clean covered containers for storage in the refrigerator or freezer for possible later feeding for your baby. Always label the container and put a date on it.
Some women prefer hand expression because it can be done silently and does not require special equipment. Other women may find it easier and faster to express milk with a breast pump. Pumps are manual, battery-operated or electric. You can find manual pumps in most pharmacies and baby stores. Do not buy those that look like a bicycle horn, because they can not be cleaned properly and milk may become contaminated.
Good hand pumps have two cylinders, one inside the other, attached to a rigid funnel-like device that fits over the breast. As you slide the outer cylinder up and down, negative pressure is created over the nipple area. This causes milk to collect in the bottom of the cylinder. This collecting cylinder can be used with a special nipple to feed your baby without transferring the milk. The entire pump can be cleaned in the dishwasher or by hand with soap and hot water.
Some hand pumps have a handle to squeeze that creates a negative pressure and draws the milk into a bottle. These may have a soft, pliable flange that fits around the nipple and areola and produces a milking action while pumping.
For most women, electric pumps stimulate the breast more effectively than manual expression or hand pumps. They are used mainly to keep breastfeeding going when a mother is not able to breastfeed for several days or more. These pumps are easier and more efficient than hand pumps, but they are much more expensive. However, you may be able to save money by renting an electric pump from your hospital or a medical supply store.
When shopping for an electric pump to buy or rent, make sure that it creates a milking action and is not simply a sucking device. Pumps that express milk from both breasts at the same time increase your amount of milk and save time. No matter which type of pump you choose, make sure that all parts of it that come into contact with your skin or milk can be removed and cleaned. Otherwise, the pump will become a breeding ground for bacteria, and the milk will not be safe for your baby.
After expressing your breastmilk, it's important that it be stored properly. Proper storage will ensure the milk does not become contaminated or spoiled and that it retains all the nutrients your baby needs. Here are some safe storage and preparation tips to keep your expressed milk healthy for your baby.
- Always wash your hands before expressing or handling your milk.
- Be sure to use only clean containers to store expressed milk. Try to use screw cap bottles, hard plastic cups with tight caps or special heavy nursery bags that can be used to feed your baby. Do not use ordinary plastic storage bags or formula bottle bags for storing expressed milk.
- Use sealed and chilled milk within 24 hours if possible. Discard all milk that has been refrigerated more than 72 hours.
- Freeze milk if you will not be using it within 24 hours. Frozen milk is good for at least one month (three to six months if kept in a 0?freezer). Store it at the back of the freezer and never in the door section. Make sure to label the milk with the date that you freeze it. Use the oldest milk first.
- Freeze 2 to 4 ounces of milk at a time, because that is the average amount of a single feeding. However, you may want some smaller amounts for some occasions.
- Do not add fresh milk to already frozen milk in a storage container.
- You may thaw milk in the refrigerator or you can thaw it more quickly by swirling it in a bowl of warm water.
- Do not use microwave ovens to heat bottles because they do not heat them evenly. Uneven heating can easily scald your baby or damage the milk. Bottles can also explode if left in the microwave too long. Excess heat can destroy important proteins and vitamins in the milk.
- Milk thawed in the refrigerator must be used within 24 hours.
- Do not re-freeze your milk.
- Do not save milk from used bottle for use at another feeding.
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The information contained in this publication should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
Copyright 1999 American Academy of Pediatrics
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