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Expressing breast milk


Expressing milk means removing milk from your breast. You may want to express milk if your breasts are feeling uncomfortably full, or if your baby is not sucking well but you still want to give him breast milk. If you have a premature or sick baby, you can express breast milk into a sterile container to be used later. Expressing is also useful if you plan to return to work or simply want to go out.  You can express milk by hand or with a breast pump. Whichever method you use, wash your hands thoroughly before you start and ensure containers and every bit of equipment used has been washed in hot soapy water, rinsed in clean water, and then sterilised.


How to help your milk flow
  • Have a sterile container ready
     
  • Sit in a comfortable position

  • Bath your breasts in warm water or use a warm flannel

  • Gently massage them with your finger tips or closed fist; work all round your breasts including underneath, towards your nipple.

  • Roll your nipple gently between your finger and thumb, but don’t squeeze it.

How to hand express

It is more effective to express milk by hand than to use a pump in the first few days. If you want to collect the milk, you will need a sterilised container. The following suggestions help:

  • Before you start, wash your hands thoroughly then gently massage your breast.
     
  • Cup your breast and feel back from the end of the nipple to where the texture of your breast feels different.

  • Using your thumb and the rest of your fingers in a C shape, squeeze gently about 3 to 6 cm behind the nipple-this should not hurt.

  • Release the pressure then repeat, building up a rhythm. Avoid sliding your fingers over the skin. At first, only drops will appear, but just keep going as it will help build up your supply. With practice, and a little time, milk will flow freely.

  • When no more drops are coming, move your fingers round to try a different section of your breast and repeat.

  • When the flow slows down, swap to the other breast. Keep changing breasts until the milk is dripping very slowly or stops altogether.

  • If the milk doesn’t flow, try moving your fingers slightly towards the nipple or further away, and try giving your breast a gentle massage.


    Breast pumps

    All pumps work by drawing the milk through your nipple into a sterilised container. Some put the milk straight into a poly bag ready for freezing.

  • Hand pumps are cheap, portable, and quiet, but can be quite hard work. You use your hand and wrist to operate a hand-held device to pump the milk.
     
  • Battery or electric pumps are quick and effective, but noisy and quite expensive.

Storing expressed breast milk

Fresh expressed breast milk can be kept for 24 hours stored in a fridge at 2-4 degree C. Store in the back or bottom of the fridge, not the door. It can also be kept in an upright freezer in sterile containers for up to 3 months; 6 months in a chest freezer. Label and date the container, and then pour the milk straight into it.
Breast milk must always be stored in sterilized container. If you are using a pump, make sure you wash it thoroughly after use and sterilize it before use.

If the fat in breast milk separates when it’s thawed, just give the milk a good shake. You can thaw milk quickly by standing the container in hot water. Use milk thawed this way immediately. Milk defrosted in the fridge will keep for 24 hours. Do not warm or defrost frozen breast milk in a microwave. It can leave hot-spots which could burn your baby’s mouth. Milk that has been frozen is still good for your baby and better than formula milk. Milk should not be refrozen once thawed.


Expressing milk if your baby is premature or ill

It is important to try to express your milk as soon as possible after your baby is born. To ensure that you produce plenty of milk, you will need to express at least six to eight times in 24 hours, including during the night, just as your baby might be doing if they were able to feed directly. Ask the hospital staff about having skin-to-skin contact with your baby. This will help with bonding and keeping up your milk supply.



Cup Feeding

Sometimes, your baby might need some extra milk, or find it hard to feed from your breast. In this case, your doctor might suggest that you give your baby some expressed milk in a cup. Ask your nurse to show you how. In this way, your baby is able to taste and begin drinking your milk. You should not pour milk directly into your baby’s mouth.

Dummies

Try not to give your baby a dummy until breast feeding is established, usually when your baby is a month old. Using dummies has been shown to reduce the amount of milk that is produced. If your baby becomes accustomed to using a dummy while sleeping, it should not be stopped suddenly in the first six months. But you should stop using a dummy when your baby is between six and 12 months.

                                        Healthy eating

You don’t need to eat anything special while you are breast feeding, just make sure you have a varied and balanced diet. There are no special foods that will help you make more milk. Being a new mother is hard work though, so it’s important to look after yourself and try to eat as varied and balanced a diet as you normally would. Keep these important nutrition tips in mind:

Drink plenty of fluids to stay hydrated (but fluid intake does not affect the amount of milk you make). Aim for at least six to eight glasses each day. It’s a good idea to have a drink beside you when you settle down to breast feed. Water, milk and unsweetened fruit juices are all good choices.
  • Eat at least five portions of a variety of fruit and vegetables a day.
     
  • Eat starchy foods such as rice, chapatti, whole meal bread, potatoes, pasta

  • Eat plenty of fibre, found in salads, fruits, pulses, whole grain bread and breakfast cereals

  • Protein, such as pulses, eggs, fish, lean meat and poultry.

  • At least two portions of fish each week, including one portion of oily fish

  • Dairy foods, such as milk, cheese and yoghurt, which contain calcium and are a useful source of protein

  • Drink a moderate amount (up to 2 or 3 cups a day) of coffee or other caffeinated beverages. Too much caffeine can cause the baby to be fussy or not sleep well.

  • Vitamin and mineral supplements cannot replace a healthy diet. In addition to healthy food choices, some breast feeding women may need a multi-vitamin and mineral supplement. Talk to your doctor to find out if you need a supplement.

Caffeine

Drinks containing caffeine can also affect your baby and may keep them awake, so drink them only occasionally rather than every day while your baby is young. Caffeine occurs naturally in lots of foods and drinks, including coffee, tea and chocolate. It’s also added to some soft drinks and energy drinks and to some cold and flu remedies. In the early days, it is important that you don’t have too much caffeine. Try decaffeinated tea and coffee, fruit juice or mineral water and limit the number of energy drinks, which might be high in caffeine.

Medicines and breast feeding

Many illnesses, including depression can be treated while you are breast feeding without harming your baby. Small amounts of whatever medicines you take will pass through your breast milk to your baby, so always tell your doctor, dentist or pharmacist that you are breast feeding.

Make sure the medicine is safe to take when breast feeding. Watch your baby for side effects such as poor feeding, drowsiness and irritability. Stop taking the medicine if your baby gets side effects.

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