Express yourself: All your questions answered!

If you’re thinking about expressing breast milk, you may not know where to begin. Here’s our guide to FAQs about expressing breast milk.

How do I express breast milk?

Answer: Breast milk is expressed either by hand or using a breast pump. Breast pumps can be either hand-operated or electric. Some women find it easier to express milk by hand in the early days as your breasts become more used to the feelings of let-down and milk flowing, and as your nipples become accustomed to their role. Hand-expressing gives you the ability to encourage milk to flow from particular parts of your breast – depending on where you place the hand which is doing the expressing, you can massage particular ducts, which is particularly helpful if one of your milk ducts is blocked.

What does “expressing” breast milk mean?

Answer: Expressing breast milk means squeezing milk from your breasts so that you or someone else can feed it to your baby. You may express breast milk if:

  • You are going to be away from your baby; for example, if you’re having a date night with your partner and getting a babysitter (hooray!), if you’re going back to work and your baby will be in childcare, if your baby is unwell, or if your baby is in special care (if your baby is premature or in hospital, for example).
  • You want to boost your milk supply.
  • You want to build up a supply of frozen breast milk for future use.
  • Your partner will be feeding your baby.
  • Your breasts are engorged (uncomfortably full and swollen).
  • Your baby isn’t able to suck from the breast, but you want them to have breast milk.

Okay, but how do I actually physically express the milk?

Answer: If you’re expressing breast milk by hand, here’s the process:

  • Wash your hands with soap and water, and ensure your breasts are clean too.
  • Have a clean, sterilised container to hand before you start.
  • 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, gently squeeze this area (this shouldn’t hurt).
  • Release the pressure and then repeat again and again, 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 more time, milk will flow freely.
  • When the flow slows down, move your fingers around (still in the C shape) to try a different section of your breast and repeat. When that flow slows down, swap to the other breast. Keep changing breasts until the milk is dripping very slowly or stops completely.
  • If the milk doesn’t flow, try moving your fingers slightly towards the nipple or further away, and try a gentle breast massage.

What about breast pumps?

Answer: There are two different types of breast pump: Manual (hand-operated) and electric. Different pumps suit different women, so ask for advice or see if you can try or rent one to try before you buy. Generally speaking, manual pumps are cheaper, but may not be as quick as an electric one. You can get single pumps, which allow you to express from one breast at a time, or double pumps, which allow you to express from both breasts simultaneously. You can purchase a breast pump from baby stores, department stores, pharmacies, and online maternity stores. Look for a reputable brand which also sells replacement parts separately, just in case.

What about expressing breast milk if my baby is premature or ill?

Answer: If your baby has to stay in hospital, it is important to start expressing breast milk as soon as possible after your baby is born. In order to ensure that you produce plenty of milk, you will need to express at least eight times over 24 hours, including during the night. Ask the hospital staff about holding your baby skin-to-skin. This can help with bonding and keeping up your milk supply. If you are freezing your milk because your baby is premature or ill, ask the staff caring for your baby for advice on storage – there should be a fridge and freezer available on the ward for you to use.

And how do I express using a breast pump?

Answer: Expressing breast milk using a breast pump is a bit different to hand-expressing, although most modern breast pumps are designed to try to mimic the way your baby would suck from your breast.

  • Ensure that your breast pump and milk collection container are clean and sterilised before using. Check out the instructions that came with your breast pump, as they all work slightly differently.
  • Ensure your hands and breasts are clean before starting.
  • Position the funnel of the breast pump over your breast. You may need to move it around to find the best spot to most effectively extract the milk.
  • The suction strength can be altered on some electric pumps. Start with low, gentle suction and build up slowly. Setting the strength to high straightaway may be painful or damage your nipples.
  • You may also be able to get different funnel sizes to fit your nipples. The pump should never cause bruising or catch your nipple as it is sucked into the funnel.

Is there a best time to express breast milk?

Answer: It may be easier to try to express breast milk in the morning, when your breasts feel fuller. But the best time to express is when you feel relaxed and calm, and when you have time to sit down and give expressing your attention. When you’re busy, in a hurry, stressed out, or having a tough day, expressing can feel like a chore – try to treat the time you’re expressing milk as a break for you, and sit down with a glass of water and a snack and relax.

What can I do to help my breast milk flow when I’m expressing?

Answer: Here are some ideas:

  • Sit upright. It will help your breasts to fall into a natural position and may also help you to pump more milk.
  • Try to relax. If you’re calm and chilled out, your breast milk will let down more easily.
  • Drink water. Keep a big glass of water or a water bottle nearby and drink it throughout your expressing session.
  • Keep a photo of your baby nearby, or your baby himself! Looking at a photo of him, or at your baby, may help your milk to flow.
  • Breastfeed on one side and pump on the other. This can be tricky, but some mums swear by it!
  • Take a warm bath or shower beforehand – sometimes it can help with let-down.

How should I defrost frozen breast milk?

Answer: The best way is to defrost frozen breast milk slowly in the fridge. But if you need to use it straightaway, you can defrost it by putting the container in a larger container or bowl of warm water, or holding the frozen container under
a warm tap until the milk has thawed. Don’t defrost it by putting it into the microwave. And once defrosted, don’t refreeze any leftover milk.

How should I warm up expressed breast milk?

Answer: If your baby doesn’t mind cold breast milk, you can feed it to him straight from the fridge, or you can warm it to body temperature by putting the container into a bowl of warm water, or holding the container under a warm tap. Before feeding your baby, swirl the container of milk to mix the fat portion in and distribute the heat evenly. Check the temperature of the milk by shaking a few drops onto the inside of your wrist. It should feel warm to the touch before you give it to your baby – not hot. Any leftover, undrunk milk should be used within an hour, and anything leftover after that needs to be tipped down the sink.

TIP: Never use a microwave to heat up or defrost milk. It can cause hot spots and uneven heating in the milk, which can burn your baby’s mouth. It also destroys some of the milk’s immunological components.

What do I do if I’m having trouble expressing?

Answer: Before you start to express breast milk, have a chat to your midwife or LMC, who can give you some handy advice and information. And if you’re having dif culty expressing once you’ve started, your midwife, LMC, or Plunket nurse can give advice. You can also contact your nearest La Leche League for advice and assistance. Remember that it takes time to get the hang of expressing breast milk, so give yourself some time to learn what you’re doing. If you’re having trouble getting more than a trickle of breast milk during an expressing session, try expressing at different times of the day.

How should I store expressed breast milk?

Answer: You can store expressed breast milk in a sterilised container or in breast milk storage bags. Expressed breast milk can be stored in the back of the fridge – the coldest part – for up to 48 hours. It can be stored in the freezer for three to six months, and in a deep freeze for six to 12 months. Make sure you date and label expressed breast milk before storing it. And never add freshly expressed breast milk to previously expressed refrigerated or frozen breast milk – once it’s expressed and in a sealed container, it needs to stay that way until you use it.

TIP: Don’t store breast milk in the door of the fridge as it’s not cold enough and is vulnerable to temperature uctuations as the fridge door opens and closes.

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