One of the most common questions I get asked by the majority of mama’s as a doula and feeding supporter on the post natal ward is …
‘When should I start expressing my milk, and how do I do it?’
I get asked this question for a number of reasons on the postnatal ward, the two most common reasons are wanting to express so babies dad can feed and bond better with the baby, or for someone else to feed the baby so mum can get more sleep. Both are valid reasons and fair however breast milk needs time to establish supply and if you miss feeds early on for bottle feeds your milk supply can be effected. It can take up to six weeks for your milk supply to establish itself and not be too effected if you miss feeds. I usually suggest after six weeks, or three months if you can wait longer (sorry I know its not the answer most of you want!).
(Sorry, que my feeding preachy bit!) …Exclusively breastfeeding for as long as you can builds your supply and is better for your baby as it produces everything their body needs in that moment (as I mentioned in a blog before your body makes antibodies for your baby within twenty minutes of being in contact with them! It really is awesome stuff!)
Don’t get me wrong though, expressing has its place especially in modern day society for a number of reasons. Our boobs and baby’s haven’t caught up with the times yet from the days we lived as hunter gatherers so sometimes expressing helps ease the pressure of on demand feeding hugely. Hunter gatherer societies past and present take the pressure off the mother by sharing the feeds with other lactating mothers in the tribe.
Expressing can also increase your supply at any stage of breast feeding if you are not dropping feeds but expressing in between feeds.
There are two different ways to express, one is using pumps and the other is by hand. Pumps can be electric, or hand pumps, and offer different shaped or sized funnels for your breast but trying a few different ones can help you find the right one.
(images from Easy pump, I love this image! )
Many women I meet seem to prefer expressing by hand, I think the skin contact helps and you can feel with your hand where in your breast the milk is emptying from and where you need to focus on when squeezing.
(images from La Leche)
The milk let down happens when you have a flood of oxytocin the ‘hormone of love’, so it is often best to try expressing with your baby in the room, or by looking at photo. I often tell parents a little foreplay will work too as this will also allow the milk to flow due to the oxytocin levels.
Before you express always wash your hands and ensure the bottle and equipment you use is sterilized. When you are ready to begin expressing whether you are using a pump or by hand try massaging your breast first to stimulate the milk production, then once you feel it come in you can attach the pump, or use your hand.
When using your hand you can cup your breast, and squeeze gently massaging your breast firmly in a downward motion or pressing and using circular motions to squeeze the milk out. It is hard to describe, but have a play and you will find the right way of hand expressing for you.
In the first few days you will be lucky to get drops of milk so dont be alarmed or worried if it isnt much or nothing at all, your milk will come in so its visible for you to see (rest assured that your baby will still be getting some even if you aren’t seeing it!). As i have said in previous blogs during the first days the milk is small amounts of golden creamy coloured colostrum, and is less than you will produce once your milk comes in around day 3 after birth, you will find as the days pass you will produce more and more.
(image from google search)
The image above isn’t an exact match to the colour of your milk but it will give you an idea of what to expect. Do not be alarmed if your milk comes out slightly different colours, some women see a blue tinge or green, pink, or even red (red will pass with feeding). Often the blue and green tinges are due to what you have eaten or medication you may have taken, but do not worry. The pink and red can be due to the fact the milk is made from our blood and it takes a few days of feeding for the transition from the blood colour to the creamy milk to occur.
The amount of milk you produce will vary from woman to woman, if you are feeding your second, third or fourth baby you may also find you are not producing excess to their needs because your awesome breasts remember how much they produced before. Keep trying though as it can take a few days for your milk production to adjust itself. If you still find after a few days of expressing that you aren’t able to produce much then you are one of many mums who are unable to express much ( I was never able to express a lot with my third and fourth babies). Do know that it wont mean your baby gets less milk if you are unable to express milk, it just means your breasts need your baby’s amazing method which is designed for suckling your milk!
Once you have expressed your amazing milk, no matter how much or little, you can store it in sealed freezer bags, bottles or small containers. The milk can remain in the fridge for up to 5 days in a sealed sterile bottle or bag. If it has been cooled in a fridge it can be carried in a cool bag with ice packs for up to 24 hours (great if you love camping or are going away!)
Always remember to make sure you label and date the containers.
When warming the milk up again, unless your baby is happy to drink it cold from the fridge, you can warm the milk to body temperature by putting the bottle in a jug of warm water or by holding it under a running warm water.
Once your baby has drunk from a bottle of breast milk it should be used within the hour, do not reuse it.
As easy as it seems please do not use a microwave to heat up or defrost breast milk. It doesn’t heat properly, can damage the cells in the milk, plus it can cause hot spots, which can burn your baby’s mouth.
To test the temperature is ok for your baby you can try dropping some of the milk from the bottle onto the inside of your wrist, the skin in this area is really sensitive, you will feel if its too hot or cold, and if it is the right temperature you shouldn’t feel it as it will be near body temperature. Or you can try dropping a bit on your tongue, or use both methods to double check it?
A top tip! When you are feeding your baby you will likely find in the beginning that both breasts will leak milk, do not waste the other side when it leaks! You can either let it drip into a container or buy little cups that fit into your bra to collect the milk. There are a few out on the market now, I loved these when feeding my little ones! You can also just put them in your bra around the house to collect any excess drips when you aren’t feeding. Every little helps when you need it.
Another tip! If you do not use your milk up for bottle feeds you can add it to baby foods(porridge, mashed sweet potato, banana etc ) when your baby begins trying solids after six months. Or you can use it for making breast milk ice lollies to sooth your baby’s gums when you baby begins teething! (my babies loved these!)
I feel I’ve reached the end of this blog, thank you again for reading it! I hope it is of some use. If you have any further questions or feel I have missed any thing out please get in touch.
(All of the information on here is from the notes I have collected over the years through training days and experience. The images I found on the internet via google, the pumps are from advertising brands, the illustrations were from la leche).