Expressing breast milk

There are only two ways by which milk can be normally released from your breasts: by expressing or by breastfeeding. The action of squeezing milk from a breast is known as expressing breast milk. It can either be manual (by hand) or automated (by an electric pump).

Expressing breast milk is an art that you need to learn so that you do not harm your breasts or contaminate the milk that is to be given to your baby. If you do not follow the right steps, your breasts may become painful. Ideally an infant should be breastfed. However, there are some circumstances which may make this impossible, hence the need to express the milk.

• Absence- If you plan to leave your baby behind, whether for a few hours or throughout the day or night, you may want to leave behind some breast milk for the baby. That way your child continues to receive the same nutritional benefits whilst under the care of someone else. This is especially the case for mothers returning to work after maternity or couples on a night out.
• Engorged breasts- After delivery, especially during the first week, your breasts may feel sensitive, tender and swollen. You may get a throbbing, uncomfortable, hard ‘fullness’ of the breast. This is known as engorgement and is caused by increased milk and blood supply to the breast in readiness for breastfeeding. It is temporary and normal. Expressing breast milk can relieve engorgement.
• Prolonged feeding- In some cases your nipples may hurt as he baby suckles. Previously expressed milk can be used in such instances, or if you are unable to feed your baby temporarily due to illness or medication.
• Pre-term or ill baby- Pre-term babies as well as sick ones need nourishment but may not be able to suckle. Mothers are advised to express milk to feed such babies with a spoon or bottle.
• Breast maintenance- To maintain your breast milk supply, you will need to express the milk often. Breasts tend to produce more milk when there is regular outflow.

Attaching Baby to the Breast
In the majority of breastfeeding cases a newborn needs to be tempted by the taste of milk in order to learn how to attach and suckle the mother’s breast. To achieve this, mothers express a little milk while holding the nipple close to the baby’s mouth.

Expressing by hand
Expressing breast milk by hand is simple and inexpensive. It is suitable if you only need to express once in a while. However, it needs practice and can be time-consuming.

Understand your breasts
It is first important for you to understand the breast structure and exactly where milk is stored within the breast. Simply remember that milk is stored in ducts located behind the nipple, and this is the area you need to squeeze. Pressing the nipple, which some women do, will not bear fruit as no milk is stored there!

Maintain proper hygiene
Wash your hands with soap and running water. This ensures that you do not transmit germs to your breasts and later to the milk. Wash and sterilise a container, for instance a small plastic bowl, into which you will express the milk. Find a container that can be covered to store the expressed milk. This can be a cup, bottle, or a jug with a wide mouth. Wash the container in soap and water and rinse thoroughly with boiling water to kill germs.

Get physically and psychologically ready
Sit quietly and privately, or with a supportive relative or friend. You may take a warm and soothing drink. Ensure you are in a relaxed atmosphere, and not in any hurry. Prepare yourself psychologically by reducing any sources of pain or anxiety, and by harbouring good thoughts about your baby. Some women find that having the baby around assists in getting into the right frame of mind. Holding your baby close to you, if possible, may also help.

Prepare your breasts
Warm your breasts by applying a pad with warm water. Stimulate your nipples by gently pulling or rolling them with your fingers. Massage or stroke your breasts gently, or ask someone to rub your back for a few minutes.

Express your milk

• Sit or stand comfortably and hold the container near your breast. Place your hand around the areola (dark part of the breast near the nipple) so as to form a ‘C’ with your thumb on the upper side of the nipple and your index (first) finger directly opposite on the lower side of the nipple, about two thumbs (4 to 5 centimetres) behind the areola. Do not place your thumb or index finger too close to your areola as this will hurt when you squeeze. Support your breast with your other fingers.
• Squeeze your thumb and index finger together while simultaneously pushing your hand backwards towards your
  chest in a rhythmical fashion. Press and release, press and release repeatedly. Massage your breast occasionally and move your fingers to other segments of the breast. This should not hurt. If it does, you are using the wrong technique.
• Avoid rubbing or sliding your finger across the skin. Avoid squeezing the nipple itself as pressing or pulling on the nipple will not express the milk.
• Express one breast until the milk outflow slows down then express the other breast. You can use either hand for both breasts and change when one tires. It takes between 20 to 45 minutes or more to express breast milk, depending purely on your individual circumstances.

Every woman will find their unique way of squeezing out the milk, so do not feel odd when you fail the first time. By moving your fingers further behind or closer to the nipple, you will soon find the spot which gives you a spray of milk! Collect the expressed milk in a clean, sterile container.

Expressing milk with a manual pump
The pump works by exerting a suction effect on the breast. Place the suction pump over your breast and operate the pump according to instructions provided by the manufacturer.

Expressing milk with a powered pump
This is like a manual pump, except that it is powered by a battery or electricity. Once you place the funnel or suction cap over your breast with the nipple pointing at the centre and put on the machine, milk is extracted automatically.

END: PG MAY 07/56