Why might I want to express my milk?
The usual reason for expressing breast milk is to make breast milk available (in a bottle or a cup) to your baby when you are not there. This might be because you are at work, in which case you might need to express every day, or because you want or need some time away from your baby occasionally. You’d then express less regularly.
A few mothers have to express from the start, because their babies are unable to feed at the breast. This includes babies with a severe cleft lip and/or palate; babies who are born several weeks pre-term and can’t co-ordinate sucking and swallowing (a skill which isn’t present if the baby is very pre-term) or babies who are too ill or weak to suck. These babies may be tube fed with expressed breast milk.
How often should I express?
If you are expressing instead of breastfeeding, then you need to express as often as you’d expect your baby to feed. That way, your breast milk supply is stimulated. For a young baby, you should aim to express at least 6-8 times a day. For an older baby – say, one of three or four months or more – who is being breastfed when you’re with him, you should express every three to four hours, maybe once or perhaps twice in the working day, if you feed your baby last thing before you leave him, and first thing when you get back.
When should I express if I am also breastfeeding?
It’s up to you. Some women express immediately after a breastfeed. Some do it at the same time as their baby is feeding – with the pump at the breast the baby isn’t on. Others do it between feeds. Find out what suits you best. You won’t be ‘pinching’ milk the baby needs – expressing stimulates your breasts to make milk, so you are increasing your supply, not decreasing it.
How long should each session take?
At the very beginning, express for a few minutes on each side. After a few days, you will find you need to take about 30 to 40 minutes in total to get the maximum amount, perhaps stopping and starting, and switching sides. If you get expert, you will then take less time to get more milk.
What should I use?
A pump, electric or manual, is helpful, though a lot of women learn to hand express and get very adept at this. Your midwife or a breastfeeding counsellor can teach you. Some pumps allow you to ‘double’ pump, which means you, express both breasts at the same time. NCT can hire you an electric pump – the big ones you see in hospital – but you can also buy smaller mains or battery operated ones. There are a number of good manual pumps available these days, too.
How much do I need to express?
This is difficult! Babies differ so much. Tiny pre-term babies can only take tiny volumes, of maybe less than 20mls at a time. Older, stronger babies take a lot more. A very rough rule of thumb is that a feed is something between 100mls and 200 mls – with older babies taking more at any one time. You may need to express more than once to get large amounts.
How do I store it?
Breast milk is safe in the fridge for 24 hours and in the freezer for 3 months. Sterilise anything you keep the milk in before you use it. Freeze breast milk in small quantities – ice cube trays are ideal. Small amounts defrost quickly, and you don’t need to defrost more than you need at any one time. Defrost by either standing it in the fridge over night or by standing the container in a jug of boiling water. The milk should be body temperature when you give it to your baby – test a few drops on the back of your hand.
How can I find out more about expressing?
Expressing is quite a detailed subject, and there is no ‘one size fits all’ set of solutions to everyone’s situation. You can ask a breastfeeding counsellor from the National Childbirth Trust (see your phone book), your midwife or health visitor.