How to express breast milk. Manual expression of milk. Execution technique

Today, breastfeeding experts say that with stable lactation, the mother does not need to pump. The intensity of lactation directly depends on how often the baby suckles, that is, the baby himself regulates this process. However, in some cases, pumping is not necessary to maintain lactation.

Important! No method of pumping will allow you to completely repeat all the movements that the baby makes when sucking, and you will never be able to express the same amount of milk that the baby can suck from the same breast

When should you express milk?

Birth of a premature baby. Babies born prematurely may not have a developed sucking reflex, and their need to receive mother's milk is perhaps even higher than that of full-term babies. After all, he must quickly gain strength and make up for everything that he did not have time to do, being born earlier.
Poorly developed sucking reflex. Such children fall asleep during feeding, swallow rarely, are lethargic, and in some cases may refuse to breastfeed.
Insufficient lactation. It can be observed both from the first days and appear after some time.
Establishment of lactation. Immediately after childbirth, the mother begins to produce colostrum, which, despite its small volume, is nourishing and very healthy. After colostrum comes milk, the amount of which is usually too large for a newborn. At this stage, it is important that the overfilled breasts be emptied so that the already stronger baby will have enough milk in the future. There is no need to be fanatical here, expressing everything to the last drop; it is quite enough if you feel that the breasts have become soft and the feeling of fullness in the chest has gone away.
Stagnation of milk (), threatening the development of mastitis. It can be caused by various reasons, including improper pumping. It is observed in individual lobules of the breast due to blockage of the ducts leading to the nipple. In this case, milk is expressed from separate lobules of the mammary gland that have hardened from excess milk.
Taking medications that can be passed on to the baby through breast milk. Expressing in this case serves as a tool that allows you to save in the future. Expressed milk has to be thrown away. At this time, the baby eats formula, unless the mother, knowing about the upcoming medication, has not prepared expressed milk in advance.
Inverted or flat nipple. Before you start pumping for this reason, you should try using special breast pads and if nothing works out, start pumping.
The child is separated from his mother. The need is quite understandable, because if the mother works, is forced to leave for several hours, or if the child is undergoing treatment without the mother, the child cannot be left without breast milk, especially since lactation may decrease with regular separation.

Which method to choose

There are two ways to express - expressing by hand and using a breast pump. The main guideline for choosing one method or another should be the frequency of pumping. If you do not plan to be separated from your baby for a long time, for example, when going to work, then you most likely will not need a breast pump. In this case, it is best to master the technique of hand expression.

Important! The main guideline for choosing one method or another should be the frequency of pumping. If you plan on expressing occasionally, then it is better to choose hand expression.

Regardless of which pumping method you use, to increase its effectiveness, you need to remember some simple rules.

if possible, sit next to the baby, let him touch the breast - this will release more milk;
if the baby is not around, look at his photo, think about him;
10-15 minutes before pumping, drink a warm drink;
take a warm shower or apply a towel soaked in warm water to your chest;
Do a breast massage using one of the options suggested below.

1 massage option

Sit comfortably and do a light, pressure-free chest massage. To do this, first make circular movements with four fingers from the edge of the breast to the nipple (Fig. 1), and then stroking the mammary gland along the flow of milk (Fig. 2). Such movements will help the movement of milk even through the narrowest ducts. Areas with compactions are massaged with spiral stroking and finger tapping. At the next stage, it is necessary to form the nipple by first squeezing the isola (Fig. 3), and then, as if stretching the nipple itself with your fingertips (Fig. 4).

2 massage option

Place the mammary gland between two palms and, bringing your palms together, gently squeeze it.
Next, use your fingers to smoothly move your breasts, first away from the armpit and then towards it. Return to the original position and grab your chest, squeezing lightly with both palms, as shown in the last picture.

As soon as the milk begins to flow out, you can start pumping.

Manual method: instructions and video

Prepare a clean container with a wide neck and a towel, and wash your hands.
Place your thumb on top of your chest, and place the rest of your fingers under your chest. The distance from the fingers to the nipple should be approximately 2.5-4 cm, depending on the size of the breast.
With a gentle movement, the chest is compressed with the fingers towards the chest, i.e. back, after which the fingers move forward to the nipple. The movements should not resemble friction, but rather rolling. Then repeat in the same sequence. At first, these steps may take a few minutes. The pressure should not be increased. We must patiently continue squeezing. At the same time, milk is released, first drop by drop, and then in streams.
Move your fingers around the breast so that milk comes out from all the breasts. You will understand when to do this by the nature of milk secretion.
Try not to let your fingers move onto the nipple when sliding towards it, otherwise injury may occur.
To prevent your fingers from slipping due to droplets of milk, wipe your chest and arms from time to time.

Important! At the beginning of lactation, pumping can be unpleasant or even painful, but if you feel pain when pumping a healthy breast when lactation is already established, there is reason to think that something is going wrong.

Advantages of the manual method

no special devices are required;
freedom to choose the place and time to express;
greater efficiency with properly mastered pumping technique;
indicated for nipple injuries that are aggravated after using a breast pump;
WHO recommendations;
according to surveys, some women find it easier to express with their hands, since the breast pump often causes pain;
for breast problems caused by lactostasis, problem areas are better worked on with your hands;
recommended in the first three days after birth when expressing colostrum.

Using a breast pump

A breast pump is a special device for expressing milk. Its main advantage compared to manual expression is the time savings. Manufacturers of breast pumps advise using them when milk begins to be produced steadily and a certain feeding regimen is established, that is, 2-4 weeks after birth.

First of all, you should always focus on the attached instructions. All the rules stated below are of a general nature.

The breast shield is selected based on the shape and size of the breast, so that it fits snugly to the breast and at the same time ensures freedom of movement of the nipple when expressing. Otherwise, pumping will be slow and painful.
Before expressing with a breast pump, we use the same preparation as when expressing by hand.

Procedure

It is best if you give one breast to the baby when feeding, and express the other. Technically, this is quite difficult to do alone, so ask your husband or one of your relatives to help you.

Stress and breast milk supply

Why is it so important for a nursing woman to remain calm, have a favorable psychological climate in the home, and simply be in a good mood? To answer this question, it is important to understand the mechanisms that trigger the process of milk secretion. The main hormone that regulates the secretion of breast milk during breastfeeding is oxytocin. This hormone starts the process of “squeezing” milk out of the alveoli of the mammary gland - small balls that produce milk. Milk fills the ducts, and the woman feels a rush of milk. The peculiarity of this hormone is that its work is highly dependent on the environmental conditions and condition of the woman. If a woman is stressed or in a noisy place, it can hardly be expected that milk will be released in sufficient quantities. The fact is that in such situations, an oxytocin antagonist, adrenaline, is released, which reduces milk production.

There is also a psychological point: it has been noticed that if, when expressing, you watch how full the pumping container is, you will never express a lot of milk. Therefore, try not to look at the set of precious milliliters.

Important! Unsuccessful pumping attempts do not indicate a low amount of milk in the breast. It is impossible to express to the last drop, since milk is produced continuously in the breast.

How much milk should you express and how often should you do it?

In order to increase the amount of milk, you need to pump frequently, but no more than once an hour.
If you are away from your baby, remember to pump every three hours at night. This is one of the conditions for maintaining
To relieve your breasts, you don’t have to pump until the last drops; stop as soon as you feel a sense of relief.
When expressing milk for feeding, complete the process after reaching the desired mark, using both breasts alternately if necessary.
If you are pumping, you should pump each breast for at least 15 minutes. If it becomes “empty” before this time, then after the feeling of emptiness appears, express your breasts for another 2 minutes.

Storing expressed breast milk

Like any food product, expressed breast milk has its own storage characteristics, if not observed, it can not only lose its beneficial properties, but also become harmful.

Breast milk storage containers

They can be made from various materials, the main thing is that they are clean and tightly closed. Modern mothers highly value convenience and ease of use in purchased containers for storing breast milk, in particular the volume corresponding to one dose of feeding, the presence of a measuring scale, and tags where you can indicate the date and time of pumping. In appearance, these can be bags, containers, bottles. For freezing, the ideal option is bags that will not burst when frozen like glass or plastic containers.

Milk storage bags Milk storage containers
Milk storage bottles

However, not everything is so simple from a security point of view. Glass containers and special polymer bags for storing milk are considered the safest to use. If you still choose plastic containers, you should definitely pay attention to their suitability for storing, freezing and heating milk. To do this, you need to determine the material from which they are made. This information, as a rule, is always contained at the bottom of the container in the form of a triangle with a number in the middle and other additional images.

To store expressed milk from all types of plastic, it is best to prefer polycarbonate dishes (number 7) and polypropylene dishes (number 5). Moreover, on polycarbonate dishes there must be an additional symbol “Bisphenol A free” or “BPA free” or “0% BPA”. This means that bisphenol A was not used in the manufacture of polycarbonate, which tends to transfer from plastic to products during long-term storage or heating.
In conclusion, it must be said that it is not necessary to sterilize reusable milk storage containers. It is quite enough if they are washed well by hand or in the dishwasher. Instead of using detergent, you can pour boiling water over the container.

At what temperature should it be stored?

Human milk has the unique ability to inhibit the growth of bacteria for a long time, so if after 4-6 hours you plan to feed your baby with it, then it is not necessary to put it in the refrigerator, unless of course the room is cool. Storing milk for several days requires the use of a refrigerator, and an even longer freezer.

Approximate shelf life of expressed milk

Storage conditions	Freshly expressed milk	Thawed in the refrigerator	Defrosted and reheated	Defrosted, reheated and started
Room +26-+32ºС	3-4 hours	0.5-1 hour	Until the end of feeding
Room +22-+25ºС	4-6 hours	1-2 hours	Until the end of feeding
Room +19-+22ºС	6-10 hours	3-4 hours	Until the end of feeding
Portable cooler or thermal pack with ice +10-+15ºС	24 hours	4 hours	Do not store
Refrigerator 0-+4ºС	6-8 days	24 hours	4 hours	Do not store
Old style freezer -10-15ºС	2 weeks	Do not refreeze
Freezer -15-18ºС	3-5 months	Do not refreeze
Deep freezing chamber below -18ºС	6-12 months	Do not refreeze

Freezing breast milk

Immediately after expressing, cover the container of milk, and if using a freezer bag, remove the air from there. The less air the expressed breast milk comes into contact with, the better it will be stored.
Make a note on the container indicating the date of pumping. Breast milk has a very interesting property - it is produced at the moment with the exact composition that the baby needs. Therefore, it is better to use it as quickly as possible, first of all the portions expressed earlier.
Cool the expressed milk in the refrigerator (+2...+4°C) for several hours, and then place it in the freezer as deep as possible. This is done so that temperature fluctuations when opening the door are minimal.
Freeze in small 30-60 ml portions if you plan to use it occasionally. Systematic feeding requires freezing in different volumes: 100-150 ml for normal feeding and smaller portions if additional feeding is needed.
Small portions of milk expressed from different breasts during the day can be mixed into one.
It is allowed to add freshly expressed milk to frozen milk less than an hour ago, if the new portion is smaller than the previously frozen one.

How to tell if milk has gone bad

Storage of milk affects its organoleptic properties. Therefore, it is important to distinguish spoiled milk from good milk that has changed its characteristics.

Many mothers worry when they see that during cooling the fatty part of the milk separates from the main mass, and they think that it has spoiled. This is not a sign of spoilage; just stir the milk and it will return to its normal appearance.
Sometimes after defrosting, milk smells like soap or tastes bitter. This smell is the result of the action of the milk enzyme lipase, which breaks down fats.
When frozen, milk turns pink, blue, or other tint. It is believed that this may be due to the action of the same lipase or to natural or artificial colors in the mother’s food.
Spoiled milk has a sour smell.

Rules for defrosting and heating milk

What to do if your baby refuses to eat defrosted milk

Pay attention to whether you follow all the rules for freezing milk.
If this does not help, before freezing, pasteurize the milk in a water bath at a temperature of 62.5ºC (the first bubbles appear in the pan) to deactivate the lipase. Do not bring to a boil. Then cool quickly and freeze. Of course, this will destroy many valuable components, but still such milk will be healthier than formula.

Types of breast pumps

Based on their mechanism of action, types of breast pumps are divided into mechanical and electrical. Improved models of breast pumps have two-phase pumping modes. First, the mammary gland is subjected to a soft and rapid effect, stimulating milk secretion, and then slow and deep expression of milk begins.

Mechanical breast pumps

The driving force that creates a vacuum in such breast pumps is the mechanical forces on the part of the device that the woman produces.

pros

low price;
no power supply required;
does not create unnecessary noise;
the force of pumping is regulated by the woman herself depending on her feelings;
All parts can be washed and sterilized.

Minuses

time is saved insignificantly due to slow work;
after prolonged use, you feel tired in your hands;
fragility of some models.

Despite all the disadvantages of mechanical breast pumps, if you express occasionally 1-2 times a day, these models are quite suitable for you.

Syringe breast pump

Pump breast pump. This is the simplest and most inexpensive type of breast pump. Consists of a breast attachment and a rubber bulb (pump). When pumping, both hands are occupied: one hand presses on the pump, creating a vacuum, causing a rush of milk, and the other presses the device to the chest. The milk then flows into the pump, and as it fills, it must be poured into the bottle. An improved version of the pump breast pump is a breast pump with a bulb connected through a hose to a bottle.
Syringe breast pump. Consists of two cylinders nested inside each other. At the end of one of them there is a funnel that is adjacent to the nipple. By moving the cylinders relative to each other, like in a syringe, a vacuum is created and milk is extracted from the breast.
Piston breast pump. Just like a pump breast pump, it consists of three parts: a silicone breast attachment, a mechanical part and a bottle. Mechanical part in this case represents a lever. Press the breast pump tightly to the breast and, using the lever, achieve expressing milk from the breast.

Pump breast pump Breast pump with bulb
Piston breast pump

Electric breast pumps

In electric breast pumps, the driving force behind expression is electricity, which powers a motor that creates a vacuum. The woman just has to press the button.

pros

quick milk collection;
pumping modes of varying strength;
Suitable for regular pumping.

Minuses

high price;
creates a lot of noise.

A high-tech variation of the electric breast pump is the electronic breast pump. In addition to the existing capabilities of an electric breast pump, an electronic memory is added here that can remember an individual pumping mode and reproduce it the next time the device is used. At the same time, when expressing, a breast massage occurs, which improves the movement of milk through the ducts, thereby maximally imitating the sucking process of an infant. Some models don't even require hand support. Electronic breast pumps are quite expensive; it is better to rent them.

Electric breast pump Electronic breast pump

Breast pump equipment

In addition to breast pumps, you can purchase spare containers for storing milk and freezer bags. There are breast funnels of different materials and diameters. All this is also sold in ready-made sets.

In contact with

Should I express breast milk? This is the most controversial and discussed issue among nursing mothers. Many doctors still promote it without obvious motivation.

However, according to WHO recommendations, there is no need to express milk provided that lactation is properly managed (this is when milk in the breast is produced on demand, i.e. the hormone oxytocin begins to be actively released when it is time to feed the baby).

So should you express breast milk or not? It is justified only in cases of necessity, and we will discuss which cases these are in this article, and also dwell on the intricacies of this procedure and the issues of storing already expressed breast milk.

When is it necessary to express breast milk?

There are not many such situations, but it is in these cases that it becomes a necessity.

	Babies born prematurely do not yet know how to breastfeed because they lack the sucking reflex. But they are able to absorb mother’s milk, moreover, they, like no one else, vitally need natural nutrition, saturated with all the necessary substances that accelerate ripening and growth.
Poorly developed sucking reflex, various pathologies in a child	In medicine, there is such a thing as a “lazy sucker.” A weak sucking reflex is due to various reasons, including pathologies of the central nervous system. However, this is not a reason to stop lactation; milk can be expressed and offered to the baby in an easier way - through a bottle.
Lactation deficiency	Is it possible to express milk when the quantity is already small? The recommendation that milk production is increased by expressing is still not universal. Pumping and natural breastfeeding are two different things, and feeding has a much stronger effect on the process of milk retention. But in the fight for lactation, all means are good: you should express your breasts next to the baby and with thoughts about him, as this promotes milk production.
Formation of lactation (milk supply)	The first milk that is produced after childbirth is not such. This colostrum is a thicker and richer substance, very filling and healthy. There is not much of it, but the child is satisfied in a couple of sips. On the 2-3rd day milk comes, and in such a volume that it is impossible for a still weak baby to cope. Swollen and heavy breasts need to be released, because not drinking milk is a signal for a decrease in its production. In order for milk to be produced at the same pace, and for an already strong baby to have enough of it, you need to pump, but not to the last drop, but until the breasts become lighter and softer.
Milk stagnation is a condition that threatens the development	Such a disaster happens when the breast is sucked incorrectly, when the baby’s sucking reflex is weak, and also when pumping incorrectly! In this case, it is targeted, from hardened slices.
Taking medications that are excreted in breast milk	Very few drugs of synthetic and herbal origin are allowed during breastfeeding. In situations where, for health reasons, a nursing mother is forced to take certain medications, she needs to express herself and pour the expressed milk down the drain - this is the only way to maintain lactation. Of course, this is not very good for lactation and for the baby, since he will have to eat formula. Alternatively, if the mother knows that she will be taking medications soon, she can store milk for future use, which we will discuss below.
Flat, inverted nipple	The reason is somewhat arbitrary, since there are special covers that are placed on the nipple and make breastfeeding easier. If all else fails, you need to pump your breasts and bottle-feed your baby.
Separation from a child	If the mother needs to go somewhere, or she works, pumping is indispensable if breastfeeding is a priority. The same situation arises if the baby is undergoing treatment, but without a mother - the milk can be expressed and transferred to the staff for feeding.
Preparing breast milk for future use	The desire to preserve breast milk for as long as possible is the reason that many mothers simultaneously feed the child and store milk for the future. But this makes sense when the mother plans to stop breastfeeding soon, but does not want to deprive the child of a valuable product. During storage, mother's milk still somewhat loses its beneficial properties, and storage also has its own strict deadlines.

Hand expression technique

How to express breast milk by hand? Before you begin this important task, preparation is necessary. If you need more milk to be released, pumping should be done next to the baby or his photograph, with thoughts about him, and best of all, touching the baby. 10-15 minutes before this, you can drink warm tea or water, massage your breasts a little, or let your baby touch your breasts. A warm shower stimulates lactation well. Hands must be washed with soap.

The thumb is placed on top of the areola, approximately 3 cm from the nipple, the index and ring fingers are located below, opposite the thumb, with the same distance from the nipple. With a gentle but confident movement, the chest is squeezed with your fingers in the direction of the ribs, i.e. back, after which the fingers roll forward, towards the nipple - at this moment the milk is squeezed out. Then everything is repeated.

Don’t feel sorry for yourself, press your chest confidently. It might hurt the first time. When expressing correctly, milk flows out in streams, not drops;
move your fingers around the orales to extract milk from all the lobules;
Be careful not to let your fingers slip onto the nipple, as it could injure him. If the milk makes your skin very moist, dry your breasts and arms, and then continue pumping;
Do not express milk until the very last drops, but until your breasts are relieved and empty.

How to express breast milk manually is usually explained in the maternity hospital, but if difficulties arise with expressing, be sure to consult your gynecologist.

Rules for expressing milk with a breast pump

Breast pumps have come to the aid of modern mothers - convenient devices that allow you to quickly and conveniently obtain breast milk. There are many types of breast pumps, which differ in price, mechanism of action and manufacturer (see, review of the best, advantages and disadvantages of manual and electric).

Preparing for expressing with a breast pump is the same as for expressing by hand. The breast pump must be clean and sterile.

How to express with a breast pump correctly? These devices always come with detailed instructions on how to properly use a particular breast pump. Let's consider the general rules of mechanical expression, since when using different models the process occurs in different ways.

The breast pump funnel is placed against the breast so that the nipple is in the center.
It is important to ensure that the funnel fits snugly against the dry skin of the breast to create a vacuum.
Further actions depend on the type of breast pump: you need to start squeezing the pump or bulb, press the piston handle (manual breast pumps) or turn on the start button on an electric breast pump.
Manual breast pumps require constant hand work - you need to rhythmically press the bulb, pump or piston handle.
When using electric breast pumps, you only need to control the process by adjusting the pumping force to suit you. By the end of the process, the breasts become empty and soft, and the flow of milk becomes a trickle.

In all cases, the flow of milk should be uniform and fairly active. Expressing should not cause pain (this is only possible in the first minutes when using simple pear-type breast pumps). After the procedure, the breast pump must be washed and sterilized.

Storing expressed breast milk

You should know literally by heart how to store expressed breast milk, because if milk is stored incorrectly, it can become not only useless, but also harmful.

Breast milk is the same food product as formula or milk from a package, which can spoil, turn sour and be easily colonized by pathogenic microbial flora if not stored properly.

Where to express milk - milk storage containers:

If this is a one-time case, you can express directly into a sterile baby bottle. The milk is stored in the same bottle and then fed from it.
If you use an electric breast pump, then most models come with bottle containers, which are also a place for receiving milk, subsequent storage and feeding - a nipple or lid is put on top of the container.
If you intend to store milk with a temporary supply of several days or more, then it is convenient to use special plastic containers, which are sold in pharmacy chains and children's stores. They are sterile and can easily be placed in the refrigerator and freezer (Philips AVENT, Chicco, etc.).
Also, for long-term storage, you can use glass baby food jars, which need to be sterilized in boiling water along with the lids for 2-3 minutes. But glass should not be placed in the freezer, as the jars may burst there.
Special industrial bags are very convenient to use because they have graduations and a place where the date and time of pumping are marked. They are easily closed using a special lace or rivet. This is an ideal option for freezing milk (disposable bags from Medela, Ardo Easy Freze, PIGEON, Lansinoh, Dr. Brown’s, etc.).

It is not advisable to pour milk several times, i.e. from one container to another, and express directly into the one that is then used for storage.

How long can I store expressed breast milk?

At room temperature, milk can be stored without refrigeration for about 4 hours. Naturally, it should not be exposed to the sun.
In a refrigerator at a temperature range from 0 to 4 C, milk can be stored for up to 4 days, but ensuring it is at the same temperature, for which the milk must be placed closer to the back wall of the refrigerator.
In the freezer at a temperature of about -18 C, milk can be stored for up to six months.
This also makes it clear where to store expressed breast milk. When storing for more than 4 hours, only in the refrigerator, and frozen milk only in the freezer.

Where to store expressed breast milk during a long journey in a car or train, when there is no refrigerator?

If you need to travel, you should purchase:

cooler bag
thermal bag - they are equipped with special cold elements that provide a certain temperature
an ordinary thermos, which, in addition to preserving heat, also perfectly preserves cold - chilled breast milk is poured into the thermos, pre-cooled from the inside. You can cool a thermos using ice frozen from boiled water.

Can breast milk be frozen? This question began to worry nursing mothers since the advent of household freezers. Low-temperature storage provides an excellent supply of time - up to six months, so it is actively used by mothers.

How to freeze breast milk? Before freezing, milk is cooled naturally in the refrigerator in the same container in which it will be frozen. The fewer transfers from container to container when storing milk, the more sterile it will be later.

After cooling, the container with milk is placed in the freezer and the freezing mode is turned on. To store frozen milk, you need to allocate a separate shelf, eliminating contact with other food products. Be sure to label each container with the date it was frozen.

Feeding expressed breast milk

How to warm up expressed breast milk? After storing in the refrigerator, milk should be heated in a water bath, hot water or a special bottle warmer. After storing in the freezer, the milk is defrosted in the refrigerator to a liquid state, and then heated using the methods described above.

Never use microwave or convection ovens, or boiling water to heat and defrost milk! Microwaves kill all beneficial substances, the structure of milk changes and instead of benefiting it, it only brings harm to the child.

Milk that has been heated, either from the refrigerator or from the freezer, must be used at once; the rest must be discarded. Shake the bottle before feeding, as milk separates into fractions during storage.

How can I use expressed breast milk? You can give it as the main food, make porridge on it, soak cookies in it. Some mothers practice using breast milk in preparing children's dishes - omelettes, porridges and other things, but milk that has been boiled is of little use, antibodies and vitamins will be mercilessly destroyed, and the protein will curdle and become poorly digestible.

Current questions about pumping

Should I express breast milk from both breasts?

Depending on the goals and time for which the mother is separated from the baby, the need to pump from both breasts is assessed. If the mother leaves for 2-3 hours and has fed the baby before, milk from one breast is quite enough. If the time period is longer, both breasts are expressed.

How often should I pump?

How many times should I pump?

Again, depending on the situations, it can be either sporadic or constant. If this is regular pumping, the mother should focus on the time periods during which the baby usually suckles. Of course, the stored milk should be enough for the child for the time that the mother plans to spend away from him.

Should I pump my breasts at night?

When separated from the baby from birth, night pumping is a prerequisite to maintain lactation, and this must be done at least once every 3 hours. The baby may not be able to drink this amount of milk, especially if he is premature, but it can always be stored for future use or, in extreme cases, thrown away if the mother does not recognize the value of frozen breast milk. In this case, the process of starting the production of further portions of milk, which is triggered by pumping, is important. If the mother no longer breastfeeds at night, then there is no need to do this at night.

How long does it take?

The manual process takes more time and lasts about 20-30 minutes, with a breast pump it takes about 15 minutes.

Is it possible to mix portions of milk obtained from several approaches?

You should not mix milk, even if one portion is 20 ml and the second is 100.

Is it possible to give milk to a child that has been stored without refrigeration for more than 4 hours?

Theoretically, milk does not spoil for up to 6 hours even at a temperature of about 25 C. But if it is summer and the bottle has been exposed to sunlight, it is better not to risk it.

Is it possible to breastfeed and express the other breast at the same time?

Technically, it’s difficult to imagine, but some mothers manage to simultaneously feed their baby and pump, citing that in this case more milk is released. If the child does not suffer, then this is possible, but only if you express by hand. But it’s better not to do this, because you will have to constantly be distracted from the child.

Which is better - hand expression or breast pump?

From a safety point of view, a sterile breast pump is a more reliable device than the mother’s hands. But in each case everything is individual. If you express your breasts with your hands correctly, no problems will arise.

Is breast milk healthy if it has been frozen?

Yes, it’s healthy, much healthier than any milk formula! But subject to the storage time, constant freezing temperature excluding changes and re-freezing, and the rules for defrosting milk. And, of course, it cannot be boiled.

And finally, why express breast milk?

If you don't see it as advisable, enjoy breastfeeding and let the moments arise when the need arises!

Every nursing mother sooner or later has to face the need to express milk. This must be done correctly so as not to damage the breasts and glands. There are 2 ways: manual and using a breast pump. Everyone chooses the method that they consider more suitable for themselves.

Indications

The reasons why a mother needs to express milk can be different:

For whatever reason, mom needs to go away. There will be no opportunity to breastfeed the baby. In this case, you need to stock up on food for the child in advance.
The first time mothers encounter the need to pump is during the first postpartum milk flow. During this period, the body can produce it in excess.
If the mother is undergoing drug treatment while breastfeeding.
To maintain lactation, if for some reason the baby cannot be put to the breast (for example, the mother urgently had to leave for 1-2 days).
Expressing milk can be used to stimulate the glands.
If your nipples become excessively rough, this procedure will help develop your breasts.
If the child is weak and does not have enough strength to suckle on a solid breast on his own, express a little milk to make the baby’s task easier.
With stagnation of milk (lactostasis).

To express milk, the mother chooses the method that seems most convenient to her. However, using a breast pump increases the risk of injury. Also, special devices are not recommended for use during lactostasis and during the first week after birth, while the breasts are developing. The rest of the time, a breast pump will help speed up and simplify the process.

Preparation

When the breasts have already been developed, there is no stagnation, special manipulations and a special attitude are not needed. However, at first, you will need a little preparation before expressing breast milk. Each woman chooses those methods that will be most effective for her, because what is suitable for one mother may be completely ineffective for another. In most cases, all efforts are aimed at causing milk flow. For this purpose it is necessary:

Warm your chest. Dry heat can be used. A hot shower helps a lot because it relaxes you. Some people may find it sufficient to apply a towel soaked in hot water.
You should drink something warm 10-15 minutes before the procedure.
Imagine your baby next to you in as much detail as possible: smell, voice, eyes, etc.
Shake and massage your breasts a little.
If the baby has enough milk from one breast, then the other can be expressed during feeding.

More thorough preparation will be needed for lactostasis. In this case, stagnation has already occurred. Before you express your milk, you need to stretch and rub your breasts well. Then do a special massage. This will take 15-20 minutes.

Hand expression technique

You should only express breast milk with clean hands. Before the procedure, they must be washed thoroughly. You also need to prepare the dishes in advance. This should be a wide-necked container or bowl. Dishes must be sterilized!

So, how to properly express breast milk by hand?

You need to prepare your workplace: sanitize your hands and utensils. Place the container at chest level so that you don’t have to reach or bend over to it later. Take a comfortable position. You can express milk while standing or sitting.
You need to clasp the areola with your fingers so that the big one is on top and the rest are on the bottom. The position of the brush will resemble the letter “C”.
The thumb and index finger should be brought together, squeezing the dark circle near the nipple. In this case, the fingers should not cross the border of the areola or come off the skin.
The remaining fingers support and also squeeze the breast a little, helping to express it.
First drops will appear, then the milk will flow in streams.
The fingers need to be moved in a circle to free the other lobes of the mammary gland.

As a rule, it takes 10-15 minutes to express milk by hand from one breast. But the procedure can take up to half an hour. A little practice and this action will no longer cause difficulties or difficulties.

A few notes

To avoid problems when expressing milk, it is necessary to take into account a number of nuances:

The fingers should be clearly fixed in one place, they should not fidget back and forth on the surface. Otherwise, abrasions may appear on the skin.
It is imperative to change the position of the fingers, since the mammary gland is divided into segments. Each of them should be expressed.
But at the same time, you need to not overdo it and stop in time to find out if the milk has run out. Further ineffective attempts will only injure the glands.
It is necessary to change breasts when pumping: 5-7 minutes one, then the other. And so 2-3 times. It will take at least 20 minutes to completely empty.
Do not squeeze your breasts too hard: the amount of milk you express depends on the correct technique, and not on the force of pressure.
There is no need to pull the nipple, as this can lead to cracks.
Your fingers should only press lightly on the areola.
If the technique of expressing breast milk is correct, then pain does not bother you. If there is discomfort, it means something is being done wrong.
Be sure to take a comfortable position so that you do not have to bend over, as this can lead to overload of the back muscles.
Before pumping for the first time, you should consult your doctor.

Advantages and disadvantages

Like any method, expressing milk by hand has a number of positive and negative properties. The undoubted advantages include the following:

no contraindications;
no need to invest money;
the woman herself regulates the entire process;
the risk of injury is minimized;
less discomfort than when using a breast pump;
upon contact with skin, milk production is stimulated;
You can develop the chest only with your hands;
absence of side effects (for example, when using devices, the areolas may increase in size, the skin becomes rougher, etc.).

There are a couple of disadvantages to this method:

high-quality pumping requires quite a lot of time;
requires training in proper technique;
not all women are able to carry out the procedure efficiently and empty the glands, so in some cases the effectiveness this method becomes very low.

What to do with milk?

Sometimes when you pump, you get quite a lot of milk. In this case, you need to decide what to do with it. It is best to store the product in the refrigerator in a sterilized container and tightly sealed so that harmful microorganisms cannot enter it. At room temperature, breast milk can be stored for up to 8 hours. It can be kept in the refrigerator for no longer than 2 days (but it is better to keep it within 24 hours). You can also freeze it. In this case, the shelf life is extended to 4 months.

Expressing breast milk is not as difficult as it seems at first glance. After a little practice it will be easy. When performing all movements, you need to monitor your sensations and listen to your body. It is important to learn to understand when to stop and when to continue.

These days, the promotion of long-term breastfeeding has reached its peak. This is not surprising and brings only positive aspects. Mother's milk is all that a baby needs for proper development and growth, for his health and the health of his mother.

Expressing breast milk: when to express

But in the life of any woman who breastfeeds at least a little, a situation may arise when it is impossible to put the baby to the breast, when for some reason you have to skip feeding. Most often, this is separation (if the mother needs to leave, if the mother works, and one of the relatives or a nanny remains with the baby) or, what is much worse, the mother’s illness.

Proper storage of expressed breast milk

With the first situation, everything is more or less clear - you can express the milk remaining in the breast after feedings (fortunately, modern convenient breast pumps from Avent, Medela, Chicco allow you to do this easily and quickly). This milk can be cooled in the refrigerator, and then the required portions can be heated to body temperature (the optimal temperature for offering food or drink to the baby). Chilled milk can be stored in the main chamber of the refrigerator at a temperature of 4-6 degrees for a day or two. Particular attention should be paid to the cleanliness of the devices that you will use when pumping - this is very important! The situation is much more complicated when it comes to the mother’s health (especially if she needs a course of antibiotics) or a long separation between mother and baby (for example, when a working mother who is breastfeeding her baby is forced to go on a business trip).
In such and other similar situations, there is a need to create “reserves” of milk. Chilled milk is not stored for a long time, so it must be frozen in order to be used later to feed the baby. Undoubtedly, frozen and then melted milk is not exactly the same as fresh milk from the mother's breast. Moreover, it has to be given from a bottle, which many children do not like and do not recognize (especially those who have been breastfed on demand for a long time). This, of course, can be dealt with by offering the baby to drink from a spoon, cup or sippy cup; Children aged about one year can be offered a straw.

Freezing breast milk

According to experts - and this is no secret to anyone - frozen milk loses some of its anti-infective properties. Based on this, some pediatricians recommend switching the child to formula for a while. But introducing formula is a somewhat lengthy process, and it cannot be introduced into a child’s diet at once and in the required volume. In addition, the mixture is still an artificially created product, and only as close as possible to the composition of human milk. Whereas mother's milk is the product that the baby “knows” well, which the infant’s body is accustomed to receiving, and which ideally suits the requests and needs of a particular child. From this point of view, it is better to feed the baby with milk that has been expressed and frozen, rather than looking for some other options. There are a few simple rules to follow when expressing, freezing, storing and using breast milk.

Clean pumping

A sterile breast pump and bottles, clean hands and breasts of the mother - without this, expressing and storing milk makes no sense. The desire for cleanliness should be laid down almost at the level of instincts, because we ourselves always wash our hands before preparing food or going to dinner. So even when expressing with a breast pump, do not forget basic hygiene rules.

Shelf life of breast milk

Deep-frozen milk, which is stored at the back wall in the freezer (at a temperature of minus 18-20 degrees) is suitable for feeding a baby for 2-3 months from the moment of freezing.

How to freeze breast milk

How to freeze. It is better to freeze milk by first cooling it (in the main chamber of the refrigerator). It is best to use ice molds for freezing - the “cubes” are almost identical (usually 15-20 ml in volume depending on the shape), they can easily fit even into a small bottle neck and thaw quickly. A convenient and practical solution to this issue was found by Avent, which produces special kits for expressing, freezing, storing milk and its subsequent use for feeding a child. This set includes a breast pump, sterile disposable milk bags, a bag holder and pacifiers. Under no circumstances should you add freshly expressed milk to already cooled or, especially, frozen milk.
You should not add frozen milk to already thawed or, especially, heated milk. It is better to melt milk in the main chamber of the refrigerator (gradual thawing, but it takes time). You can melt the milk in a water bath. You can also heat thawed milk in a water bath or a special device for heating baby food. In this case, one should take into account the fact that overheating the milk will further reduce its anti-infective properties.

There is no exact data on changes in the properties of milk after defrosting and heating it in a microwave oven. However, it is not recommended to heat milk in the microwave, primarily due to the risk of “hot drops” in the milk that can burn the baby. The experience of expressing, freezing and then using breast milk is just as important as feeding itself. After all, sometimes it is “milk reserves” that help preserve and even prolong natural feeding. Whatever it is, mother's milk will always remain so. Indeed, for a child, especially in the first months of life, breast milk is food, health (essential vitamins, minerals, antibodies that help strengthen the immune system), comfort, and the closest and warmest contact with the mother. Nature has not created anything better than mother's milk. And it’s unlikely to create one anymore.

How to pump properly to increase lactation

Young mothers often hear advice that expressing milk is an integral part of breastfeeding. However, this statement is erroneous.

When feeding on demand, when the baby correctly grasps the mother's breast and the mother produces as much milk as the baby needs for daily consumption, pumping is not a necessary procedure.

When to pump

But there are a number of situations when it is simply impossible to do without pumping. For example, if the mother has more milk than the baby can consume. In this case, the remaining milk may stagnate and lead to painful sensations. Or vice versa, if there is not enough milk, that is, lactation is reduced, then pumping can stimulate its increase. Expression is also necessary when the mother needs to leave temporarily or can no longer attend maternity leave. And if the mother has lactostasis, mastitis, or hardened and cracked nipples, then pumping is necessary for medicinal purposes.

Let's talk about how to pump correctly. As a rule, expressing is done using hands or a breast pump. Before starting the procedure, it is recommended to take a warm shower. In order to open the milk ducts, you need to make a warm compress (a piece of cotton cloth is moistened with warm water and applied to the breast) and massage. The massage is done like this: one hand supports the breast from below, and the fingers of the other massage it in a circular motion. If lumps are found in the chest, then the massage should be the most intense in these places. You need to stretch both breasts, after which you can start pumping.

Technique for expressing breast milk

To express, you will need a sterile container and clean hands. Place your thumb and index finger on the outer contour of the areola. Use gentle rhythmic movements to press on the areola. Having emptied one area of the breast from milk, you should move to the adjacent one. Repeating the compressions, you need to move clockwise until the entire chest is emptied. These steps should be applied to both breasts. When expressing, do not directly squeeze the nipple, as this can lead to microtrauma. As a rule, even in the maternity hospital, the midwife should familiarize the young mother with the pumping procedure. If this does not happen, then the necessary information can be obtained from a lactation consultant.

Today there is a wide range of mechanical and electric breast pumps. Some mothers believe that this is a very important and necessary device. But there will definitely be those who prefer manual expression. It should be noted that with the help of such a technical device you can express only the front part of the breast. The remaining milk is expressed by hand.

Expressed breast milk can be stored for 10 to 14 hours at room temperature (19-20°C), a day at 15°C, about 2 days in the refrigerator (6°C), up to 7 days in the freezer.

The healing properties of breast milk

Every woman knows how important breast milk is in the life of every baby. It contains all the necessary elements for the normal growth of the baby. But many people don’t even realize that milk has healing properties.

I was still in the maternity hospital. I just gave birth to my first daughter, Katyushka, and I developed cracks on my nipples. It was very painful. But I didn’t know how to treat it. The cream didn't help. She would have endured it if the doctor hadn’t come in and asked, “Do you already have milk?” So what are you waiting for? Treat with your milk." And left. I tried it. After each feeding, I left a drop of milk on the nipple. Until it dried out. And literally the next day almost everything went away. And there was no trace left of the cracks.

Breast milk will also help your baby if he has a runny nose. Place a couple of drops of milk in each nostril and observe. The child will breathe better. And the runny nose will go away quickly.

If a child’s eyes become sour, you can use special drops, you can rinse with tea, or you can rinse with breast milk. When feeding, drop a couple of drops on the eye. And the eye will soon stop turning sour.

That's exactly what we did. And when I saw that the child was getting better right before my eyes, I began to appreciate breastfeeding and understand how important it is for my child and how much it gives him.

How to properly express breast milk video

How to properly express breast milk by hand? In what cases is this necessary? What is the technique of the procedure and how to make it easier? What to do next with the resulting product and how to feed expressed breast milk? Features of manual expression in the formation of proper lactation and solving problems.

There are a lot of misconceptions about pumping while breastfeeding. They were formed historically, so they are still practiced not only in the outback, but also in families during the formation and maintenance of lactation. Among these misconceptions there are truly dangerous ones. Let's look at them in detail.

5 dangerous myths

Expressing breast milk is not a mandatory procedure for every breastfeeding woman. Experts from the international breastfeeding organization La Leche League insist on this. They also dispel the main myths that exist in this area today.

Myth 1: You need to express milk after every feeding.

Even 40 years ago, medicine was of the opinion that this should be done without fail. The reason for this is the approved principle of feeding according to the regime. According to it, it was allowed to put a baby to the breast no more than six times a day and only to one breast per feeding. Such rare breast stimulation led to frequent mastitis and the complete disappearance of lactation within three months. Pumping solved the problem and made it possible to maintain a woman’s health while maintaining lactation for a longer period of time.

Today, lactation consultants, when asked whether it is necessary to express milk after feeding, answer: only if there is a need for it. It may be dictated by the following factors.

Not enough milk. Due to insufficient quantities, the child does not eat enough and does not gain weight. Pumping allows you to increase lactation by naturally stimulating it. Nature intended this mechanism to be self-regulating. That is, the flow of milk occurs exactly in the volume in which it was drunk.
Need stock. Pumping allows you to build a “milk bank” in case you leave your baby for a while. Relatives or a nanny can feed your baby your milk.

Myth 2. You need to express until the last drop.

La Leche League expert Natalia Gerbeda-Wilson argues that this is not necessary. Moreover, it is simply impossible to express to the “last drop”. Milk does not enter the breast all at once, but flows into it constantly.

Myth 3. Even if there is enough milk, you still need to express it

This misconception only leads to an excess of milk in the breast, causing a feeling of fullness. You have to get rid of the milk by pumping again, and the process repeats again. If there is enough milk, there is no need to express it! Otherwise, the volume of lactation will be uncomfortably large for you and the baby.

Myth 4. Breasts must be expressed by hand after childbirth

This is also not necessary if your baby was born healthy and is nearby. Have you received any medications that would prevent you from starting breastfeeding immediately? Your baby will stimulate lactation much more effectively than pumping, and the process itself will become much more enjoyable and less traumatic.

Myth 5. You need to express with force.

One of the most dangerous misconceptions that causes injury to the delicate tissue of the mammary glands. It is impossible to squeeze milk out of them, no matter how hard you press on them. Moreover, there are no “reservoirs” in the breast itself where it would accumulate in large quantities. Valuable fluid is distributed evenly in the mammary gland and is located in its ducts.

The process of milk secretion is ensured solely by hormones. The work of both is important here.

Oxytocin - it provides the very factor for milk flow. This factor becomes a consequence of the influence of “external stimuli”. These include the warmth felt by a woman’s skin when the baby is applied to the breast, the smell of the baby, and gentle stimulation of the glands. When the “oxytocin reflex” is achieved, milk begins to pour out of the breast on its own, without any effort.
Prolactin is a hormone that controls the amount of milk and restores it to the volume that was removed from the breast.

With rough mechanical impact, the integrity of the breast tissue is disrupted. This becomes a risk factor for the development of lactostasis and mastitis.

Rules for hand expression

Modern medicine names 6 situations when you need to express breast milk. In other cases, this procedure will be useless and even harmful.

Relief from full breasts. If milk comes in abundantly, you can express it slightly. It is important to do this until you achieve a feeling of lightness and comfort. It is important to avoid excessive engorgement due to the risk of microtrauma of the mammary glands, soreness and injury to the nipples. You should express little by little, since additional “selection” of milk will only lead to increased milk production.
Inability to breastfeed naturally. If a child, for a number of reasons, cannot suckle on his own, in order to maintain lactation and establish breast milk feeding, it is important to express the valuable product. It should be used to feed the baby.
Mom's illness. If infectious mastitis develops or medications that are incompatible with breastfeeding are taken, it is necessary to maintain lactation by removing milk from the breast with your hands. The resulting product should be poured out. In the future, you will be able to continue breastfeeding.
Formation of lactation. In the first days, the volume of milk may not be enough for the baby. Additional stimulation of the mammary glands will allow the development of lactation.
Prevention of lactostasis. If lumps are found in the mammary glands, you need to gently massage these areas and express a small amount of liquid. Regular self-examination and light massage will be the best protection against the formation of stagnation.
Mom leaving. A woman’s inability to always be with her baby does not mean it is necessary to interrupt breastfeeding. Mom can express milk daily in the morning and evening for afternoon feedings. Or create a “power bank” if you plan to leave for several days.

In other cases, pumping while breastfeeding is not necessary. If the baby is eating well, growing well, and you are not bothered by chest discomfort, then the lactation process is ideal.

Marmet technology

How to express breast milk by hand? Marmet technology has been developed for an efficient and safe process. Despite its apparent simplicity, comprehending it is akin to art. This process is only superficially similar to sucking; in fact, for the body it is artificial and unnatural. To master it, you need to understand a few subtleties.

The breast “gives” milk on its own. This happens when the level of “oxytocin factor” is sufficient. The best incentive for him is having a child nearby.
Pumping may not produce much milk. Often a woman has no problems with feeding, but when she needs to leave and leave a “portion for lunch,” she cannot express even a couple of spoons. The fact is that the mammary glands need to be “taught” to release the product on demand. Only personal practice will help with this.
There is no milk in the nipple. Therefore, it is pointless to stimulate him. The valuable fluid is located in the ducts of the gland itself, and it should be “pushed” to the exit by influencing the area around the nipple.
To increase lactation, you need to express little by little, but often.. This is more effective than prolonged mechanical action and straining “to the last drop.”

The technique for correctly performing the procedure is as follows.

Wash your hands with soap and wash your breasts.
Drink warm tea, relax, place a towel soaked in warm water on your chest. Warmth and peace help the hormone oxytocin create a milk production factor.
Place the container near your chest and hold it with your left hand.
Place your right thumb on the areola above the nipple. It should be located at the “junction” of the nipple and white skin. Place your middle and index fingers under your thumb, at the bottom of the nipple.
Gently press your fingers on the mammary gland in the direction of the chest, wait a few seconds. Relax your fingers after milk appears. Repeat again.
Move your fingers to other parts near the nipple area. This will allow fluid to be evenly removed from all lobes of the mammary gland.

Do not apply significant force when performing the procedure. Movements should be soft and careful. Proper pumping is only painless, so if you experience discomfort, change the technique.

Fingers should not “fidget” over the skin, as this can lead to irritation and chafing. It is important to firmly fix them in place and apply gentle pressure. It may take you one, two, five minutes for the milk to appear. It is in the chest and will definitely appear! Therefore, continue with rhythmic movements. Once you're done with one gland, move on to the next one.

For painful nipple engorgement, try this technique from breastfeeding expert Jim Ketterman. It offers relaxed pressure on the nipples for the initial flow of milk. Place all fingers directly on the nipple and apply gentle pressure for three minutes. This will soften the breasts and make pumping painless.

Using expressed milk

In addition to the questions of whether you need to express after each feeding, and how to do it correctly, there are many others. Let's answer the main ones.

Do not heat breast milk in the microwave! Microwaves destroy active immune factors and reduce the quality of baby food. In addition, there is a risk of too hot “areas” in the container and burns to the delicate surface of the baby’s mouth.

Only practice and personal experience will help you master the technique of hand expression. When you need to learn quickly, a breast milk pumping service can help. Its specialists help nursing mothers at home or with consultations online or by phone. Reputable breastfeeding organizations such as La Leche League provide free consultations. In their opinion, using the correct technique of manual expression according to indications allows you to solve lactation problems, so it is important for every woman to know its features.