How to manually express breast milk: recommendations and video tutorial. When exactly to express. efficient schemes. How long is breast milk

It is useful for any new mother to know how to properly express breast milk with her hands. Previously, even in the maternity hospital, they were taught to express after each feeding. The babies were fed on a schedule, so it was important to stimulate milk production. Today, doctors and consultants recommend feeding on demand. But in some cases, even now, additional manipulations cannot be dispensed with.

When is pumping necessary?

Nature has made sure that the composition of milk and its quantity are adjusted to the needs of a particular child. Regular application, especially at night, contributes to normal lactation. If everything is in order, then the baby will empty the chest. But sometimes it is difficult to do without pumping.

With a significant rush of milk after childbirth. Often it comes on the third day. At the same time, the sensations are not pleasant: a “stone” chest, which is painful to touch. Ideally, you need to constantly apply the baby, so two goals are achieved: the baby is saturated, and the mother feels relieved. But the newborn is still rather weak, he does not need much food, so he does not always cope. In addition, it is difficult for him to capture a richly filled chest.
To enhance lactation. Setting up this process is often not so easy. The mother's body needs time to determine the amount of milk that needs to be produced. But sometimes it turns out to be less than necessary, for example, if the baby does not grasp the breast correctly. Expressing breast milk helps to increase its production.
To maintain lactation. When a baby is not able to suckle on his own - as happens with premature babies - it is not necessary to stop breastfeeding. It is worth remembering its usefulness. If you express several times a day, including at night, then it is quite realistic to get a full daily portion. During the period of taking medications that are not compatible with feeding, you can carry out the procedure three times a day. This will support the production of milk for the period of treatment.
When mom has to leave. The smaller the child, the more often he eats. Often there is no way to leave it even for two hours. Milk keeps well in the refrigerator, so you can keep a supply of it for other things.
With lactostasis and blockage of the duct. If there is a stagnation of milk, then it is necessary to take action. If the child does not suck well on the affected breast, then it is necessary to express. Otherwise, serious consequences are possible, up to mastitis.

Mechanical and manual pumping

You can decant both with the help of a special breast pump, and manually. Both methods have their pros and cons. The manual method is less traumatic, the intensity of compression, movements are selected individually. In addition, it does not require any costs and is available at any time, no need to carry the device with you.

The advantage of the mechanical method is the rapid production of a large volume of milk. It is practically indispensable when it is not possible to put the baby to the breast: the baby cannot suckle, the mother is often absent, for example, she works.

How to prepare for the procedure?

Why is expressing milk often difficult? It's about how the chest is arranged. It does not have a special tank where milk would be collected. It is evenly distributed along the channels. So physical strength is unlikely to help extract any acceptable amount. The child does not need to make significant efforts: under the influence of hormones, the breast itself gives up its contents, helping the baby. Milk flows by itself. It is important to start this process when pumping, that's when it will be successful.

Hands must be thoroughly washed and dried before handling the breast. In order for the milk to flow well, it is worth attaching a slightly heated towel, drinking a glass of warm drink, and rolling the nipple between your fingers. Since the mother is tuned in to the baby, contact with the child will also be stimulation. You can hold him in your arms, look at him, even just smell the clothes he wore.

Expressed breast milk may separate. It's not scary, you just need to shake the bottle before feeding. It will become uniform again.

A well-established method of mitigation by pressure. It is especially effective in cases where the chest is full, the areola is hard or swollen. With this method, the fingers are placed near the nipple, gently pressed and held for at least a minute, and preferably three. Then uniform stimulation of the nerves will trigger the milk ejection reflex, and it will be easier for fluids to pass through the expanded ducts.

How to express properly?

Knowing the rules for expressing breast milk, it is easier to achieve the desired result.

Manual procedure is carried out according to the following scheme.

Prepare a container by washing it and dousing it with boiling water. It is convenient if it is with a wide neck.
Take a comfortable posture.
The fingers are placed where the light skin passes into the areola. In this case, the thumb should be on top, and the index and middle fingers should be on the bottom.
Press the fingers on the chest towards you. It will probably have to be repeated more than once before milk appears.
Then you need to make a squeezing movement, holding the fold and pulling it away from you. The procedure must be painless.
The fingers must be moved gradually so that all segments are emptied.

It is important not to rub the chest, you can not knead it, massage it, squeeze it. There is no point in pressing the nipple. The fingers should touch gently. So that they do not slip off, it is necessary from time to time to wipe them and the breast from milk with a pre-prepared towel or diaper.

The procedure takes from 5 minutes for each breast. After the flow of milk decreases in one, you can move on to another. Then repeat. It will take about half an hour in total. There is no need to strive to express milk completely: this is impossible, since it always arrives.

Possible mistakes

In cases where you need to express breast milk, it is important not to make common mistakes.

Using the wrong technique that causes pain. If everything is done correctly, then there will be no unpleasant sensations.
Carrying out manipulations in an inclined position. It takes half an hour to express milk. During this time, the back will get tired due to the load on the muscles.
Squeezing the nipple. Milk is not in it, so such actions are meaningless. But you can provoke cracks in it.
Inaccurate movements. The chest should not be rubbed and kneaded. Intense actions can lead to tissue injury, inflammation, mastitis.
Expressing too much milk. If the goal is to alleviate engorgement, then the procedure should be carried out until you feel comfortable. Otherwise, in the future, milk production will increase.

Errors include refusal to pump if the first attempts were unsuccessful. Do not give up, the breast will gradually begin to react and give milk in the desired amount. Especially when the subtleties of the tides are studied, the right movements are selected and the appropriate mood is created.

Features of breast milk

Breast milk should not be expected to look like cow's milk. It comes in different textures: yellow and oily or translucent and bluish. In any case, it is able to meet the needs of the child at different ages. No matter how it looks, it will not be empty, unless, of course, the woman eats well.

Milk keeps well. It can be kept in the refrigerator for a day, during which time it will not have time to deteriorate. If you need to keep it for a longer period, then you should freeze it. Then it will be usable for several months.

Some manufacturers produce special containers for storing milk. Or any glass container with a tight-fitting lid. Often, jars of baby puree are used for this purpose. It is best to defrost in a water bath. Before giving food to the baby, you should make sure that the milk is not hot and not bitter.

During the establishment of lactation, it is useful to know how to express breast milk, because it can come in excess. In addition, the possession of this technique will allow a nursing mother to make a small supply in the freezer. Then an unexpected absence or the need to take medication will not be taken by surprise.

Every nursing mother at some point in her "career" feels the need to express milk. Of course, we have it easier than our mothers and grandmothers, who were forced by Soviet punitive pediatrics to squeeze themselves “dry” after each feeding. Today there is enough information about the correct organization of breastfeeding, which does not require routine pumping. And yet, sometimes knowing how to pump your breasts can be a huge benefit.

Why breast pump

Expression of milk from the breast can be of two types: for the sake of the breast or for the sake of milk.

Breast pumping is needed when the supply (production) of milk exceeds the demand (needs of the baby). Milk comes in, but there is no one to suck it out. Perhaps mom is at work or breastfeeding is over. For prevention, it is necessary to express without fanaticism, only when discomfort (seals) is felt, only until this discomfort disappears. We must not forget that as much milk will come as was spent.

With breastfeeding on demand, constant pumping is not necessary: the amount of milk is regulated by the child himself. Frequent pumping "to the last drop" can lead to hyperactivation - excess milk production.

Does this mean that you don’t need to express at all, never and no one? Not at all. There are cases in which pumping is really necessary. Here they are:

With a strong postpartum flush milk, which is accompanied by engorgement (usually 3-4 days after birth). Here it is important not to overdo it and give the mother's body time to figure out how much milk the child really needs. Pumping begins no earlier than a day from the onset of the tide. The fact is that substances that signal that milk is being produced in excess appear in the breast only after a day. If you express milk earlier, then it will come again in the same amount. Your best breast pump during this period will be ... a child whom you will breastfeed at his request and on your own initiative, if the breast becomes stony between feedings.

And only in a situation where the baby does not want to suck in any way, it will be necessary to strain the chest until a feeling of relief.

For increasing lactation in cases where the child for some reason cannot empty the breast well enough. In this case, pumping plays the role of additional stimulation of the breast and increases the volume of milk produced.
For maintenance of lactation if mother and baby are temporarily separated. Expressing in a rhythm 2-3 times a day, you can maintain lactation for quite a long time. If you need to reach the volume of the child's daily diet, you need to do this at least 6-10 times a day, including at night.
If mom needs go away and leave milk for the duration of his absence.
In case of occurrence lactostasis- stagnation of milk. With lactostasis, you need to express if the child sucks on the diseased breast reluctantly or does not suck at all.

What is the best way to express - with a breast pump or with your hands?

Each option has its supporters. If you are expressing milk for the first time in your life, try doing it manually first. With your own hands you will not hurt yourself and you will not injure your chest with errors in technique. In addition, when pumping with your hands, you can take into account the anatomy of your breast, choose the right movements, speed and strength of compression.

When using mechanical devices, the risk of injuring yourself is much higher. The first three to four days after childbirth - during the colostrum period and the period of postpartum milk flow, as well as during milk stagnation (lactostasis), pumping with a breast pump is especially not recommended.

it is inefficient
you can only aggravate the swelling and worsen the outflow of milk.

On the other hand, a breast pump can be of great help to you later, when the breasts are already developed. It makes sense to use it when you need regular pumping - for example, if the mother goes to work or is often absent from the child.

Hand Expression Technique

Prepare a clean dish with a lid; it is inconvenient to express in a baby bottle, it is better to take an ordinary wide cup or bowl. Wash and dry your hands so they don't slip on your chest.

To improve the outflow of milk before pumping, you can: apply dry heat to your chest for a few minutes, drink something hot, warm your hands and feet in hot water, take a hot shower; roll the nipple between thumb and forefinger.
Sit or stand comfortably, place the dishes under your chest.
Place your thumb above the areola, and the index and middle fingers below it: the pads of the fingers and the nipple are in the same vertical line. Make sure that during pumping, the fingers are on the border of the areola and white skin, or slightly beyond this border.
Press your thumb and forefinger on the areola towards the chest (i.e. TO YOURSELF, not away from you). This may have to be done several times before the milk drips, flows or splatters.
Now make the next movement - “bringing out”: slightly squeeze the fold with your fingers and bring it forward (this time away from you). This movement is squeezing.
Move your fingers in a circle to empty all the lobes of the chest. Make sure that your fingers do not slip on the skin - for this, the hand and chest sometimes you have to wipe it, for example, with a diaper.
It is advisable to express the breast for at least 3-5 minutes, but not more than 20-30 minutes, changing the hand until the milk flows weaker. It is impossible to express all the milk from the breast “dry”, as it is produced constantly.

What not to do with manual pumping: rub, press, massage the chest, and also make any movements that bring pain.

Pumping technique

On the one hand, everything is easier with a breast pump: you just need to follow the instructions that come with it. On the other hand, it is more difficult: not every breast pump can effectively express exactly your breast. If you did everything according to the instructions, but did not achieve success, the following tricks can help:

comfortable posture, relaxed shoulders and neck;
such an inclination of the body, in which the chest will be turned down, will hang down;
warmth on the chest before pumping, hot drink;
express both breasts at the same time (here you need a double breast pump);
pumping right during the feeding of the child (we feed one, we express the second in parallel);
thoughts about the child, imagine him feeding;
"white noise": sounds of nature, running water, the sound of rain.

If you are unable to express milk

Have you not been successful or have you pumped less than you expected? When feeding on demand, the mother's body usually produces the amount of milk that is needed for one feeding. Accordingly, it can be difficult to get something extra. But do not lose hope: already from the third or fourth attempt, pumping will become more effective. The breast will “learn” to give milk in a new way, you will adapt to make the necessary movements, study the rhythms of the flow of milk, find the right mood. Pumping is a constant practice and experience.

Keep in mind that you can draw the required portion of milk not at once, but over several pumpings - for example, during the day. The expressed milk should be stored in the refrigerator.

What does expressed breast milk look like?

Some moms are scared by the sight of their own milk. It seems to them bluish, transparent, empty or, conversely, too fat. Breast milk is not like cow milk! It can look like melted butter, and like translucent bluish water. The expressed milk that has stood for several minutes may separate - the fatter component will float to the top in the form of cream, and the more liquid one will remain below. By the type of milk, it makes no sense to judge the nutritional value. The milk of one woman may differ from the milk of another, "two-week" milk is not like "three-month" - but at any lactation period it will certainly meet the needs of a particular child.

Storage of expressed milk

Expressed breast milk is stored:

without refrigerator - 12 hours
in the refrigerator - a day
in the freezer with quick freezing (temperature -18 degrees) - up to 4-6 months

As storage containers, you can use both special containers and clean glassware that is hermetically sealed. Baby food jars, for example, are fine. You can use just tight, hermetically sealed plastic bags.

To thaw your breast milk, hold the container of milk under running warm water. Check the temperature by dropping warm milk on the back of your wrist. Do not defrost milk in the microwave.

And the last. Be sure to taste the milk before giving it to your baby. It shouldn't be bitter!

To begin with, when a mother expresses milk, the same mechanisms are triggered as when feeding a baby, but weaker - after all, pumping is only a “manual imitation” of the natural feeding process ... and this even though you own pumping technique and know all the rules of hand pumping. However, in both cases, the hormone oxytocin first acts, which helps the milk to stand out, and when pumping itself, the hormone prolactin is produced, on which the amount of milk depends. From here follow two important pumping rules that a nursing mother needs to know:

In order for milk to be expressed well, you need to help the oxytocin reflex;
- pumping itself provokes further milk production.

Pump one breast for at least 5-6 minutes until the flow of milk slows down; then express the second; then both again. You can express each breast with one hand or change them if you are tired. The most effective pumping scheme is 5+5, 4+4, 3+3, 2+2, 1+1.

Do not trust pumping to anyone but yourself, unless a lactation consultant, and then it is better to listen to what he says, but do everything yourself. Otherwise, your chest may be damaged or injured.
Psychological moment: do not look into the pumping container! Studies have shown that you can express more milk without looking into the container.
Another illustration showing pumping technique. In the picture, the green arrows show the correct pressure points for a correct grip and correct pumping, the blue arrows show a good flow of milk. Incorrect pressure points are shown in red, they correspond to poor outflow of milk.

With breast engorgement and soreness, it is sometimes very difficult to express milk with your hands. In this case, a breast pump should be used. The breast pump is easier to use when the breasts are full. It may be less effective for soft breasts. It happens that mothers combine two types of pumping - first, the breast pump to the stop, then with their hands, or vice versa (in case the breast pump does not take the full breast well).

Also, a breast pump is useful when you have to pump often, as you can do some business while pumping. On the other hand, hands are a more versatile tool that is easy to clean, always with you, in any situation, and does not cost money.

It is worth noting that for better pumping results some points should be taken into account:
1. Fast, efficient milk flow is essential for optimal pumping. Large volumes of milk are not stored in the ducts because the lactiferous sinuses (dilated ducts) do not exist, so only a very small amount can be downloaded before milk is released. It is known that at first the baby sucks quickly, stimulating the "rush". Studies show that the rapid release of milk at the beginning of suckling leads to additional milk production.
That is why it is important to properly apply the baby to the breast to stimulate the tide, and when pumping, use a breast pump with two-phase pumping technology at the most comfortable level of vacuum, which effectively stimulates the flow of milk. In fact, 80% of breast milk is excreted in the first 7 minutes of using such a breast pump.
2. If you are pumping with a breast pump, please note that the funnels must be the correct size and fit for each individual mother. A properly fitting funnel will help avoid clamping the superficial milk ducts. It will allow you to completely and comfortably pump milk into the container.
3. Squeezing of the ducts and tissues during pumping leads to the fact that milk cannot flow freely from the breast; this provokes blockage and engorgement of the mammary glands, and then a decrease in the amount of milk. To avoid such situations, it is necessary that during feeding or pumping, you do not have to put too much pressure on the chest.

Rada Melnikova, Breastfeeding Consultant, Member of the CMPF,graduate of the ProGV Project www.progv.ru: Until now, you can sometimes hear advice to a young mother to express her breasts "dry" after each feeding. The arguments are very different: so that the milk does not disappear, so that there is no stagnation, “I did this, only thanks to this I fed!”. Indeed, in the middle of the last century there were such recommendations. There was a good reason for them: after all, then another recommendation was widespread - feeding on a schedule. The child was applied to the breast 6-7 times a day with a long night break. As a rule, one feeding - one breast, thus, the child was applied to each breast 3-4 times a day. Feeding in this rhythm is a critically insufficient stimulation of the breast to produce milk. Regular pumping in this case made it possible to somehow maintain lactation.

If the mother feeds the child on demand day and night, does not limit the duration of feedings, attachments to the breast for 12 days or more, the baby gains weight and develops according to age norms, then there is no need for additional pumping!

Milk production is the law of supply and demand: the more milk is removed from the breast, the more milk is produced, and vice versa. If a mother regularly expresses her breast, the body perceives this as a signal that the baby needs more milk than it actually sucks. This can easily lead to hyperlactation, and too much milk is no more pleasant than not enough milk, and can lead to congestion, inflammation in the mother, and digestive problems in the baby.

WHEN EXPRESSING CAN HELP

However, there are situations in which pumping can be very helpful. Here are the most typical ones.

1. Pumping in order to establish lactation and feeding a child who, for some reason, cannot yet breastfeed (a small, premature newborn, a child with anatomical structural features that make sucking difficult, other particular situations when it is difficult for a child to suck effectively).

2. Pumping to relieve severe fullness or breast engorgement, when it is difficult for a child to take a full breast.

3. Pumping to maintain lactation and feeding the child, if for some reason the child refuses or cannot temporarily breastfeed (refusal of the breast, illness of the child).

4. Expressing to increase the amount of milk when it is really needed.

5. Mom goes to work or she needs to be away from home (regularly or from time to time).

6. Pumping in case of stagnation of milk.

7. To maintain lactation, if the mother is forced to be separated from the child for some time.

HOW OFTEN DO YOU NEED TO PUSH?

Each situation is different and the best solution is to seek the help of a lactation consultant. The specialist will develop an individual pumping scheme, teach pumping techniques.

1. To establish lactation, if the child after childbirth for some reason cannot suckle, it is necessary to start pumping as soon as possible. Preferably within the first 6 hours after delivery. At first, it will be just a few drops of colostrum - the first milk that is in the breast of a woman immediately after childbirth.

Then you need to express approximately in the rhythm of applying the baby to the chest. At least once every 2-3 hours, including at night. Try to get at least 8 pumpings per day.

If nighttime pumping is difficult, one break of 4-5 hours is possible.

Night pumping is very important for sufficient milk production! Try to have at least 1-2 pumps between 2 and 8 in the morning.

Rare pumping or their absence in the early days, if the baby is not attached to the breast, can interfere with the normal development of lactation processes and provoke insufficient milk production in the future.

2. To maintain the amount of milk in the mother, if the baby is temporarily not attached to the breast, it is advisable to express at about the rhythm in which the baby sucked or a little more often, since no breast pump can stimulate the breast as effectively as the baby.

But not less than once every 3 hours for a child under 6 months.

3. No matter how much time has passed since the last pump, it is necessary to pump a little, until a feeling of relief, if the mother feels too full. Even if, according to the developed scheme, the pumping time has not yet come.

4. When working to increase the amount of milk or create a milk bank, everything is very individual and depends on the specific situation. Consult with a specialist!

5. If it is not possible to express as often and for as long as planned, it is important to remember that any breast stimulation is a “request” for the mother’s body to produce milk. Even 5 minutes of pumping is better than nothing. A child in the first months of life can be breastfed up to 20 or more times a day and suck from a few minutes to 1 hour or even longer. If you can't pump at a specific pace, just pump whenever you can.

WHEN TO DESCRIBE. EFFICIENT SCHEMES.

Here, too, there is no single algorithm, much depends on the situation. The general principles are.

1. If the baby is attached to the breast, then you need to express immediately AFTER feeding or 30-40 minutes after it (that is, between feedings), and not before. There are situations when pumping before feeding is acceptable and even necessary, but these are special cases and a specialist should recommend them. In the vast majority of cases, it is advisable to express after the baby has eaten well from the breast.

2. It is very effective to express one breast while breastfeeding the second breast, as the baby stimulates the flow of milk in both breasts by sucking.

3. The most effective pumping regimen is “5 + 5 ... 1 + 1”: first, 5 minutes on one breast, then 5 minutes on the other, then 4 minutes on each breast, then 3, 2, and finally 1.

4. Simultaneous pumping of both breasts also stimulates milk secretion and milk production very well (this can be done both with a breast pump designed for simultaneous pumping, and manually, after some training).

5. Usually one pumping takes 15-20 minutes for each breast. If you are working on increasing the amount of milk, continue to pump for another 2-3 minutes after the milk has stopped flowing.

6. Sometimes mothers combine two types of pumping - first they express with a breast pump, and then a little more with their hands. Often this allows you to express more milk.

7. Don't think too hard about expressing a lot of milk. Practice shows that if a mother expresses herself without looking into the container and not counting milliliters, then she manages to express more milk.

IMPORTANT! The baby creates a stable vacuum and performs a whole range of movements (almost all facial muscles are involved in the sucking process) in order to get milk. When pumping with your hands or with a breast pump (even the best), it is impossible to achieve a complete imitation of the actions of the child. Pumping is a skill! The volume of expressed milk cannot be used to judge whether a mother has enough of it.

EXPRESSION TECHNIQUE

What to express?

What is the best way to express - with a breast pump or with your hands? Each option has its supporters. If you are expressing milk for the first time in your life, try doing it manually. It is easier to control the process with your hands and immediately stop if the sensations become painful. When expressing with your hands, you will be able to study the characteristics of your mammary gland, choose effective pumping movements, speed and force of compression.

A breast pump is usually easier to use when the breasts are full. It may be less effective with soft breasts.

Some mothers note that immediately after childbirth, expressing with their hands is much more effective than with a breast pump.

There are women who, due to the characteristics of their breasts, cannot express a single drop with a breast pump, but they do it perfectly with their hands. Try and find your option.

If you have to pump regularly, consider using an electric breast pump. The best of the electric breast pumps are clinical devices and those that pump both breasts at once.

Avoid using the simplest "pears" - breast pumps: they are easy to injure the chest, and the pumping efficiency is low.

Never use a breast pump if your nipples are cracked or swollen! This may make the situation worse.

Preparing for pumping.

When milk is expressed in the body, the same processes are triggered as when feeding a child, but weaker - after all, pumping is only an imitation of the feeding process. However, both breastfeeding and pumping increase levels of the hormone oxytocin, which helps milk flow from the breast, and prolactin, which is responsible for milk production during lactation.

To help milk flow more easily from the breast, before pumping, you can help build the "oxytocin reflex". Here are some activities that can help you relax, calm down, and thus help milk flow more easily from your breasts and pump more effectively.

1. Wash your hands before you start pumping and have everything you need ready during the process (pumping container, warm drink and snack, tissues, phone, book, etc.)

2. Sit comfortably, relax, you can turn on quiet calm music.

3. To stimulate the secretion of milk, you can use a light breast massage: “tapping” with your fingertips, stroking, fingering “like loto barrels in a bag”, you can “shake” the chest a little, leaning forward, easily run your fingers from the periphery to the nipples. It's a good idea to stimulate the nipples for a while by gently sipping or rolling them with your fingers (just be very careful!).

IMPORTANT! From any action you should not be hurt!

4. It is very good to drink some warm drink before pumping. What exactly is not important, you should be tasty :-).

5. If there is no temperature and inflammation, you can warm your chest for several minutes immediately before pumping - for example, put a towel moistened with warm water on it, or take a warm shower. You can warm your hands and feet in water.

6. If possible, have someone close to you massage your neck and back - this will help you relax.

7. If the child is nearby, skin-to-skin contact helps, look at the child, touch him, hold him in your arms.

8. If the child is not around, you can look at his photo or keep some of his clothes nearby. Give free rein to pleasant thoughts about the child.

9. Some mothers in the process of pumping imagine a running stream of water, waterfalls.

You may feel the milk ejection reflex kick in or see the milk flowing from your breast, but you may not feel anything. In order for you to produce milk, you do not need to know about this reflex or feel it.

Hand pumping.

1. Place your thumb above the areola (or about 2.5-3 cm from the nipple) and your index finger opposite your thumb under the areola. The remaining three fingers of the hand support the chest.

2. “Roll” your fingers a little, put them a little higher or lower, feel for “peas” under your fingers (they are located approximately on the outer border of the areola). It is precisely on them that you will need to act (they can not always be felt. If you don’t feel anything, don’t worry, just keep your fingers approximately on the outer border of the areola). There is no milk in the nipple! 🙂

3. Slightly squeeze your chest back with your thumb and forefinger, towards the chest, as if pushing your fingers a little inward.

4. Roll your fingers forward and when the milk is squeezed out, relax your fingers. Repeat everything again. Important: fingers should not move over the skin, they stand in one place. They do not move, namely, they “roll” over the chest!

5. For the first minute or two, until the milk release reflex starts, it can stand out very weakly (or not stand out at all), it is important not to stop rhythmic decanting movements.

6. When the milk has ceased to actively flow out, move your fingers a little along the border of the areola and continue to express. From time to time move your fingers in a circle so that all segments of the chest are emptied evenly (the exception is the targeted pumping of a certain proportion during milk stagnation).

7. Direct pumping movements are good to alternate with additional stimulation. If you see that the outflow of milk has slowed down after the end of the tide, you can:

attach the baby to the breast (if possible),
drink something warm
make a light chest massage, and then continue pumping.

If you feel the “tides” well, then you can focus on the fact that for 1 “tide” about 45% of milk comes out of the breast, 2nd tide - more than 75%, 3rd tide - more than 94%.

If not, then just focus on pumping time (about 15-20 minutes for each breast).

Expression with a breast pump.

1. Read the instructions carefully: is the pump assembled correctly, are the parts in contact with the breast and milk clean.

2. It is important to choose nozzles that are exactly the right diameter, otherwise milk can be expressed painfully or inefficiently, cracks or swelling of the nipples are possible.

3. If your breast pump has multiple power levels, start at the lowest setting to avoid injury to your nipples, and then gradually increase the power until it is comfortable but not painful.

4. Stop pumping immediately if you get sick! Further:

make sure that the nipple is exactly in the center of the nozzle and that it fits you,
reduce the power
Don't pump too long, take breaks.

WHAT TO DO WHEN "THE MILK HAS COME"?

Separately, you need to talk about the correct actions at the time of the arrival of milk (usually on the 3-5th day after childbirth). Even before giving birth, many mothers hear stories that “on the third day my milk came, my breasts became just stone, everything hurts, the baby does not suck, they barely drained! And what a pain!” And this very arrival of milk and decanting "to the stars in the eyes", mother begins to expect with fear. And, meanwhile, with the right actions after childbirth, you may not feel anything at all at the time of the arrival of milk, or the sensations will be quite comfortable and the breast will simply become more full. What should these actions be?

1. The most important thing to do is to ensure the removal of milk from the breast from the first hours after childbirth. This is done by applying the baby to the breast at least once every 2-2.5 hours or by pumping, as described above.

If the first milk, colostrum, is not removed from the breast before the arrival of a large amount of milk, then in the future it becomes literally a cork that prevents the outflow of milk from the breast (since it has a thicker consistency).

2. The key to removing milk from the breast is effective suckling. Make sure the baby is well latched onto the breast and sucking out the milk, and not just holding the breast in her mouth.

Here are the signs that all is well:

the baby's mouth is wide open (obtuse angle of 120 degrees or more),
both lips are turned outward,
the tongue covers the lower gum,
in the mouth, not only the nipple, but also most of the areola,
cheeks are round, not retracted,
the child's chin is pressed to the chest,
You do not hear any extraneous sounds when sucking,
You don't get hurt,
when the baby releases the breast, the nipple is round or slightly oval (not flattened, no creases and bevels).

3. Continue to apply the baby at least once every 2-2.5 hours or express (if it is not possible to attach the baby) after the arrival of milk.

4. If at first there is a lot of milk (and this is normal in the first days), and the chest is full to the point of discomfort, you can sometimes pump for 3-5 minutes, “to relief” between the main pumping, if the baby is not applied to the breast . Or apply the child more often, if possible.

5. Between pumping or feeding, you can apply a cool compress (for example, a diaper soaked in cool water). Well relieves discomfort and swelling.

IMPORTANT! With any manipulation of the chest, you should not be in pain! In no case should you aggressively massage, knead the seals, or painfully decant. These actions are not related to the exit of milk from the breast, but can lead to injuries of the mammary gland and the development of inflammation.

You can massage very gently and apply the baby to the breast more often or gently express it (if you don’t have the opportunity to attach the baby).

6. If you understand that the situation is out of control: