Milk does not flow well when pumping. Hello. The question is. The mechanism of milk production in the mammary glands

Breastfeeding often involves a procedure such as pumping. Many mommies don't know enough about this process and booty breast milk from the mammary gland for them becomes torture or does not work at all. How to properly express breast milk? Why is this necessary and is it necessary at all? How long can this product be stored and how to do it correctly?

Why Express Breast Milk?

There are many reasons for breast pumping:

• Stagnation in the mammary gland, which can lead to mastitis. In this case, pumping is a necessary procedure.
• The baby weaned from the breast during a break in breastfeeding and does not want to take the breast. Then the mother expresses herself and feeds the baby with breast milk from a bottle.
• The breast is too full, the nipple is tense, the baby cannot take the breast. A little pumping of breast milk will help relieve tension, and the baby will feed on his own.
• Mom often has to leave for work or study. In this case, expressed milk is an excellent alternative to adapted formulas.
• Taking medication by the mother leads to a forced break in breastfeeding, and pumping helps to maintain lactation.
• Often you have to pump to increase insufficient lactation.
• If the breasts are too full and sore, and there is no way to feed the baby, then pumping will help relieve the condition.

All these reasons are quite common, and the pumping procedure really makes life easier for a young mother. The main thing is to know how much and when to express breast milk so that the procedure brings relief, and does not aggravate the situation.

When and how often to pump

The frequency of pumping procedures and the amount of milk received directly depends on the cause:

• At congestion- once every 1-2 hours. You need to express the amount of milk that will succeed before the compaction decreases. The procedure should last at least half an hour, but not longer, as too long pumping can injure the mammary gland.
• To increase lactation - after feeding and one or two times in between the child's meals. The procedure lasts about 10 minutes after feeding and 15 minutes in between.
• To relieve breast fullness, it is enough to express only when discomfort is felt. In this case, you need to express very little milk only to a state of relief, since the more you express, the more it will arrive next time. In this case, you need to express no longer than 5 minutes.
• To maintain lactation during a break in breastfeeding, it is necessary to express every three hours, imitating the baby's feeding regimen. The amount of expressed milk should be sufficient so that when you resume breastfeeding the baby ate. The length of each procedure is from 20 to 30 minutes.
• In order to make supplies, it is enough to express several times a day in between the baby's meals. The time and amount of expressed milk should be chosen so that by the next feeding the breast has time to fill up and the child does not remain hungry. In this case, everything is individual and depends on the particular woman, the volume of her lactation and the rate of breast filling.

How much milk can be expressed in one procedure

It all depends on when mommy pumps. If immediately after feeding, then you can not get a single drop of valuable liquid. The exception is hyperlactation, when there is too much milk.

Immediately before feeding the child, you can get 50-100 ml. This portion is enough to fully feed the baby with expressed breast milk. Sometimes, even before feeding, mothers cannot strain anything - this indicates the wrong technique.

Milk is expressed especially well at night, since it is at night that prolactin is produced, it is responsible for milk production. Therefore, to replenish supplies, it is better to pump between 2 a.m. and 6 a.m.

The reasons for the small pumping can be:

• The baby eats all the milk produced.
• Not correct technique hand pumping or a poorly fitted breast pump.
• Mom is too tense and cannot relax.
• A woman neglects preparation for pumping and does not wait for the tide.

Basic rules for expressing breast milk

Subject to these rules, pumping procedures will be completely safe and will only benefit:

• Breast pumping shouldn't hurt! If any painful sensations appear, then this indicates an incorrect technique, and pumping must be stopped.
• Before the procedure, be sure to wash your hands with soap and prepare a clean boiled container for the resulting dairy product.
• In order for pumping to go as quickly and painlessly as possible, before it you need to cause a rush of milk (wash your chest warm water, contact with the child, drink a warm drink, easily massage the mammary glands, give one breast to the baby, and express the other at the same time).
• After the milk has arrived, you need to express it with your hands or use a special apparatus. When hand pumping, only the right technique is important (learn more about how to express breast milk with your hands,). During the hardware procedure, you should correctly select the breast pump and accessories ().

The mammary glands should be massaged gently and gently, in circular motions, without squeezing them.

It is necessary to alternately change the grip of the areola to horizontal and vertical. Such decanting will be more effective.

The correct position of the fingers when grasping the nipple is indicated by green arrows. Red arrows show wrong capture

Selection of the funnel of the breast pump according to the size of the nipple

• The pumping process should not be too fast. You can not pull hard, crush and pull the chest. You need to work for 4-5 minutes with each mammary gland alternately.
• If it doesn’t work out the first time, then don’t despair. You need to try again, and soon everything will definitely work out. The main thing is not to be too zealous so as not to damage the chest.

How to express breasts for the first time

The first pumping will have to be done in the hospital. Most likely, lactation will be plentiful, and a newborn baby is not able to eat so much milk. Pumping will help avoid congestion. And also decanting is necessary to relieve tension that prevents the child from grabbing the nipple.

Basic principles:

• Don't panic and don't worry.
• Carry out the very first procedure under the supervision of a nurse to ensure proper technique.
• Listen carefully to your feelings. There shouldn't be any pain.
• Express milk only until relieved, so as not to increase lactation even more.

How to express breasts with mastitis or congestion

To express or not breasts with congestion and mastitis? Of course, express! This is the main prevention and treatment similar states. Sometimes mommy can only get by with breastfeeding, but often even a child cannot resolve lactostasis. There are several features of the pumping procedure for mastitis and congestion:

• It is necessary to determine exactly where the seals formed. This is usually felt immediately, but you can gently feel the mammary glands to make sure.
• Before pumping, gently massage the breast or take warm shower. The pressure of water and massage with light pats should be directed exactly where the stagnation has arisen.
• Do not try to crush or knead the bumps: this is extremely dangerous! Everything must be done with the utmost care.
• With purulent mastitis, you can not warm the chest!
• During the pumping process, direct efforts to those parts of the mammary glands where stagnation has formed.
• In no case should you press on the place of stagnation!

Subject to these rules, pumping will be as painless as possible, and the unpleasant phenomenon of mastitis or congestion will gradually pass.

Do I need to pump "stone" breasts

Often in the first days after childbirth, one can observe such a phenomenon as a "stone" chest. At the same time, the mammary gland is hard and tense, swelling is observed, the nipple is retracted or flat. Many experts believe that this is normal, the baby will dissolve the breast, and the phenomenon will go away on its own. But in practice, the newborn cannot even grab the nipple to start the meal. As a result, the baby is hungry, and the mother suffers from heaviness and discomfort.

Signs of a "stone" chest. She is shown on the right in the picture.

Pumping will help get rid of the "stone" breast. There are several rules:

• A breast pump will not help in this case. First you need to work with the nipple to give it the desired shape.
• Then you can start pumping. Milk will drip in drops, this is a sign that the ducts have not yet developed.
• If it doesn't work right away, try again. You can not leave the matter halfway, as stagnation may form.
• You can try this method: take the breast at the base with both hands and slightly pull forward towards the nipple. So the milk flow can go easier.
• After expressing some milk, you can offer the breast to the baby. If the nipple is formed and the main tension is gone, then the baby will cope on its own.

How to feed your baby with expressed milk

In order to feed the baby with expressed breast milk, it must be heated to a temperature of 36 degrees. If the milk was in the refrigerator, then it is heated in hot water, in a water bath or in special electric heaters.

Frozen milk must be taken out, put in the refrigerator so that it takes a liquid form. After that, it is heated, as described above.

Experts do not advise using microwave ovens to heat milk, as microwaves destroy its structure and destroy many useful substances.

During storage, milk can be divided into fractions, then before use, you need to shake the bottle several times, and it will take on its original form.

When milk is taken out of the freezer or refrigerator, it must be used all at once. The rest must be poured

Can I give my baby food made from breast milk?

Experts do not advise cooking hot dishes based on breast milk, such as cereals, omelettes, casseroles. The fact is that the main benefit will be destroyed by heat treatment. Protein under the influence high temperatures curl up, and it will be difficult for the child to learn it.

It is good to give breast milk by mixing it with baby biscuits, for example. You can also use a slightly warmed strained product as the basis for instant cereals that do not require cooking.

How long is breast milk

The shelf life of milk depends on the storage method:

• At room temperature milk is stored no more than 6-8 hours. If the house is very hot, then it is good for food within 4 hours.
• In the refrigerator - 2 days.
• In the freezer - 1 year.

Tip: When expressing, you need to mark the container, indicating the time and date of the procedure. So the likelihood that the baby will eat an expired product is significantly reduced.

Is it possible to mix milk expressed at different times

The ideal option is to express into a separate container each time, but if this is not possible, then you can mix the expressed milk, following a few rules:

• Collect and mix expressed milk only for one day.
• Each serving should be expressed into a separate container and then cooled in the refrigerator to the same temperature.
• Do not mix breast milk of different temperatures!

Many experts generally advise against mixing milk that has been expressed in different time, since the composition and taste of the liquid is different each time. When mixed, the taste can change unpredictably, the child will simply refuse to drink it, and all the work will be lost. Therefore, mixing is a forced measure, which should be avoided if possible.

Pumping is really easy. Subject to simple rules this procedure will great helper during GW.

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

Important! No way of pumping will allow you to 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 milk be expressed?

1. Birth premature baby. Born ahead of time babies may not have a sucking reflex, and their need to receive mother's milk is perhaps even higher than that of full-term babies. After all, you need to quickly gain strength and make up for everything that he did not have time, being born earlier.
2. Weakly developed sucking reflex. Such children fall asleep during feeding, rarely swallow, lethargic, and in some cases may refuse to breastfeed.
3. Insufficiency of lactation. It can be observed both from the first days, and manifest itself after a while.
4. Establishment of lactation. Immediately after childbirth, the mother begins to receive colostrum, which, despite its small volume, is satisfying and very useful. After colostrum comes milk, the amount of which, as a rule, is too large for a newborn. At this stage, it is important that the overcrowded breasts be sure to be released so that there is enough milk in the future for an already strengthened baby. Here it is not at all necessary to show fanaticism, decanting everything to the last drop, it is quite enough if you feel that the chest has become soft and the feeling of fullness in the chest has gone.
5. Stagnation of milk (), threatening the development of mastitis. Can be called different reasons, including improper expression. It is observed in individual breast lobules due to blockage of the ducts leading to the nipple. Expression of milk in this case is carried out from individual lobules of the mammary gland hardened from excess milk.
6. Taking medications that can be passed to the baby through breast milk. Pumping in this case serves as a tool to save in the future. The expressed milk has to be thrown away. The baby at this time is fed with mixtures, unless the mother, knowing about the upcoming intake of the drug, has not prepared expressed milk in advance.
7. pulled in or flat nipple. Before you start pumping for this reason, you should try to use special overlays for the chest and if nothing works as a result, start expressing.
8. The child is separated from the mother. The need is quite understandable, because if the mother works, is forced to leave for several hours, or if the child is on treatment without a mother, the child cannot be left without breast milk, especially since lactation may decrease with regular separation.

Which way to choose

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

Important! The main guideline for choosing one or another method should be the frequency of pumping. If you plan on pumping from time to time, it's best to opt for hand pumping.

Regardless of which pumping method you use, there are some simple rules to keep in mind to increase its effectiveness.

• if possible, sit next to the child, let him touch the breast - so more milk will stand out;
• 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 put a towel soaked in warm water on your chest;
• do a breast massage according to one of the options below.

1 massage option

Sit comfortably and give a light, pressure-free breast massage. To do this, first do circular motions with four fingers from the edge of the breast to the nipple (Fig. 1), and then stroking the mammary gland in the course of milk secretion (Fig. 2). Such movements will help the promotion of milk even through the narrowest ducts. Areas with seals are massaged with spiral strokes with tapping fingers. At the next stage, it is necessary to form the nipple by first squeezing the peripapillary region (Fig. 3), and then, as it were, pulling the nipple itself with your fingertips (Fig. 4).

2 massage option

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

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

Manual method: instruction and video

1. Prepare a clean wide-mouth container and a towel, and wash your hands.
2. Place your thumb on top of your chest, 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.
3. With a gentle movement, the chest is squeezed with 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. These steps may take a few minutes to get started. 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.
4. Move your fingers around the breast so that the milk comes out of all the lobules. When to do this, you yourself will understand by the nature of the milk secretion.
5. Try not to slide your fingers onto the nipple, otherwise injury may occur.
6. To prevent your fingers from slipping due to milk droplets, wipe your chest and arms from time to time.

Important! In the early days of lactation, pumping can be uncomfortable or even painful, but if you feel pain pumping healthy breasts while you're already lactating, there's reason to think something's going wrong.

Advantages of the manual method

• no special devices are required;
• freedom of choice of place and time for pumping;
• greater efficiency with properly mastered pumping technique;
• indicated in the presence of nipple injuries, which are aggravated after the use of a breast pump;
• WHO recommendations;
• according to surveys, some women find it easier to express with their hands, as often the breast pump causes pain;
• with breast problems caused by lactostasis problem areas are better worked out by hand;
• recommended in the first three days after childbirth when decanting colostrum.

Using a breast pump

A breast pump is a special device for expressing milk. Its main advantage compared to manual pumping is time saving. 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 childbirth.

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

The funnel is selected based on the shape and size of the breast, so that its snug fit to the breast at the same time ensures the freedom of movement of the nipple during pumping. Otherwise, pumping will be slow, causing pain.
Before expressing with a breast pump, we use the same preparation as when expressing with our hands.

Procedure

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

Stress and the amount of breast milk

Why is it so important for a nursing woman to maintain calm, a favorable psychological climate in the house and just good mood? To answer this question, it is important to understand the mechanisms that trigger the process of milk release. The main hormone that regulates the release 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. A feature of this hormone is that its work is highly dependent on the surrounding conditions and the condition of the woman. If a woman is under stress, is in a noisy place, then it can hardly be expected that milk will stand out in sufficient quantities. The fact is that in such situations, an antagonist of oxytocin, adrenaline, is released, which reduces milk production.

There is also such a psychological moment: it has been noticed that when you pump, you observe how much the pumping container fills up, you will never draw a lot of milk. Therefore, try not to look behind a set of precious milliliters.

Important! Failed attempts pumping is not an indication of a small amount of milk in the breast. It is impossible to express to the last drop, since milk is produced in the breast continuously.

How much milk to express and how often to do it

1. It is necessary to express, in order to increase the amount of milk, often, but no more than once an hour.
2. If you are away from your baby, remember to pump every three hours at night. This is one of the conditions for saving
3. It is not necessary to pump to the last drops to relieve the chest, stop as soon as you feel a sense of relief
4. When expressing milk for feeding, finish the process after reaching the desired mark, using both breasts alternately if necessary.
5. If you are pumping, each breast must be pumped for at least 15 minutes. If it becomes “empty” before this period, then after the appearance of a feeling of emptiness, express the breast 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 features but also become harmful.

Breast milk storage containers

Can be made from various materials, the main thing is that they are clean and tightly closed. Modern moms in purchased containers for storing breast milk, convenience and ease of use are highly valued, in particular, the volume corresponding to one dose of feeding, the presence of a measuring scale, a tag where you can indicate the date and time of pumping. By appearance it can be packages, containers, bottles. For freezing ideal option are 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 in terms of security. The safest to use are glass containers and special plastic bags for storing milk. If you still opted for 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.

For storing 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 badge "Bisphenol A free" or "BPA free" or "0% BRA". This means that no bisphenol A was used in the manufacture of polycarbonate, which has the property of long-term storage or heating to go from plastic to products.
In conclusion, it must be said that it is not necessary to sterilize reusable milk storage containers. It is quite enough if they are well washed by hand or in dishwasher. Instead of using detergent you can pour boiling water over the container.

At what temperature to store

Human milk has a unique ability to inhibit bacterial growth 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 even more long term freezer.

Approximate shelf life of expressed milk

Freezing breast milk

1. Immediately after pumping, cover the container with milk, and if using a freezer bag, remove air from there. The less air the expressed breast milk comes into contact with, the better it will be stored.
2. Mark the bottle with the date of pumping. Breast milk is very interesting property- it is produced in this moment the exact composition that the child needs. Therefore, it is better to use it as soon as possible, especially the portions expressed earlier.
3. Cool the expressed milk for several hours in the refrigerator (+2…+4°C), and then place it in the freezer as deep as possible. This is done so that temperature fluctuations when opening the door are minimal.
4. Freeze in small portions of 30-60 ml if you plan to use it from time to time. Systematic feeding requires freezing in different volumes: 100-150 ml for normal feeding and in smaller portions if you need to supplement.
5. Small portions of milk different breasts decanted during the day, it is permissible to mix into one.
6. It is allowed to add freshly expressed milk to frozen 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.

1. Many mothers are worried when they see that when cooled, the fatty part of the milk separates from the main mass, and they think that it has gone bad. This is not a sign of spoilage, just stir the milk and it will return to normal.
2. Sometimes, after defrosting, milk smells like soap or is bitter. This smell and the result of the action of the milk enzyme lipase, which breaks down fats.
3. When frozen, milk acquires a pink, blue or other hue. It is suggested that this may be due to the action of the same lipase again, or to natural or artificial colors in mom's food.
4. Spoiled milk has a sour smell.

Rules for defrosting and heating milk

What to do if the baby refuses to eat thawed milk

Pay attention to whether you follow all the rules for freezing milk.
If this does not help, pasteurize the milk in a water bath at 62.5°C (the first bubbles appear in the saucepan) before freezing to deactivate the lipase. Do not bring to a boil. Then cool quickly and freeze. Of course, this will destroy many valuable components, but all the same, such milk will be more useful than the mixture.

Types of breast pumps

Types of breast pumps according to the mechanism of action are divided into mechanical and electrical. Advanced models of breast pumps have two-phase pumping modes. First, the mammary gland is subjected to a gentle and rapid action, stimulating the release of milk, and then slow and deep pumping 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 strength of pumping is regulated by the woman herself, depending on her feelings;
• all parts can be washed and sterilized.

Minuses

• time is saved slightly due to slow work;
• with prolonged use, fatigue is felt in the hands;
• fragility of some models.

Despite all the downsides mechanical breast pumps if the nature of pumping is episodic 1-2 times a day, these models are quite suitable for you.

Syringe breast pump

1. Pump breast pump. This is the simplest and most inexpensive type of breast pump. Consists of a nozzle for a breast and a rubber pear (pump). When expressing, both hands are occupied: one hand presses on the pump creating a vacuum, causing a rush of milk, and the second presses the device to the breast. At the same time, milk enters the pump, as it fills up, it must be drained into a bottle. An improved version of a pump-action breast pump is a breast pump with a pear connected by a hose to a bottle.
2. Syringe breast pump. It consists of two nested cylinders. At the end of one of them there is a funnel that is adjacent to the nipple. The movement of the cylinders relative to each other, like in a syringe, creates a vacuum and milk is extracted from the breast.
3. Piston breast pump. As well as a pump-action breast pump, it consists of three parts: a silicone nozzle for the breast, a mechanical part and a bottle. Mechanical part in this case is a lever. By tightly pressing the breast pump to the breast and, working with a lever, they achieve the expression of milk from the breast.

Pump-action breast pump
Piston breast pump

Electric breast pumps

In electric breast pumps driving force pumping is the electricity that powers the motor that creates the vacuum. The woman has only to press the button.

pros

• quick collection of milk;
• pumping modes of various strengths;
• suitable for regular pumping.

Minuses

• high price;
• makes 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, electronic memory is added here that can remember individual mode expression and reproduce it the next time you use the device. At the same time, when pumping, a breast massage occurs, which improves the movement of milk through the ducts, thereby imitating the sucking process as much as possible. baby. Some models do not even require hand support. Electronic breast pumps are quite expensive, it is better if you rent them.

Electric breast pump Electronic breast pump

Complete set of breast pumps

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

In contact with

How to express breast milk with your hands and is it necessary to do it? This question worries mothers who are breastfeeding. If you feed the baby on demand, then he himself regulates the amount of milk produced (how much he drinks, so much he will arrive) and pumping is required only if necessary.

In what cases is pumping required?

• The chest is abundantly filled with milk and becomes dense.
• Taking medications that pass into breast milk and harm the baby, while the mother wants to maintain lactation and start feeding after stopping the medication.
• Laktostasis.
• Cracked nipples.
• Mastitis.
• To maintain lactation during the period of separation of the mother from the child.
• If the baby is premature and has not yet developed a sucking reflex.
• The baby refuses to take the breast and feeds only from the bottle.
• We need to stock up on milk.

Benefits of manual pumping over breast pumps

Breast milk is expressed by hand or with a breast pump. Hand pumping has a number of advantages:

• available;
• physiologically;
• increases lactation;
• can be used in any conditions;
• does not injure the mammary gland, subject to the technique;
• painlessly.

Flaws:

• need experience and practice;
• the process takes at least 20 minutes.

A breast pump can quickly pump out a large amount of milk, but a high-quality device is expensive, the pumping process is painful (you need to get used to it), there is swelling of the nipple and areola, and the risk of bruising.

Rules for expressing breast milk

• If you need to get rid of the feeling of fullness in the chest, then you need to express a little until you feel relief and soften the mammary gland.
• To get full-fledged milk (front and back), decant for at least 20 minutes.
• Do not stop the procedure if the milk began to stand out drop by drop. You have to wait and it will trickle again.
• You can express milk from one breast while the baby suckles the other. This makes the process easier.
• Manual pumping is carried out by alternating the mammary glands. After emptying the first, they take the second, and after 5 minutes they return to the first. This method produces more milk and does not skip the "back" fatty portion.
• The procedure is carried out every 2-3 hours, which corresponds to the interval between attachments to the baby's chest.
• You can not squeeze and stretch the nipple: the milk ducts are damaged.
• It is contraindicated to slide your fingers over the skin and squeeze it.
• Milk is expressed into a clean, boiled water or sterile dish, before that, hands are washed with soap and water.

How to prepare for pumping

The manual pumping procedure is carried out in a calm, relaxing environment. Before you start, you need to drink two glasses of water or warm tea, take a shower, massage your breasts, which helps to improve the flow of milk.

Massage is carried out with the fingertips, making circular movements of small amplitude. Starting from the armpit, gradually reaching the areola. Thus, they pass through the entire mammary gland with movements from top to bottom and in a spiral. Finish by stroking the breast towards the nipple, then move to the other mammary gland. Movements should be soft and delicate. Massage allows you to resume the flow of milk if it has stopped.

Psychological techniques help to get more milk and speed up the process:

• mental representation of the streams of the river flowing into the sea;
• physical contact with the child;
• contemplating a photo of the baby while pumping or remembering him if the child is not around;
• listening to relaxing music or sounds of nature (the sound of water, rain) through headphones.

Manual Expression: Technique

1. Every nursing mother should know how to properly express breast milk with her hands. This art is easy to master. Hands - best breast pump. If you follow the technique, then the process of manual pumping will be easy and painless. Procedure steps:
2. Place your hand on your chest to thumb was on top, and the rest below (clearly opposite the big one), at a distance of 2-3 centimeters from the nipple.
3. Press simultaneously with your thumb and other fingers on the breast tissue in the direction chest, then roll your fingers forward to push the milk out of the milk ducts. If there is pain, then the technique is broken. Repeat these movements until the milk runs out, then move to the next section.
4. To effectively empty your chest, you can imagine it as a clock face. First, the fingers are located at 12 (big) and 6 (other fingers) hours, then we shift to 13 and 7 hours. Thus, you need to go through the entire mammary gland.
5. Milk may not appear immediately. First it appears drop by drop, then it is released in a jet. The woman must carry out the procedure for manual decantation on her own.

Rules for storing and freezing breast milk

Breast milk retains its properties and does not deteriorate under the following conditions:

• at room temperature, the shelf life is 4-6 hours in a sterile, tightly closed container;
• in the refrigerator 8 days;
• in the freezer for up to 6 months at a temperature of at least -13 degrees Celsius.

In the general compartment of the refrigerator, breast milk is placed as deep as possible; it cannot be kept in the door.

For storage use a special container, which is sold in pharmacies. This plastic containers and bags, cups and bottles made of glass. High-quality containers are airtight and tightly closed, sterile, equipped with a measuring scale.

Glass and plastic containers with transparent thick walls better preserve the nutritional and immune components of breast milk. Disposable plastic bags are used for freezing. They save space in the refrigerator, but it's best to store them in an extra container to avoid damage. Packages change the taste of milk and this is a drawback.

Features of breast milk freezing:

• before freezing, the milk is cooled in the general compartment of the refrigerator;
• on the container, be sure to indicate the date and time of freezing;
• if plastic bags are used, they are not completely filled, leaving room at the top (milk expands when
• freezing and tearing the package filled to capacity);
• freeze in portions of 60-80 ml;
• defrosted milk can be stored in the refrigerator for up to 24 hours.

Defrost breast milk in warm water. Do not heat in the microwave or on the stove, as this destroys the beneficial properties.

Breastfeeding mothers often pump for various purposes. This can be both to increase its volume, and to create a stock. But sometimes such a nuisance happens when a woman cannot express milk with her hands or with a device - nothing comes of it. Of course, if milk is not being expressed, a lactation consultant or an appropriate doctor will help you figure out what to do. But it is not always possible to contact them.

The main thing is to understand the causes of such a problem as the inability to express. They can be different and almost all of them can be solved:

1. Narrowed ducts of the mammary glands. Most often this happens in primiparous mothers. But it is also possible if there is a spasm of the milky ways.
2. Beginning lactostasis or mastitis. In this case, fatty hindmilk itself blocks the exit.
3. Strong stress.
4. Insufficient fluid supply.
5. Lack of milk at all (hypolactation). This case is very rare, occurs only in 5% of women who have given birth, but it is quite possible.

If you have previously managed to express, and suddenly there was a failure, then it is worth considering what happened in Lately. Perhaps you were lying on your stomach (that is, on your chest), which is why the ducts are pinched. Or you were in the cold, so there was a spasm and the ducts narrowed.

The mother should have a comfortable and calm atmosphere at home, scandals and quarrels are not allowed. IN domestic plan you should also rely for the most part on the help of your husband and other relatives.

Problem Solving Methods

It is best to solve breast problems by consulting with a specialist. If this is not possible, then it is necessary to analyze why this could happen.

Any medical methods there is no solution to the problem. Even doctors advise the old folk recipes:

1. Cabbage leaf. The cabbage leaf is beaten a little so that it becomes soft and releases juice. And it is important that it is warm. Then apply to the chest. Change the sheet as it dries.
2. Warm towel. Soft terry towel put in a little hot water(it should not burn, the temperature is pleasant to the body). Then it is squeezed well and placed on the chest. Lie down like this for 20-30 minutes. But you can feel relief sooner.
3. Plentiful drink. It must be warm. It is also good to drink soothing infusions and herbal teas. In particular, mint, lemon balm, chamomile, valerian help.
4. The mother should not have any stress. It also promotes better outflow of milk.
5. Another important factor - in no case should you overcool the chest. This provokes spasms of the ducts, as a result of which milk is not expressed.
6. And of course, be sure to put the baby to the chest. You may not be able to express, but the milk is there and the baby will suck it out. Thus, he will develop ducts.

Also, do not do it completely, to the last drop. Pump in a calm, relaxed environment. All this will create a favorable mood and improve the outflow of milk. Drink warm milk tea 20-30 minutes before the process.

You need to get as much sleep and sleep as possible. You can also use such a folk remedy as a honey cake ( Rye flour mixed with honey to a plastic state) or various homeopathic ointments that relieve swelling and remove seals. But for any painful sensations you need to see a doctor.

What Not to Do

With difficult pumping, there are a number of prohibitions:

1. You can't stop breastfeeding your baby.
2. You don't need to warm your breasts unless you're going to pump or feed your baby right after.
3. You can not limit yourself in the amount of water you drink, thinking that it will become easier.
4. It is forbidden to smear the chest with various warming agents, such as Vishnevsky ointment, alcohol or camphor alcohol. This can lead to the child's refusal to suckle the treated breast (due to taste and smell), also provoke inflammatory process and generally cessation of lactation.
5. In no case do not leave everything as it is. It is necessary to take measures, as it subsequently leads to deterioration and mastitis. And in this case, the only solution to the problem is surgery.

Expression of milk

Formerly a woman decant after each feeding. This was done on the recommendation of doctors and in order to maintain lactation, as it was advised to feed on time every 3 hours. This method is currently not supported. It is believed that this is most likely the milk will disappear. In fact, it is not so bad, it has its advantages. Therefore, even now, some experts advise constantly decanting.

It is considered the safest manual method. It is less painful, more anatomical. At the same time, at correct application this method does not form cracks in the nipples. Another point that most mothers will not like is the duration of the procedure. It can take from 40 minutes to 1.5 hours, and hind milk comes with difficulty. While most mothers also need to deal with domestic issues, this becomes simply impossible. However, some problems can only be solved by manual pumping. With lactostasis, it is best to express this way. The same method is necessary when mastitis has begun, which is initial stages can be resolved conservatively.

Another disadvantage when expressing milk with your hands is that there is no hind milk. It is thicker and more difficult to obtain. Therefore, it is best to do this with a breast pump. The choice must be turned towards piston mechanical or electric. They are less traumatic, take a little time to work (15-20 minutes).

If there is a lot of milk, and it is very stagnant, then when decanting, most likely, there will be pain. This is very unpleasant, but they must be endured in order to alleviate the condition. Therefore, you first need to help yourself with your hands, and then apply the breast pump. If you can’t express yourself from severe pain, then you need to resort to the help of loved ones - husband, mother, sister, etc.

Each method has its positive and negative points. No matter how great the desire, you should not give up feeding the child with this problem. naturally and switch to artificial mixtures. This is advised by many "well-wishers" and even doctors, saying that since it is impossible to express milk, it means that it is not there at all. But it happens that mommy just has one of the above problems. Do not be upset if milk is not expressed - you already know what they do in such cases. Try various ways decisions and everything will work out. The amount of expressed milk does not indicate its full volume. After all, no matter how much you do it with the help of hands and other devices, the child receives as much milk as he needs at the moment.

Among young mothers, there is an opinion that in order to improve lactation, a woman needs to constantly express milk from her breast. Instead of devoting more time to the newborn, such women are forced to express their breasts after each feeding. However, lactation consultants believe that this is not necessary at all, since the process of lactation is best regulated by the child himself. But excessive pumping can lead to hyperlactation, which can cause a lot of inconvenience and problems. Let's try to figure out whether it is necessary to express milk, in what cases and how it should be done.

When should you express milk?

It is believed that the child, sucking a certain amount of milk from the mother's breast during feeding, gives female body a kind of signal about how much it should be produced in the future. If the baby begins to eat worse, then the amount of milk produced also decreases. Thus, the wise nature provided for the natural regulation of the lactation process.

With normally established lactation, when the baby is fed on demand and he sucks milk well, grabs the nipple correctly, the mother and baby are healthy and feel good, additional pumping is not required.

However, there are situations in which it is necessary to drain milk from the glands. Let's consider the main ones.

• During the formation of lactation, milk should be expressed after feeding to regulate its production. After the birth of a child, milk arrives quite intensively, and if the child does not have time to completely suck it out, then by the next feeding it will be produced in a smaller amount. Therefore, you should express the remaining milk, otherwise it may burn out over time. And when the appetite of the newborn improves, there will be nothing to feed him. The main thing in this case is not to overdo it and not cause hyperlactation, so the milk should not be squeezed out completely, but only until the breast becomes soft. Otherwise, you can come to vicious circle when more and more milk will be produced with each feeding, and it will be necessary to express the breast longer and harder. It is believed that normal lactation should be established within a week after childbirth, and during this period you can strain 2-3 times a day.
• In the case of lactostasis, when the milk ducts are clogged and in mammary gland lumps form, which then become very painful and can cause a fever, you should manually express milk from such areas. It may take several days to break down such lumps, but if this is not done, then mastitis will begin - inflammation mammary gland. After restoration of patency of the ducts, pumping can be stopped. In the future, you should ensure that the child sucks each breast well, and if this does not happen, strain it yourself.
• During the period of illness of the woman in labor, when she needs to take antibiotics or other medications, which can harm the newborn, the baby is not applied to the breast, and milk is expressed manually to maintain lactation. Doctors recommend pumping 6-10 times during the day, with an interval of 3-4 hours during the day and 6-7 hours at night. You can continue to breastfeed your baby after you stop taking the medication.
• If the baby is born prematurely or with any pathology in which stress is contraindicated for him (and the sucking process is physical labor for the baby), then he is fed from a bottle with expressed mother's milk. If, for some reason, the newborn is not breastfed immediately after birth, then pumping should begin within 6 hours after birth. At first, it will be possible to extract only a few drops of colostrum, but this will give a signal to the body that it is necessary to activate milk production.
• Sometimes, due to the overflow of the gland with milk, it becomes very hard and the child cannot properly latch on to the nipple. In this case, you can eliminate the swelling of the gland by expressing a little milk before feeding, and then applying the child to it.

Instructions for nursing mothers on the correct expression of breast milk with lactostasis

How to express properly?

Milk can be expressed manually or with the help of breast pumps, which, in turn, are mechanical and electric. When using a breast pump, it is necessary to carefully monitor its cleanliness and sterilize it before each use in order to eliminate the risk of pathogenic bacteria on its surface. The use of breast pumps by women with cracked nipples is prohibited.

When using a breast pump, make sure that the nipple is located exactly in the center of the funnel, and its edges fit snugly against the skin of the breast. Breast pumps are more effective when the breasts are full, and work worse if the breasts are soft. In this case, women combine pumping: first they use a suction device, and then they manually strain.

Before manual pumping, a small breast massage should be performed.

This will cause the pituitary gland to produce oxytocin, which will expand the mammary ducts of the glands and facilitate the movement of milk.

In the process of decanting, no effort should be made, all movements should be smooth and light so as not to damage the milk alveoli. You need to express milk for about 20-30 minutes. If a woman does not have the experience of self-expression, she should seek help from a midwife or nurse in the hospital, who will show what movements to massage the glands while expressing milk.

The phenomenon when the mother's body produces more milk than the baby needs is called hyperlactation. To eliminate it, you should reduce the number of pumping. However, this should be done gradually so as not to provoke lactostasis.

The signal to the body about excessively produced milk is received within 24 hours. Therefore, you must first refuse to express after night feeding, and during the day, express the milk completely so that the breast is soft. After three days, it will be possible to refuse one more pumping and so gradually increase their number to 1-2 per day. In this way, it will be possible to get rid of excessive production of breast milk in 1-1.5 weeks.

Mother's milk: causes of extinction and prevention

How to store milk

Expressed milk should be stored properly. Of course, you need to collect it in a thoroughly washed and preferably sterilized container. And if necessary, keep it for a long time - milk should be placed in the refrigerator.

Unlike artificial mixtures human milk contains a large number of protective antibodies that inhibit the development of pathogenic bacteria. Therefore, it can be safely left out of the refrigerator for 2-3 hours before next feeding without fear for its quality. If you plan to store milk for more than for a long time- you need to put it in the refrigerator. And the milk, which is planned to be stored for more than two days, should be frozen in the freezer.

Every woman should master the techniques of manual pumping as early as possible, as sooner or later she will need it in the process of breastfeeding a child. In order to learn how to do this correctly, it is advisable to seek help from health worker or more experienced mom. By carefully monitoring the condition of the breast and the process of milk production, you can significantly extend the duration breastfeeding which will bring great benefits to both the newborn baby and his mother.