Expressing And Storing Breast Milk

Expressing and storing your breast milk allows you to leave your baby for a while. without altering her usual diet. Although awkward and slow at first, expression becomes easier with practice.

You will need clean hands, clean equipment, and bottles or disposable baby bottle liners (any container meant for food storage is fine). Pumping and expressing milk is most effective if you can do it while you are having a let-down reflex.

Getting Ready to Pump

Nurse your baby and take advantage of the let-down reflex that comes during a regular feeding time. As your baby suckles, collect any milk that drips from the other breast, or pump that breast at the same time. It may take another person or a one-handed breast pump to express at the same time you feed your baby. Other good times to pump are following a feeding; when your baby feeds from only one breast (pump the unnursed breast); or when your baby skips a feeding or you feel particularly full of milk.

Find a private, uninterrupted, warm environment for pumping or milk expression.

Massage your breasts with your fingertips. Imagine the round shape as the face of a clock. Massaging at twelve o'clock, one o'clock, and so on, use your cupped hand and massage your whole breast. Start way back under your arms and at the outer boundaries of your breasts and massage toward your areolae, or use any of the massage techniques (see Enhancing Milk Flow).

Apply warm, wet towels to your breast.

Relax and imagine your baby nursing and the milk flowing.

Some mothers occasionally use a prescribed nasal spray. This drug is expensive and has side effects such as headaches, and it may only work for a short time. If the other methods do not work, you might discuss this option with your doctor.

Expressing Breast Milk

There are many ways to express or pump milk.

Expressing by hand is effective for many, and also inexpensive and convenient. Once milk is flowing, grasp your breast behind the areola with thumb above and one or two fingertips below. Lift your breast, press toward your chest and compress the milk sinuses between the pads of your fingers. Your milk may drip or spurt into a collecting container. At first you may obtain only several drops to a half-ounce. With practice, you will be able to collect more.

You can buy or rent effective equipment designed for pumping your breasts. Your breast-feeding counselor, childbirth educator, or physician may help you select a pump. If only an occasional bottle is needed, hand expression or a small battery-operated pump is sufficient. If you need to pump large quantities (several bottles) a day, or if you are pumping milk to maintain your milk supply during a period when your baby is unable to nurse, you will probably need one of the large and powerful but gentle electric pumps. It may be helpful to know that you can never pump all the milk out of your breasts. There is always some there.

Using Expressed Breast Milk

Fresh

Feed the milk to your baby right after pumping.

Refrigerated

Use within forty-eight hours if kept at 40 degrees F (4 degrees C) .

Frozen

Use within two months if your freezer is very cold (cold enough to keep ice cream very hard) or within two weeks if not very cold. It can be stored in a deep freeze for two to three months. Place the milk at the back of the freezer away from the door. One disadvantage of freezing milk over using it fresh or refrigerated is that freezing destroys some of the anti-infective properties.

To thaw frozen breast milk, hold the container under warm water until it is liquified, or let it thaw and warm slowly, six to eight hours, in the refrigerator. Do not overheat the milk since this destroys more of the anti-infective properties. There is no clear data about changes in breast milk defrosted by microwave, but the Academy of Pediatrics advises against thawing or warming in a microwave as this has been associated with scald burns to the baby's mouth and throat due to "hot spots" in the milk.

Introducing a Bottle to a Breast Fed Baby

You may want your baby to use a bottle when you are gone for a feeding or while you are at work. Some babies take a bottle with no problem, while others do not take it so easily. If you have a problem introducing a bottle to your baby, try the following suggestions:

Wait until breast-feeding is well established before introducing the bottle. A baby who is still learning to breast-feed or who needs coaxing to latch on and remain latched is at risk of becoming "nipple confused." Usually, wait until your baby is three or more weeks old is a good idea.

If possible, put expressed breast milk into the bottle rather than formula. Providing a familiar milk may be helpful as your baby adjusts to sucking from a bottle.

Sucking from a bottle is a new experience for the breast-fed baby. Babies are able to learn something new most easily when they are calm and rested. Offer a half ounce or so of breast milk in a bottle following a feeding and during a time when you feel calm. The goal at first is to acquaint your baby with a bottle, not to replace an entire feeding.

Sometimes babies take a bottle best from someone other than their mother. Other babies are happy to accept bottles from their mothers. You will discover what your baby prefers.

You will probably feel better about leaving your baby once you are sure he will take milk from a bottle. Help your baby learn about bottle-feeding well in advance of your returning to work, if possible.

Occasionally, a baby absolutely refuses to take a bottle. (Usually this is a temporary situation for a baby in day care.) Fortunately, babies can take milk in other ways--from a small cup, a dropper, or a spoon. A small cup such as a shot glass or medicine cup works well. Sit the baby upright and tip a little milk into his mouth for him to swallow. A medicine dropper allows you to squirt small amounts between his cheek and gum, which he will swallow. Babies three months old or older can learn to use a small stiff straw.