You may be expressing to ease any engorgement, to boost your milk supply or to have a stash of milk for bottle feeds. Some women find expressing easy, while it can be more of a challenge for other women – this is a basic guide to help you find something that works for you, along with links to more information and videos.
You need to be as relaxed as possible – sitting comfortably, not feeling rushed or tense and where you won’t be disturbed can help your milk to flow. It can take a bit of experimentation to find the best time of day for you – some mums find it easier to express in the morning when their boobs feel fuller and their milk flows easier, other women are more relaxed in the evening so this is a better time for them to express.
Make sure you are not hungry or dehydrated as this could make expressing harder.
If you are expressing regularly, it can be beneficial to plan it into your day rather than just trying to fit it in.
The La Leche League recommends combining hand expression, to stimulate the let down reflex, with a pump to collect larger amounts. Hand expression could be ideal if you need to ease any engorgement or if you need to collect colostrum for initial feeds. Some women also find this the most effective way to collect breastmilk and they don’t need to use a pump.
This is the NHS guidance for hand-expressing:
Before you start, make sure you wash your hands really well. You’ll also need a sterilised container – this could be a feeding bottle or a wide jug or bowl.
1. Get comfy – preferably in a warm, quiet room where you can relax undisturbed. Place the container within easy reach.
2. It can be helpful to start by gently massaging your breasts (make sure your hands are warm). Start off with long strokes from your armpit, working towards your nipple.
3. Next, cup your breast in a C-shape near the outside area of your nipple (but not on it). Your finger and thumb should be opposite each other – if you imagine that your breast is a clock, your thumb would be at 12 o’clock and your finger at 6 o’clock.
4. Start by feeling for a change in breast texture, you’re looking for something that feels like a ridge, away from the softness of your nipple. This is where you need to start gently squeezing, or compressing your breast.
5. It may take a few minutes so be patient! Gradually your breast milk (or colostrum) will start to slowly drip out. Keep going, try to build up a rhythm – you’re doing really well!
6. When you notice your milk flow slowing down, move your hands around your breast so you are expressing from a different area (position your finger and thumb at 11 o’clock and 5 o’clock) and repeat the process.
7. Once you’ve expressed as much as you can from one breast, repeat the process on your other breast. Then move back to the first breast – you may be surprised at how much milk you can express.
There are two types of breastpump available:
*manual – where you squeeze to the pump to create suction
*electric – where the pump does all the work and this might be quicker
Again, this is down to preference – some women find a manual pump works really well for them, while others prefer the ease of the electric pump. It depends on what your expressing needs are – this can vary from pumping to fill the freezer with a store of milk or it can be to feed your baby throughout the day, when an electric pump might be more effective for you.
The NHS guidance for using a breastpump states:
- It can help to massage your boob before your start, to encourage your let-down reflex.
- When you start to use the breastpump, it can take a few minutes for your milk to flow. If using an electric pump, it can be more comfortable to start on the lowest setting.
- When your milk slows down, you can swap to the other boob and then swap back again.
- Once you have expressed, put a lid on the bottle and you can store it in the fridge immediately or it can be at room temperature for about 4 hours.
- Wash and sterilise the pump.
These are a new addition and they are proving popular with many of the women I talk to. There’s some discussion about whether these are more of a milk collection device than a pump – some women agree it can be used as both.
You can attach the silicone pump when you are feeding, to catch any let-down, or on its own, to express some breastmilk.
It’s good for:
*catching the let down milk, so prevents waste and mess
*quick and easy expressing because you can use it while feeding your baby
*being easy to clean – just pop into your steam steriliser or boil for 2-3 minutes. If you use any soap/detergent, it will turn cloudy
Just be aware of:
*the pump being too full – it may slip off the boob. Have a sterilised bottle to hand so you can empty the milk into there.
*your baby could kick the pump
*the pump can be a bit unstable when it stands – pop it into a mug when you are finished using it so it won’t fall over.
*it probably won’t drain your breast – if you need a lot of milk you may been to use another breastpump as well.
Breastmilk can be stored milk storage bags or a sterilised pot.
Storage guidance is:
Fridge – at the back of the fridge, not in the door for up to 8 days
Fridge Ice Compartment – up to 2 weeks
Freezer – up to 6 months
- If you have time, put it in the fridge to thaw out
- If you need it quickly, you can put the bag/container of frozen milk under running warm water or in a jug of warm water
- Use the breastmilk as soon as possible after defrosting and don’t refreeze it
Using the expressed breastmilk
It may be as simple as putting the breastmilk into a bottle but you can also feed your baby expressed milk using a syringe, a spoon and a feeding cup, especially if your baby is premature or poorly – it can be helpful to get some specialist breastfeeding advice if you need to do this.
Experiences from mums:
*A Haakaa (or similar is great to catch your let down, best used when baby is smaller and doesn’t kick!! Or when pumping use on the opposite side. The Elvie is also amazing!! Pumping hands free is a game changer and took so much stress out of it. I’ve also heard cover the bottle part of your (standard) pump with baby socks so you can’t see how much is/isn’t been collected as that totally affects the supply. I believe this. I used to get so stressed with how little I got until I couldn’t see it.
*Invest in a double pump, if possible. If you want hands free cut holes in an old bra to hold the pump in place.
*I found taking a manual pump out with me (Plus storage for the milk) meant I could express easily and quickly when I got full.
*I found expressing in the morning after a warm shower optimum time to get the most milk expressed. Hand pump easy to take out with you if you need to express whilst out & about.
*If at all possible try different pumps. There isn’t a best one, what is best for one person isn’t necessarily the best for another. I was lucky and was able to use a hospital grade pump supplied by the HV. The difference was amazing.
*Massage before expressing and also as you are coming to the end of an expressing session, try massaging or giving a squeeze as there will usually be quite a bit more milk.
*I found that expressing the same side after I had fed the baby, rather than the opposite side, helped increase my supply which in turn made the next session more productive.
*I learnt that my supply was better in the morning and one boob was better than the other! Once I worked that out I could express quickly and efficiently.
*Take a hot shower or bath beforehand and don’t stress.