Should I express breast milk? Important nuances when pumping: what you definitely need to know

Sometimes there is a need to express milk. Therefore, every woman should be able to express her breasts. When is this really necessary? Expressing breasts after feedings may not be a procedure that is necessary regularly. A nursing mother, as a mammal, is designed to produce milk according to the needs of the child; her body is not designed to produce excess milk, like the body of any mammal. What animal in the wild expresses the remaining milk after giving birth to its baby? Some animals are deliberately milked by humans. Prejudices associated with breastfeeding, formed over the 20th century, force some women to breastfeed themselves too...
Why is it recommended to express after every feeding?

There is an opinion that this is necessary when feeding according to a regimen when the baby is fed 6-7 times a day in order to preserve milk. Usually a child, unless he is specifically taught to follow a routine, does not behave this way. But if he is accustomed to the regime, he can suck out the milk completely, there will be nothing to express. The amount of milk will begin to decrease not due to a lack of pumping, but due to insufficient stimulation of the breast by sucking. Often a child, even when feeding according to a schedule, does not suck the breast completely, and the milk remains. The endocrine system will receive a signal that excess milk is being produced and there is no need to produce it. By expressing these remains you can support lactation for some time. Typically, it takes a woman a lot of time and effort to express milk, and often fatigue from pumping leads to giving up breastfeeding.

Under natural conditions, a child never latches on 6 times a day at regular intervals. It can be applied relatively rarely in the first week of life, but from the second week the baby’s need to suck appears more often than 6-8 times a day. The baby's need to suck is not associated with a feeling of hunger. He just wants to suck in response to any of his discomfort, he tries to get rid of it this way, regardless of what it is caused by - a feeling of hunger or a desire to sleep, for example... Under natural conditions, the child attaches to the breast on demand, quite often . Over hundreds of thousands and millions of years of evolution, the endocrine systems of mammalian creatures have become accustomed to producing sufficient quantities of milk with frequent stimulation of the mammary glands by sucking. This is what happens when you feed your baby on demand. In this case, the baby constantly sucks out small portions of milk; there is no long-term accumulation of milk in the breast. When feeding on demand, the baby is attached to one breast for about 1.5-3 hours, during which time he sucks it out and begins to attach to the other. If the baby is fed according to a schedule, the breast can wait 6-8 hours for the next feeding; it is not at all designed for such accumulation of milk. The woman’s body “concludes” that no one needs milk...

When feeding on demand, a woman’s lactation quickly stabilizes and milk is produced according to the baby’s needs, without excess or deficiency. There is simply nothing to express. This is technically impossible, because... breastfeeding is rarely less than 12 per day. There are mothers who still try to pump after feedings, even putting the baby to the breast on demand. Usually they quickly get bored with this tedious task, but sometimes, unfortunately, they start producing excess milk - hyperlactation. The mammary gland begins to produce milk for a very voracious baby or twins, because... The principle of milk production “according to the child’s needs” continues to work.

But still, sometimes there is a need to express milk. Therefore, every woman should be able to express her breasts. When is this really necessary?

To maintain lactation if mother and baby are separated for various reasons. Regular pumping can maintain lactation for a relatively long time. In such a situation, it is advisable to express 6-10 times a day, depending on the circumstances, for each breast for 10-15 minutes.
If the mother needs to leave the baby, and leave milk for him during her absence.
If the mother has developed lactostasis - blockage of the duct of the mammary gland lobule with a fatty droplet or milk clot. Lactostasis must be strained if the baby cannot resolve it.
With a significant supply of milk after childbirth. At this time, most mothers are still in the maternity hospital and receive a recommendation to express until the last drops, otherwise mastitis will supposedly await them. This is how hyperlactation often starts - the formation of excess milk. In this situation, you cannot express yourself completely! What to do in such a situation?

Usually, more milk comes in than the baby needs, and the excess must be “removed,” but not earlier than a day after the start of the flow. When your milk comes in, you can’t express everything without leaving any residue! Substances that signal that excess milk is being formed appear in a full breast after about a day. If you express all the milk earlier than a day later, then the same amount will be produced.

When milk is actively coming in, you need to apply the baby to the breast, as often as he asks, apply at the request of the mother, when he does not ask, and the mother feels that it is time to suck the milk. And only in that situation, if the child does not want to suckle at all, for example, is fast asleep, but the mother already has pronounced discomfort in the chest, she needs to pump the breast a little until she feels relief! Typically, the need for such pumping occurs no more than 1-3 times a day for 1-3 days.

If there is a rush of milk in the first three weeks after birth, you need to do the same. During the first month after birth, in most women who managed to organize breastfeeding naturally, lactation stabilizes, periodic flows of milk disappear, and the breasts become soft.

Mothers experience the most problems with breasts in the first days after childbirth when they are separated from their child. The baby is brought in, but according to the schedule after 3.5 hours and he does not always want to suckle. In this case, the mother needs to focus on proper breastfeeding while feeding the baby and place the baby on both breasts to better stimulate lactation. When kept separately, a child is always fed from a nipple, and he may latch onto the breast incorrectly from the first day of life. Poor sucking does not empty the breast well. In the first days before the milk comes in, while the mother has colostrum, she can consider each feeding of the baby, during which he suckled, as pumping. If the baby was brought in and he did not suck or sucked sluggishly, she definitely needs to pump both breasts for 10-15 minutes each. If there is no milk coming in on the 3-4th day after birth, then you need to add two additional pumping sessions, for a total of eight feedings/pumpings during the day. When the milk comes in and the breasts fill, the mother who is bringing the baby according to the schedule needs to be very attentive to herself, because... in this case, breast engorgement may develop. The self-regulating mother-baby system does not work in such a situation, therefore, when filling the breasts, it is necessary to limit fluid intake to 3-4 glasses per day and express the breast twice, in the morning and in the evening, but not after 9 pm and before 9 am. If you express at this time, for example, at 12 am, you can stimulate lactation, because... The main hormone responsible for milk production, prolactin, has a circadian rhythm and is most produced at night in response to sucking or pumping. If the condition does not improve after a day, then once a day you need to express completely (in the morning or at night, after 9 am or before 9 pm), and during the day - only until you feel relief after or instead of feeding according to the feeding regimen, depending on the sucking activity child. If the mother feels relief after the baby has sucked, there is no need to express.

When a mother ends up at home after being separated, the baby usually gets used to the routine and may have difficulty latching on to the breast. In this situation, mother and baby need consultation on breastfeeding, because... need to teach the child correct application, and the mother - how to control the correct attachment and continue teaching the baby high-quality sucking, it is necessary to transfer the child to feeding on demand and learn to feed comfortably from different positions. Expressing should be gradually abandoned, reducing the volume of expressed milk and the number of expressions. Usually the mother stops pumping within 3-7 days.

In what cases is pumping necessary and how to do it is described in the article.

Often, competent pumping of milk can solve the problems of a young mother. Therefore, every young mother should know the principles and rules of this procedure.

Why express milk?

Everyone's reasons for pumping are different:

Stagnation has formed (read below)
The breast is too tight, the baby cannot latch. It is necessary to express some milk until the baby is able to latch on
The baby cannot or does not want to breastfeed. Express milk and then bottle feed it
The baby is not with you, but you want to feed him milk from a bottle. Express the maximum amount of milk every three hours and pass a bottle of milk to the baby

If you cannot feed (for example, when taking medications) to maintain lactation. In this case, you need to express at least once every 3 hours. Otherwise, less milk will begin to be produced. And after the baby resumes feeding, he will not have enough milk
To enhance lactation (read below)
Mom needs to go away. Express the required portion of milk and store it according to the rules
The chest is full, painful sensations. The main thing here is not to overdo it: express just enough to stop the pain. If you express more, then next time the milk will come in larger quantities than needed. And then you will walk in a vicious circle

IMPORTANT: If you are affected by one of the listed reasons, then before pumping, learn the technique so as not to harm your breasts

How often should I express breast milk?

The frequency of pumping depends on the reason for pumping:

If to increase lactation, then after each feeding and in between
If it’s to relieve your breasts, then in fact: if it hurts, you pump, if it doesn’t hurt, you don’t pump.
If to maintain lactation, when the child does not breastfeed for any reason, then every 3 hours. If less often, then the milk will become less and less
If stagnation occurs, then every hour to an hour and a half

How to express breasts correctly?

The rules for pumping depend on which method you choose: by hand or with a breast pump. Read about both methods in this article below in more detail.

IMPORTANT: There is only one general rule: you need to express in such a way as not to injure your breasts. And if you are experiencing very severe pain, then you are probably doing something wrong.

Time to express breast milk

The pumping time also depends on the purpose of pumping:

For relief - 2-3 minutes
For bottle feeding - until you have expressed the desired portion, approximately 20-30 minutes
To enhance lactation - 5-10 minutes after feeding and 10-15 minutes between feedings
In case of stagnation - until the compaction decreases, but no more than 30 minutes. Otherwise you will injure your chest.

How to properly express breast milk with a breast pump?

IMPORTANT: The main condition before any pumping is clean hands

Drink hot liquid 20 minutes before pumping. This will improve milk flow
Before pumping, you can warm your breasts in the shower. This will make milk flow easier
After warming up, you can lightly massage your breasts (read more about massage below)
Thinking about your baby helps your body make milk flow easier

Relax - this will also help milk flow
It is advisable to express at least a few drops with your hands. This way the nipple will take the desired shape and the breast pump will express better
Insert the nipple into the middle of the breast pump funnel
The first pressure on the breast pump should be very light, otherwise you risk getting a crack in the nipple due to the strong vacuum
When the breasts feel lighter and not so painful, you can speed up the process a little. But don't get carried away by the speed anyway
Periodically remove the breast pump from the breast and massage the breast again
If the outflow is poor, then try leaning forward a little
If the nipple becomes wet, wipe it and only then continue expressing. Expressing wet breasts is much worse
After pumping, for prevention, apply a cream like Bepanten to your nipples.

IMPORTANT: Breast pumping is a technique that does not sense whether you are in pain or not. Therefore, pump very carefully, especially the first time. Afterwards, the breasts get used to it and accept this process more easily.

The success of expressing with a breast pump directly depends on the model you choose. How to choose the right model, see the video below.

Video: How to choose a breast pump? — Dr. Komarovsky

Will pumping help increase lactation?

Pumping can increase lactation, but no one can promise you a 100% result.

Milk is produced according to the supply and demand principle. So pumping helps because it gives the body extra signals that more milk is needed. This is how the body begins to produce more.

Principles of pumping to increase lactation:

After each feeding, try to express another breast from the breast you fed. Even if you strain a few drops, it will be good. The body will perceive these attempts as demand. And produce more milk
In between feedings, also try to pump for 10 minutes the breasts that you do not plan to give to your baby. Otherwise he won't have enough milk. Or strain into a sterile bottle to feed your baby with this milk later
It works very well to express one breast while the baby eats from the other. During feeding, milk flows in both breasts. These hot flashes are very easy to get through the breast pump into the bottle

But not all mothers manage to increase lactation in this way.

The main problem is that I cannot express even a drop of milk.

IMPORTANT: Many mothers manage to increase lactation by pumping

How to express breast milk by hand?

The good thing about hand expressing is that you feel your body. At first this is quite difficult, but once you get used to it, you will do it very quickly and effectively.

Preparation for pumping the same as with a breast pump (see above):

Clean hands
Hot drink
Massage

Technique:

Squeeze the nipple between your thumb and index finger to make it more elongated
With your left palm, pick up your breasts from below
Move your thumb up and to the side so that your hand seems to be holding the entire chest
Place your right thumb on top of the nipple on the nipple-skin line
Place your index and middle fingers on the same line, but under the nipple
With your fingers you should feel something on the line that looks like balls. If you feel it, then you are definitely doing the right thing.
Next, press your fingers towards the back, i.e. towards you and squeeze the nipple a little along this line

IMPORTANT: The last two movements must be done very quickly

Those lobes of the breast that are located on the side of the fingers that directly express the breast are well expressed.
Therefore, you need to constantly turn your fingers clockwise and counterclockwise so that all lobes are expressed.

IMPORTANT: Most likely, you won’t succeed the first time, but try and try. Feel yourself and everything will work out

Expressing milk for the first time

The first pumping, as a rule, is carried out in the maternity hospital, when a lot of milk comes in, which the small child is not yet able to eat
You need to express to avoid congestion in the breast.
Expression technique is standard (see above)
But when pumping for the first time, you must be extremely careful not to injure your breasts.

IMPORTANT: If you express with a breast pump, the draft should be minimal. If with your hands, then the movements should not be too strong and sharp

How to express breasts with lactostasis or mastitis?

Pumping for lastostasis or mastitis is the most mandatory point of treatment if the child cannot resolve the congestion on his own. Therefore, pumping must be done correctly. The technique of expressing with a breast pump and by hand is described above. Just a few features:

With lactostasis, a nursing mother usually feels in which lobe stagnation has occurred
Preparatory shower and massage should be aimed primarily at this lobe of the chest
Do not overheat your breasts too much, as this is unacceptable with purulent mastitis.
Lightly tap the stagnant lobe with your fingers.
And when pumping, all your efforts should be directed to this share
To do this, the fingers of the left palm should be on the stagnation side, as well as the index or thumb of the right hand

IMPORTANT: Do not press on the stagnation area under any circumstances!

How to express stone breasts?

Stone breasts are a problem for almost all mothers in the first month after childbirth.

The pumping technique can be used as standard for manual expression or pumping with a breast pump (see above), taking into account some features:

A breast pump will not immediately take a stone breast. You first need to shape the nipple into an elongated shape and try to express a couple of drops with your hands
If the breasts become stone in the first month after childbirth, then the difficulty is that the ducts are still narrow and not developed. For this reason, milk may drip drop by drop.
Don't give up. Try and try. Otherwise, stagnation may occur
If you have stone breasts, you can try to grab the breast at the base with both hands and, as it were, stretch them towards the nipple, pressing a little. This way the milk can flow more easily

IMPORTANT: The most effective way to express stone breasts is to give it to your baby

How to express milk into a bottle?

All modern breast pumps come with bottles included. We are not talking about a breast pump right now. This breast pump can cause breast injury and pumps worse than others.

Therefore, to express into a bottle, you need:

Sterilize your breast pump and bottle
Dry
Attach the bottle to the breast pump
Express milk

IMPORTANT: Pour this milk into a clean feeding bottle or into a milk storage bag ()

Hind milk when expressing

As you pump, you may notice that your milk starts out clear and bluish in color and then becomes yellower and opaque.

This yellow and opaque milk is hindmilk. If you leave the milk to sit, you will see how it has separated into layers: the cream on top is hindmilk.

Expressing with a breast pump is more difficult to express hind milk. More often it turns out to get only the front one.

IMPORTANT: The chances of getting hind milk with your hands are usually higher. But this is all individual.

Therefore, if you cannot express hind milk, do not be discouraged, as this can happen.

Massage for expressing milk

Rubbing the chest with both hands in a circle
Rubbing with both hands from the base of the breast to the nipple
Tapping fingers on chest

IMPORTANT: All movements must be light and calm to prevent damage to the mammary glands

How much milk should I have when pumping?

The amount of milk depends on when you express it:

If you express after feeding, you may not express even a drop.
If you express your breasts before feeding, you can express the required portion for the baby (both 50 and 100 ml)
At night you can express more milk, since the hormone prolactin, which is responsible for milk production, begins its active work from 2 to 6 am

Some mothers cannot express even 10 ml before feeding: this is most likely due to a violation of the pumping technique.

After feeding, on the contrary, you will most likely not be able to express even 10 ml, unless we are talking about hyperlactation.

Why is little milk expressed?

Poor pumping technique
Preparatory measures have not been completed (see at the beginning of the article)
Bad breast pump (see above about choosing a breast pump)
The child ate everything
You can't relax

IMPORTANT: No breast pump or hands can express as much milk as a baby can suck. If you cannot express even 20 ml of milk before feeding, do not think that there is no milk in the breast. There is milk in the breast and the baby will suck it

Expressing milk before feeding

It may be necessary to express milk before feeding if:

You're going away and need to pump into a bottle.
You smeared something on your breasts, after which it is recommended to express some milk into the sink before feeding
The baby does not latch and you are forced to express milk for him every time
The breast is too tight or rocky and the baby cannot latch on to it

IMPORTANT: It is easier to express your breasts before feeding

Expressing milk after feeding

Previously, doctors and our grandmothers recommended expressing your breasts to the last drop every time after feeding. Now this approach is not considered correct, since the body will consider that the milk expressed after feeding is also useful to the child. This means that next time it will produce a little more milk. Then you will find yourself in a vicious circle, which will subsequently lead to excess milk, which in turn is fraught with constant stagnation
To increase lactation. Expressing after feeding for this purpose is quite justified. Read about this method in this article above. Will pumping help increase lactation?
If there is too much milk and the baby eats very little. When you still experience breast pain from too much milk after breastfeeding, you need to pump some until your condition gets better. Too much is not possible, as this will also lead to hyperlactation

Pumping is sometimes necessary, but remember that your best partner in pumping your breasts is your baby.

Unique video: lactostasis: how to express milk?

There are different ways to feed your baby breast milk. Someone attaches the baby at every call and spends with him around the clock. Some people go to work immediately after giving birth, but the baby is still fed breast milk. Pumping will help give the baby milk in the absence of the mother. Pumping skills will be useful to any woman: after all, there are a lot of situations when this will need to be done.

Why do you express milk?

Expressing milk is the emptying of the mammary glands without the participation of the child. The reasons for pumping may vary. For example:

You have to pump in the first days after giving birth. For some, it is to “accelerate” lactation, for others, to get rid of excess milk.
Medical indications. For example, after childbirth, a mother needs to take medications that are incompatible with breastfeeding. Or the baby was born too weak and cannot suck milk on his own.
If the mother needs to leave for a while, the milk is expressed so that the nanny or relative can feed the baby the usual food.
Pumping helps minimize the consequences of mother’s “sins.” In particular, many women pump after consuming junk food or drinks. This milk is disposed of. The breasts have to be emptied of milk even after fluorography or a chest x-ray.
If the baby ends up in intensive care after birth, the mother will have to express milk for quite a long time. Firstly, to maintain lactation, and secondly, so that this milk is fed to the child.
This procedure is useful during the treatment of congestion, lactostasis, and also during the “winding down” of lactation, after completion of feeding.
Mothers of twins and especially triplets are forced to pump in order to at least sometimes take a break from feeding.
You can express breast milk not only for your baby, but also for someone else’s. Donor milk can be sold or given to those who need it.

There are cases when a woman breastfeeds her child for many months or even years, but she is never given the opportunity to express herself. That is, this procedure is completely optional. But for many mothers, pumping helps regulate the amount of milk and gives them some freedom - to go to the cinema, go shopping or just visit a friend. These seeming little things often affect the maintenance of lactation as a whole.

You can express with your hands, on your own or with the help of others (nurse, doctor, husband). There are also special devices - breast pumps. They can be manual (they have a special bulb at the end that needs to be squeezed and unclenched by hand) or electric. The electric breast pump does everything itself. For expressed milk, sterile bottles or special containers are usually prepared.
Test jars are an excellent alternative to expensive milk containers: they are sterile and have a measuring scale

Preparation

The process of pumping takes energy and time. To make it as comfortable and safe as possible, you need to carefully prepare.
First you need to prepare containers for milk. Ideally, they should be sterile: use a sterilizer or simply hold them over steam.
If the milk is not intended for the baby, you can express it over the sink or over the table, laying a soft towel on it.

To make milk flow faster, you need to speed up its outflow. To do this, it is recommended to take a warm shower before starting pumping. You can massage your breasts with water from the shower head, directing it towards yourself. The water should be warm and pleasant, and the streams should be soft. After this you need to do a light massage:

One hand should be placed under the chest, the other on the chest.
Using circular movements you need to “pass” the entire mammary gland from the ribs to the nipple area.
If compactions are felt somewhere, you need to massage these places longer.

Hand movements should be soft so that the massage brings only pleasant sensations.

Hormones also affect milk flow. To stimulate yourself, you can look at photographs of your baby or think about him. There is no need for embarrassment here: the sight of your beloved child is guaranteed to trigger the release of oxytocin.

In order not to experience discomfort, you need to take a comfortable position. You can turn off the lights and sit in a soft chair, turn on pleasant music. From a medical point of view, the best position for pumping is sitting, slightly leaning forward.

How to properly express breast milk

Having prepared the containers and breasts, you can start pumping. Before starting, you need to wash your hands with soap.

Place one hand under the breast to support the mammary gland.
Place your other hand on your chest - your thumb above the nipple, slightly above the areola. Index - under the areola. Your fingers should form a C shape around the areola of the nipple.
Squeeze your index finger and thumb lightly, as if directing the flow of milk outward. Movements should be rhythmic and smooth. Pumping shouldn't be painful.
The lower hand can be released and used to hold the milk container.
As soon as the flow of milk has decreased, you need to slightly change the place of pressure (thumb position). Thus, you need to go through the entire gland in a circle.
If lactation has already been established, there is no point in expressing until the last drop, because it simply won’t be there. Valuable liquid will be formed directly during the pumping process. You need to stop when the flow of milk has weakened significantly, or the planned volume of milk has been reached.

The position of the fingers near the areola needs to be changed to free all the ducts

When using a breast pump, you need to do all the preparation and then follow the instructions of the device. A comfortable position and complete relaxation will help you survive pumping without damaging your nipples or causing nervous tension.

When expressing, there is no point in putting pressure on the nipple - this can only injure it. It is necessary to influence the mammary gland itself.

How often should you pump?

There is no general rule regarding the number of pumping sessions per day. Everything is determined in a specific situation. Only some general recommendations can be described:

If the baby is full term, born healthy, quickly latched onto the breast and suckles well, there is no need to express. Attaching a baby on demand will be the best prevention of congestion.
If the baby does not immediately take the breast in the first days, he is lethargic and sleepy for some reason, then he will need to be woken up for feedings. If, upon waking up, the baby actively suckles for less than 10 minutes, you will have to pump the milk for the same amount of time. It is advisable to give everything that has been expressed to the child from a syringe or pipette. This will need to be done every couple of hours. Upon discharge, the pediatrician will give his recommendations.
If the baby was born too early and was admitted to intensive care, the mother will need to pump every 2-3 hours for 15 minutes, regardless of the amount of milk. This will allow you to maintain lactation by the time the baby is discharged.
If the breast is literally swollen from too much milk, the breast will need to be emptied slightly before feeding to make it easier for the baby to latch on to the nipple. If stagnation and overcrowding bother you greatly, you can express completely once a day. If lactostasis begins (thickness appears and the temperature rises) - 2-3 times a day, but not more often! The more often a woman expresses, the more milk will come - it will be a vicious circle. It is best to do this little by little until the discomfort goes away.
If for some reason the mother is not near the baby, but wants to support lactation, she will need to express 7–8 times a day, of which at least once at night.

The amount of milk that can be expressed at one time varies from woman to woman. It depends on the stage of lactation, time of day and many other factors that influence lactation “here and now.” The average portion of milk for women with established lactation is 130 ml at a time, but you should not rely on this figure. Whether there is enough milk is determined by the baby’s weight.

Doing the procedure for the first time

For those who do not have experience pumping, it is best to do it under the supervision of a specialist. In maternity hospitals, midwives or nurses are required to help women in this matter. They will show you how to work with your hands and what is the best position to take.
The first pumping should be done manually. This will be the gentlest way for the still tender breasts. With this approach, it will be easier to understand your sensations and see exactly what movements help push milk out of the ducts. It will be possible to “find” the appropriate speed and intensity of movements. If a woman plans to use a breast pump in the future, you should not set the device to high intensity the first time.

Before pumping for the first time, it is advisable to watch the video instructions. This will help you make sure your actions are correct.

Breast preparation and pumping - video from the Union of Pediatricians of Russia

Storage and use

Expressed milk can be used immediately, stored in the refrigerator or frozen.
If for some reason a woman cannot feed the baby directly from the breast (for example, a painful crack), she can express milk and give it to the baby in a bottle. You don’t need to warm up the newly expressed milk in the summer, but if the apartment is cool and it has cooled down a lot during the pumping process, you can warm it up slightly.
There are two ways to heat breast milk - in a special warmer or in a water bath (when a bottle of milk is placed in a jar or saucepan with warm water).

Do not use a microwave to heat breast milk! Microwave waves destroy the beneficial properties of this valuable liquid. In addition, you can easily overheat the milk.

For those who like to express for future use (for the next few days or just “in reserve”), a refrigerator or freezer will help preserve milk. If you are unable to collect enough milk in one pumping session, you can mix portions from different pumping sessions. But this should only be done with a chilled product! That is, both portions should stand in the refrigerator for some time, and only after that they can be poured into one storage container.

The shelf life of milk for healthy children and babies being cared for in a maternity hospital is different.

Table: product shelf life

To defrost breast milk, it is advisable to put it out of the freezer and into the refrigerator in advance. If you need to feed your baby urgently, you can defrost the milk at room temperature. Breast milk thaws very quickly, so there is no need to warm it up with anything.
The supply of milk in the freezer is called a “bank”: the date of pumping must be written on each container

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

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

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

When is it necessary to express breast milk?

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

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

Hand expression technique

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

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

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

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

Rules for expressing milk with a breast pump

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

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

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

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

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

Storing expressed breast milk

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

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

Where to express milk - milk storage containers:

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

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

How long can I store expressed breast milk?

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

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

If you need to travel, you should purchase:

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

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

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

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

Feeding expressed breast milk

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

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

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

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

Current questions about pumping

Should I express breast milk from both breasts?

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

How often should I pump?

How many times should I pump?

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

Should I pump my breasts at night?

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

How long does it take?

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

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

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

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

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

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

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

Which is better - hand expression or breast pump?

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

Is breast milk healthy if it has been frozen?

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

And finally, why express breast milk?

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

When breastfeeding on demand, constant pumping is not necessary: the amount of milk is regulated by the baby himself. Frequent pumping “to the last drop” can lead to hyperactivation - excessive milk production.

Does this mean that there is no need to pump at all, ever, for anyone? Not at all. There are times when pumping is truly necessary. Here they are:

With strong postpartum hot flash milk, which is accompanied by engorgement (usually 3-4 days after birth). It is important not to overdo it and give the mother’s body time to figure out how much milk the baby actually needs. Pumping begins no earlier than a day after the start 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, it will come again in the same quantity. Your best breast pump during this period will be... the baby, whom you will attach to the breast at his request and on his own initiative, if the breast becomes hard between feedings.

And only in a situation where the baby does not want to suck, will you need to pump the breast until you feel relief.

For increase 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 maintaining lactation if mother and baby are temporarily separated. By expressing at a rhythm of 2-3 times a day, you can maintain lactation for quite a long time. If you need to reach 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 the milk for the duration of your absence.
In case of lactostasis- stagnation of milk. With lactostasis, you need to pump if the child sucks the sore breast reluctantly or does not suck at all.

What is the best way to express - with a breast pump or by hand?

Each option has its supporters. If you are expressing milk for the first time in your life, first try doing it manually. You won’t hurt yourself with your own hands and you won’t injure your chest if you make mistakes in technique. In addition, by expressing with your hands, you can take into account the anatomy of your breast, select the necessary movements, speed and compression force.

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

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

But a breast pump can help you perfectly later, when your breasts are already developed. It makes sense to use it if regular pumping is necessary - for example, if the mother goes to work or is often away from the child.

Hand expression technique

Prepare a clean container with a lid; It is inconvenient to express into 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 milk flow before pumping, you can: apply dry heat to your breasts for a few minutes, drink something hot, warm your hands and feet in hot water, take a hot shower; roll the nipple between your thumb and index finger.
Sit or stand comfortably and place the dishes under your chest.
Place your thumb above the areola, and the index and middle finger below it: the fingertips and nipple are in the same vertical line. Make sure that while expressing your fingers are on the border of the areola and white skin or slightly beyond this border.
Using your thumb and forefinger, press the areola towards your chest (that is, TOWARDS YOURSELF, not away from you). This may need to be done several times before the milk starts to drip, flow or splash.
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 a squeezing one.
Move your fingers in a circle to empty all lobes of your breast. Make sure that your fingers do not slip on the skin - for this, use your 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 no more than 20-30 minutes, changing hands until the milk flows weaker. It is impossible to express all the milk from the breast “dry”, since it is constantly produced.

What not to do when hand expressing: rub, press, massage the breasts, and also do any movements that cause pain.

Expression technique with a breast pump

With a breast pump, on the one hand, everything is simpler: you just need to follow the instructions that come with it. On the other hand, it’s more complicated: not every breast pump can effectively express your breast. If you did everything according to the instructions, but still did not achieve success, the following tricks may help:

comfortable posture, relaxed shoulders and neck;
such a tilt of the body, in which the chest is facing down, will hang down;
warm on the chest before pumping, hot drink;
express both breasts at the same time (here you need a double breast pump);
pumping directly while feeding the baby (we feed one, and express the other at the same time);
thoughts about the child, imagine him feeding;
“white noise”: sounds of nature, flowing water, sound of rain.

If you are unable to express milk

Have you not been successful or pumped less than you expected? When feeding on demand, the mother's body usually produces the amount of milk needed for one feeding. Accordingly, getting something extra may not be easy. But don’t lose hope: after the third or fourth attempt, pumping will become more effective. The breasts will “learn” to give milk in a new way, you will get used to making the necessary movements, study the rhythms of milk flow, and find the right mood. Pumping is a constant practice and experience.

Keep in mind that you can express the required portion of milk not at once, but over several pumping sessions - for example, during the day. Expressed milk should be stored in the refrigerator.

What does expressed breast milk look like?

Some mothers 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's milk! It can look like melted butter or like translucent bluish water. After standing for several minutes, expressed milk may separate - the fattier component will float to the top in the form of cream, and the more liquid component will remain at the bottom. It makes no sense to judge the nutritional value of milk by the type of milk. One woman’s milk may be different from another, “two-week” milk is not like “three-month” milk - but at any stage of lactation it will definitely meet the needs of a particular child.

Storing expressed milk

Expressed breast milk is stored:

without refrigerator – 12 hours
in the refrigerator - 24 hours
in the freezer with quick freezing (temperature -18 degrees) – up to 4-6 months

As storage containers, you can use either special containers or clean glass containers that are hermetically sealed. Baby food jars, for example, are fine. You can simply use thick, hermetically sealed plastic bags.

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

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

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