Expressing breastmilk

Expressing involves pumping milk from your breasts so you can give it to your baby at another time or using a different feeding method like a bottle of cup.

Why might I need to express?

There are a number of reasons mums decide to express breastmilk. It might be because their baby is struggling to get the hang of breastfeeding and a midwife, lactation consultant or breastfeeding support worker has suggested expressing as a way of making sure they get enough milk while feeding is still getting established.

Expressing can also help relieve feelings of discomfort if your breasts are engorged and feel uncomfortably full. And as breastfeeding works on a supply and demand basis, the more milk you remove from your breasts, the more you will produce. This means expressing can help boost your milk supply.

The reason many parents express is to allow someone else to feed their baby. This might be because you want your partner to be able to help out more and take a more active role in feeding or it could be because you have to be away from your little one because they are in special care, you have gone back to work, you need to go into hospital or you are going for a trip without your baby.

How do I express breastmilk?

You can express milk by hand or by using a breast pump – either manual or electric. Which method you choose will probably depend on your circumstances.

If you just want to express a small amount to ease discomfort in your breasts or to make sure your newborn gets some colostrum, hand expressing will probably be the best method. However, if you need to express regularly or you need to collect a significant quantity of milk, using a pump will probably be easier and more effective.

One thing to remember with expressing is that some women find it more challenging than others so don’t be discouraged if you don’t get much milk, especially when you are first getting started. Struggling to express does not mean you are not producing much milk so don’t think that a small quantity indicates a problem with your milk supply.

Many women find expressing easier when they are calm, relaxed and either near their baby or thinking about them. If you can’t be near your baby, looking at a photograph of them can help get your milk flowing.

You may also find expressing easier after you have had a shower or bath or if you place a warm towel on your breasts before you start.

How to express by hand

In the first few days after giving birth, many women find it easier to express by hand. One of the major advantages of hand expressing is that you don’t need any special equipment- just a sterile container to catch the milk in.

Make sure your hands are clean before you start and then cup your breast with one hand. Use the other hand to create a C-shape using your thumb and forefinger and squeeze your breast firmly but gently.

Be careful not to squeeze the nipple itself as this can cause soreness. Instead, keep your finger and thumb outside the areola (the darker skin surrounding the nipple).

Try to build up a regular rhythm. Squeeze, then release and keep repeating the process. You should see drops of fluid start to appear on your nipple. If you don’t try to readjust your hand into a different position but remember to avoid the nipple itself.

As the milk flow slows, move your fingers to target a different area of the breast and keep going until the flow slows down considerably or stops. That is a sign to switch to your other breast and repeat the process.

What type of breast pump should I use?

When choosing a breast pump, you will have the option of manual or electric. Manual pumps are operated by hand and are usually more affordable, although it may take longer to use than an electric option.

If you use a pump in the hospital, it is likely to be an electric pump. If you are going to need to express often, it may be worth looking into hiring a hospital-standard electric pump – your midwife, health visitor or breastfeeding support team should be able to give you details of hiring services in your area.

Electric pumps are often quicker and more efficient than manual ones but they are a bigger investment so if you’re only planning to express occasionally, you may want to stick with a manual one.

If your circumstances mean you will be expressing regularly and will need to produce a large amount of milk this way, you may want to consider buying or hiring a double breast pump. This allows you to express from both breasts at the same time, which will save you a considerable amount of pumping time.

Make sure the funnels you use fit your breast properly – some pumps will offer a selection of sizes. It is not normal for a breast pump to cause bruising so if this happens, stop using it and try a different size funnel.

How to use a breast pump

With any pump, it is important to read the instructions carefully as the method for use will vary depending on the model. One thing you should always do is make that the pump and container have been thoroughly cleaned and sterilised before use.

Manual pumps usually work by squeezing a handle. Try to keep a steady rhythm and make sure the funnel is properly positioned over your breast. Be patient – it can take a little while for the milk to start flowing.

With an electric pump, there is usually a way of adjusting suction strength. Start on a slow setting and then build up slowly until you find the level which works best for you – this may take a little bit of experimenting to find.

Trying to start with the breast pump on a high speed can hurt and may even cause blisters or sore nipples, which will make breastfeeding and expressing painful.

How do I store expressed milk?

Once you have expressed your breast milk, you need to know how to store it properly. You can keep it in a sterilised container or you can get breast milk storage bags which are specially designed for this purpose.

Freshly expressed breast milk can be kept at room temperature for four hours but if you aren’t planning to use it straight away, it is best to keep it in the fridge or freezer. If your fridge has a temperature of 4C or lower, breast milk can be safely stored for up to eight days but if you’re not sure about your fridge temperature, use the milk within three days to be on the safe side.

Expressed breast milk can be kept in the freezer for up to six months or in the ice compartment of a fridge for two weeks. Always label and date containers of expressed breast milk before you store them so you know when they need to be used by.

It is best to store expressed milk in small amounts if possible to avoid any waste. When defrosting frozen milk, you can defrost it slowly in the fridge or if you need it quickly, you can put it under a rap of running warm water or in a jug of warm water.

Shake the container before use and don’t freeze it again. If your baby is happy to drink milk cold, this is perfectly fine but you can warm it up using warm water – either by holding it under the hot tap or putting it into a jug. Don’t try to heat expressed milk in a microwave as you can end up with hot spots and there is a risk your baby could get a burnt mouth.

Once your baby has started a bottle of expressed breast milk, make sure it is used within an hour. Any unfinished feeds should be thrown away after this time.

If you are expressing in hospital, speak to the staff there about how you can store your milk safely.

To find out more about expressing, we have an online antenatal class on infant feeding. This two-hour workshop covers breastfeeding, formula feeding and expressing so you can make an informed choice about feeding your little one.