Expressing and storing breast milk

You can release milk by hand (manually) or with a breast pump. This is called expressing.

There may be times when you need to express your breast milk.

This can happen when you miss a feeding, your baby takes a bottle, or your breasts are engorged. You can save the milk for a later feeding. Read on for how to store breast milk.

Expressing breast milk manually

To express your breast milk:

• Wash your hands.
• Help your milk let down by first massaging or stroking your breast. Avoid sliding your hand over your breast down to the nipple. This can cause painful skin burns.
• Put your right hand on your right breast. Put your thumb above your nipple (in the 12 o'clock position) and your first two fingers below your nipple (in the 6 o'clock position). Keep your fingers 1 to 1 ½ inches from the nipple. In this position your thumb and fingers will put pressure on the area where milk is stored.

• Push straight back into the chest wall without spreading your fingers. If your breasts are large, lift your breast and then push. Do not squeeze your breast. This can cause bruising. (See figure a.)
• In one motion roll your thumb and fingers forward about one inch. This rolling out motion compresses the areola without injuring sensitive breast tissue. Do not pull your nipple out. (See figures b and c.)
• Repeat rhythmically: position fingers, push in, and roll out.
• When you no longer get milk, rotate your thumb and fingers. Move your thumb to 11 o'clock and your fingers to 5 o'clock to compress this area of the areola. Then move to 10 and 4 o'clock, and 9 and 3 o'clock. Switch to your left hand to compress the other areas. Put your left thumb at 1 o'clock and your fingers at 7 o'clock. Finally, put your thumb at 2 o'clock and your fingers at 8 o'clock.
• Express your right breast for five to seven minutes and then express your left breast.
• Massage your right breast and repeat the expressing routine for three to five minutes. Then massage and express your left breast.
• Repeat this procedure again for both breasts, expressing each breast for two to three minutes.

Expressing milk with a breast pump

Breast pumps vary considerably in quality and effectiveness. Talk with a lactation consultant or a La Leche League group leader about how you plan to use a pump. That way you can choose one that best meets your needs.

Using a breast pump should never cause you pain. If you do have pain stop using the pump and call a lactation consultant right away. She may be able to recommend a different sized attachment to make pumping more comfortable. If necessary, she can suggest a different type of pump.

It is important that the parts of the pump that come in contact with the breast, milk, or collection containers be very clean. Wash them in hot, soapy water. Rinse and air dry them on a clean towel. You can also wash them in a dishwasher.

Before you start pumping, wash your hands well. Sit comfortably and take a few slow relaxing breaths before you start. Massage your breasts to help your milk let down. Pump your breasts according to the directions that came with the pump.

If you are trying to store milk for future use, your milk supply is usually most plentiful in the morning. Also, try to pump when your baby would normally breastfeed.

Storing breast milk

Breast milk stores very well. It can be kept in the refrigerator for use within five days. Breast milk can be kept in the freezer for up to six months. If you are planning to freeze milk, there are several styles of containers available for storing breast milk. These include specially designed plastic bags, bottles and glass containers.

Throw away any milk that is left over after a feeding.

How to store breast milk:

• Pour the pumped milk into a storage container.
• Leave space at the top of the container to allow for the expansion that happens when the milk is frozen.
• Freeze milk in two to four ounce portions. This is about what a newborn takes during a feeding. This portion also thaws quickly in warm water.
• When using plastic bags, use only those designed specifically for milk collection. Before storing, fold the top over several times and seal with freezer or masking tape. Twist ties can also be used. Then, put the date on the bag.
• Once the milk is frozen, place the plastic storage bag in a larger bag to help prevent punctures.
• If you pump in small quantities, you can add fresh milk to already frozen milk if you chill the milk before adding it. The amount of added cold milk must be less than the amount of the frozen milk.
• You can collect small amounts of milk during the day and store it in the refrigerator. Then freeze the entire amount at the end of the day. If you are at work, make arrangements with your employer.
• There are two ways to thaw frozen breast milk:

— in the refrigerator. Place the container in the refrigerator. It takes about 12 hours for the milk to thaw in the refrigerator. Thawed milk can remain in the refrigerator up to 24 hours.

— placing the container in warm water. Place the container under running warm water or in a pan of warm water. It takes a few minutes for the milk to thaw depending on how much you are thawing.

• Do not refreeze thawed breast milk.
• Gently shake thawed or refrigerated milk to remix the creamy portion that separates during storage.
• The color, consistency, and odor of your breast milk may vary, depending on your diet and the time since giving birth.