Breast Milk

Breast Milk

 Expressing breast milk
Expressing milk means squeezing milk out of your breast so that you can store it and feed it to your baby at a later time.

 You might want to express milk if you have to be away from your baby. This could be because your baby is ill or premature, or because you’re going back to work. You may want to express milk if your breasts feel uncomfortably full or if your baby isn’t sucking well but you still want to give them breast milk.
You may also want to express some breast milk to use with your baby's first solid foods.

How do I do express milk?
You can express milk by hand or with a breast pump. Different pumps suit different women, so ask for advice or see if you can try one before you buy it. Always make sure that the container or pump is clean and has been sterilised before you use it.

Expressing breastmilk by hand
You may find it easier to express milk by hand than to use a pump, especially in the first few days. It also means you won't have to buy or borrow a pump. The following suggestions may help:

  • Before you start, wash your hands thoroughly with soap and warm water, and gently massage your breast.
  • Cup your breast just behind your areola (the darker part of your breast).
  • Squeeze gently, using your thumb and the rest of your fingers in a C shape. This shouldn’t hurt (don't squeeze the nipple directly as you’ll make it sore and unable to express).
  • Release the pressure then repeat, building up a rhythm. Try not to slide your fingers over the skin. At first, only drops will appear, but keep going as this will help to build up your milk supply. With practice and a little time, milk may flow freely.
  • When no more drops come out, move your fingers round and try a different section of your breast, and repeat. 
  • When the flow slows down, swap to the other breast. Keep changing breasts until the milk drips very slowly or stops altogether. 
  • If the milk doesn’t flow, try moving your fingers slightly towards the nipple or further away, or give the breast a gentle massage. 
  • Hold a sterilised feeding bottle or container below your breast to catch the milk as it flows.

Cup feeding with breast milk
Sometimes your baby may need extra milk or find it hard to feed from your breast. In this case, your midwife may suggest that you give your baby some expressed milk in a cup.
This should be done under the supervision of a midwife until you feel confident enough to avoid the risk of your baby choking.

Storing breast milk
You can store breast milk in a sterilised container:

  • in the fridge for up to five days at 4°C or lower
  • for two weeks in the ice compartment of a fridge
  • for up to six months in a freezer.

Breast milk must always be stored in a sterilised container. If you use a pump, always sterilise it before and after use.

Defrosting frozen breast milk
If you have frozen your milk, defrost it in the fridge before giving it to your baby. Once it’s defrosted, use it straight away. Milk that's been frozen is still good for your baby and better than formula milk. Don't re-freeze milk once it's thawed.

Warming breast milk
You can feed expressed milk straight from the fridge if your baby is happy to drink it cold. Or you can warm the milk to body temperature by placing the bottle in lukewarm water.
Don’t use a microwave to heat up or defrost breast milk as it can cause hot spots, which can burn your baby's mouth.

Breast milk if your baby is in hospital
If you're expressing and storing breast milk because your baby is premature or ill, ask the hospital staff caring for your baby for advice on how to store it. 

Feeding with breast and bottle
You may want to combine breastfeeding with bottle feeding. For example, if you:

  • are breastfeeding and want to express milk to give your baby by bottle
  • want to breastfeed for some of your baby’s feeds but give infant formula for one or more feeds by bottle
  • are bottle feeding your baby and want to start breastfeeding.

If you are introducing infant formula, this will reduce the amount of breastmilk you produce. It may make breastfeeding more difficult, especially in the first few weeks, because your body will make less milk.

Introducing infant formula
If you choose to introduce infant formula, it’s best to do it gradually to give yourself time to adapt and to give your body time to reduce the amount of milk it makes. It usually helps to give the first few bottles when your baby is happy and relaxed – not when they're very hungry.

It may also help if someone other than you gives the first feeds, so that your baby is not near you and smelling your breast milk. It can take your baby a little time to get used to the bottle, so keep trying and don’t force the baby to feed.

If you're going back to work, think about how you'll do it. Start a few weeks beforehand to give both of you time to get used to it. You may find that you don’t need to introduce a bottle if your baby can drink milk from a cup and you can breastfeed when you're at home.

Choosing to restart breastfeeding
Breastfeeding is the healthiest way to feed your baby. If you decide not to breastfeed or have stopped breastfeeding, it is possible to restart. This can be difficult because your milk supply will naturally reduce once you aren't breastfeeding, but it can increase again to meet your baby's needs.

If you want to reduce the number of bottles and breastfeed more:

  • Holding and cuddling your baby in close contact (skin to skin) as much as possible will give you and your baby the time and opportunity for breastfeeding to happen more easily.
  • This stage can take some time while your baby builds up feeds little and often.
  • When your baby comes off the breast, offer the second. It doesn’t matter if they're not interested or don’t feed for long. This is OK. Start with that breast next time as it helps to boost your milk supply.
  • Talk to your midwife, health visitor or trained volunteer (peer supporter) about ways to reduce the amount of infant formula or expressed milk.
  • As your milk supply increases, you can gradually decrease the amount of infant formula or expressed breast milk. Some mothers find that it helps to do this one bottle at a time until that feed is replaced by a breastfeed.
  • If you've been expressing milk for most of your baby’s feeds, it's often helpful to carry on so that you keep your supply high during the changeover period.

Help and support
If you have any questions or concerns about combining breast and bottle feeding, ask your midwife or health visitor. You can also call the National Breastfeeding Helpline on 0300 100 0212 and get support and information from someone, often local, about breastfeeding your baby.

 Source: NHS Choices.

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