Expressing your milk

Expressing can be useful if:

• You go somewhere without your baby, and he will need to feed while you are away
• You’re worried about breastfeeding in public
• You need to encourage milk flow
• You need to produce milk in the first few days for an ill baby
• You need to tempt your baby to attach and feed
• You need to help your baby attach to a very full breast

You can express your breastmilk by hand or using a breast pump. Hand expressing can be useful in the early days, especially if your baby is ill or reluctant to feed. Once breastfeeding is established, you can use a breast pump to express milk.

How do I do it?

You can use hand expression or a pump – or both – to express your milk. Whichever method you use, practice helps.

For information on sterilising feeding equipment and safely storing your breast milk, please see the Ready Steady Baby website.

Getting the milk to flow

However you express your milk, the most important thing is encouraging the milk to flow. Start with breast massage to stimulate the letdown reflex (see below).

Breast massage

Whether expressing by hand or with a pump, massage can be helpful. Try the following different massage techniques to find the one that suits you best.

• Gently stroke from the outside of your breast towards the nipple with the tips of your fingers

Then, try either of the following:

• Beginning at the outside of your breast, gently massage your breast with circular movements towards the areola and nipple area. Follow this by gentle stroking as above and complete this by standing up and shaking your breasts
  
• Use your knuckles to gently massage the outside of your breast towards the nipple – this is particularly useful if you have a duct which has become blocked or if your breasts are slightly engorged

Hand expressing

Hand expression is a handy skill to have and for some women it may be more effective than a breast pump. It also doesn't cost anything, and is convenient giving you full control. It can also help you understand how your breasts work.

Finding the place you need to press

Find where your milk-collecting ducts are in your breasts. Feel for them about a few centimetres from the end of the nipple – they might feel a bit like peas or peas in a pod and you'll feel a change of 'texture' inside your breasts. The milk-collecting ducts are usually found where the darker tissue of the nipple area (areola) meets the skin of your breast.

Removing the milk

• Use something with a wide neck to catch the milk, like a jug or a plastic container.
• Place the flat of your thumb above and first finger below, in a ‘C’ shape over the milk-collecting ducts. Without sliding your thumb and finger over your skin, gently push your breast back towards the chest wall.
• Bring your thumb and finger together in a press/release movement. Repeat this process, moving your finger and thumb around the breast, building up into a rhythm. You may need to swap hands to express milk from the other side of the breast.
• Unlike breastfeeding, when hand expressing you may get more milk by changing from one breast to the other. Each time you stop managing to produce spurts of milk, change to the other breast.
• During the first few days, your colostrum comes out in drips. That's normal – colostrum is produced in small amounts, as that's all your baby needs. When your milk has 'come in', it drips at first and then may come out in streams or spurts – this is what you want. Continue until the flow of milk either stops or slows down to drips, then move your finger and thumb round your breast to the next set of milk-collecting ducts and start again.
• Some women find that they get plenty of milk following the above methods. However, other women find that their breasts need more stimulation to get streams or spurts of milk flowing. Massaging your breasts should give this extra stimulation.

Some women find that they get plenty of milk following the above methods. However, other women find that their breasts need more stimulation to get streams or spurts of milk flowing. Massaging your breasts should give this extra stimulation.

Other suggestions for helping the milk to flow include:

• Heat: try a warm flannel on your breast or have a shower or bath beforehand
• Sit somewhere warm and comfortable
• Try to relax – perhaps doing some deep breathing, watching TV or listening to some music you like
• Try thinking about your baby – a photo or piece of his clothing may help, or even a tape of his sounds.

Many women find it most effective to combine pump and hand expressing if they are separated from their baby.

Expressing with a pump:

Most hospital maternity units have electric pumps for use on the unit, or you can hire or borrow similar models for use at home. You can also hire electric breast pumps from the National Childbirth Trust, call 0300 330 0770 or visit their website. Smaller electric pumps, which run on batteries or from the mains, can also be purchased on the high street.

Hand pumps come in different versions. You can buy them from pharmacies or baby stores and by mail order.

How much to express?

As a rough guide, a baby under three months will take 100-120 ml (3-4 ounces) of expressed breastmilk per feed, and a baby over three months will take 150- 200 ml (5-7 ounces) per feed. But this is approximate – after you’ve done it a few times, you'll soon become good at knowing what your baby is likely to need.