HAND EXPRESSION OF BREASTMILK

All mothers should learn to express their breastmilk. This can be taught during pregnancy and practiced soon after birth.

Expressing milk is useful to:

  • Feed a low birth weight or sick baby.
  • Relieve engorgement.
  • Maintain the milk supply when the mother is ill.
  • Relieve leaking breasts.
  • Leave milk for the baby when the mother goes out, or to work.
  • Feed a baby while s/he learns suckling from inverted nipples.
    • Hand expression is the most useful method. A woman should express her own milk. Before expression it is useful to stimulate the oxytocin reflex to assure a copious milk flow.

    How to stimulate oxytocin reflex

  • Remain confident.
  • Try to reduce source of pain or anxiety.
  • Keep good thoughts and feelings.
  • Find a quiet place and ensure privacy.
  • Hold your baby on her lap with skin to skin contact, or looking at the baby.
  • Take a warm soothing drink.
  • Warm the breast with warm water.
  • Stimulate your nipples by massaging the breasts gently towards the nipple and stroking the nipple and areola gently with fingertips, or gently rolling a closed fist over the breast.
  • Ask a helper to rub the knuckles of her fist firmly up and down the your, on either side of the spine from the neck to the shoulder blades for 1 to 2 minutes.
    • Method of expression

    For expression of milk the mother should wash her hands thoroughly and sit or stand comfortably holding a clean container near the breast. The thumb and the first finger should be placed on the areola above and below the nipple opposite each other (Fig. 8). The thumb and the finger should be pressed inwards towards the chest wall, then the areola behind the nipple should be pressed between the finger and thumb so that the lactiferous sinuses beneath the areola are compressed. (Fig. 9)

    Pressure should be alternately given and released till the flow of milk starts. If the procedure is painful, the technique is wrong. The fingers should not be slid along the skin nor should the nipple itself be squeezed. Pressing or pulling the nipple cannot express the milk. Pressure should be given on all the sides to ensure expression from all segments of the breasts (Fig. 10). The breast should be expressed for at least 3 to 5 minutes until the flow slows, then express the other side and repeat alternately.

    To express milk adequately it takes 20 to 30 minutes. It is important not to attempt expression in a shorter time.

    Fig. 8: How to express breastmilk        Fig. 9: How to express breastmilk

    Fig. 10: How to express breastmilk

    Storage of expressed breastmilk:

    Fresh breastmilk can be stored in a refrigerator for 24 hour and at room temperature for 8 hours. Refrigerated breastmilk should not be heated as it well protective properties.

    Mixed Feeding

    You can continue to breastfeed when at home and the baby can be given top milk by the care-taker when she goes out to work. It is preferable to use fresh animal milk than the commercial baby foods. It is best to use a cup and spoon to feeding the baby. These are easier to clean than a feeding bottle and nipple. Bottle and nipple are easily contaminated and expose the baby to an added risk of infection. When a mother goes to work she may find that her breasts become very full during the day. It is important to relieve by expressing the milk for few days till the breasts adjust to the new routine.

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