Expressing Breast Milk - Take Action - Breastfeeding

There will be times when you will need to leave your baby, whether it is to work outside the home or for other reasons. To continue giving your baby breast milk, which is best for your baby's health, you will need to express your milk for use in a bottle or cup. There are two ways to express breast milk, either by hand or with a pump.

Using the hand to remove milk from the breast takes practice. You need to duplicate the sucking rhythm of the baby at the breast. Some mothers find that they get a better response from manual expression because of the skin touching skin and not hard plastic from a pump. This technique is also useful if you do not have access to a pump and must express to prevent engorgement. The touching and stroking of the breast stimulates the nerves that in turn stimulate the pituitary gland to send the hormones out to supply the milk and allow a milk ejection reflex, or let-down, to occur.

When choosing a breast pump, ask yourself the following questions: Is the pump efficient, quiet, convenient and flexible with adaptors for use in a car? Is it affordable and is repair service available? Is the pump easy to clean and easy to use? What type of pump is best for me — manual (hand pump), electric or battery operated? Do I plan to pump one breast, or both at the same time?

If you work full-time and want your baby to receive only (or nearly only) breast milk, an electric pump with double-pumping capacity is your best bet. If you just want to be able to express a bottle here or there for a caregiver to use while you run errands or go out to dinner, a manual or battery-operated pump may do the trick. Talk with friends who have used pumps—and visit the website of the La Leche League (www.laleche.org) to learn more about different kinds of pumps.

Pumps can be rented or purchased. Shop around, because prices can vary widely. Buying (or borrowing) a pump that has been used before may seem cost-effective but is not always desirable. There may be problems replacing parts, as some manufacturers will not sell parts if you are not the original owner. And there is the chance that bacteria and viruses may be hidden in the mechanical parts of the pump, which can put you and your milk at risk of contamination.

To figure out how often you'll need to pump, determine how long you will be away from your baby and remember to add in driving times. It is much faster and more productive to pump both breasts at the same time for 10 to 15 minutes at least every three to four hours if the baby is nursing exclusively. If the baby is older and taking other foods, pumping once or twice while at work may be enough.

Some mothers find it easy to pump milk; others find that their breasts don't let down milk the way they do during actual breastfeeding. If that is the case with you, here are some suggestions:

Relax and take deep breaths before and during the pumping to relieve tension. Use mental imagery to relax.
Listen to soothing music.
Look at a picture of your baby while pumping.
Have piece of clothing or blanket that has your baby's scent and inhale the fragrance.
Massage your breasts gently. This helps in stimulating the let-down reflex. Use smooth strokes from the outer edge of the breast to the nipple.
Use warm, wet face cloths over the breast before pumping.
Take the phone off the hook.
Lock the door to ensure your privacy if you are at work.
Make sure you are sitting in a comfortable chair.
Have a warm or cool drink next to you.
Wear clothing that is pumping friendly — easy to open and close.

Most pumps come with a bottle to pump into, which you can use for storage as well, although you may want to transfer your milk into a storage bag (look for ones made especially for this purpose) if you are planning on freezing it (takes up less space).

How to use the pump: It is important to keep your pump parts clean. Review all instructions before using the pump. If you have questions, contact your local pump-rental station, a lactation consultant (your obstetrician or pediatrician should be able to help find you one), or La Leche League (they have a wide network of nursing mothers available to give advice).

Start with the lowest vacuum setting and gradually increase it, but not to the point where you're uncomfortable. You should not experience pain while pumping. Some pumps provide custom-designed cups or horns to accommodate differences in breast size.
When applying the breast cup or horn make sure that the nipple is in the center, and that there is good skin contact on the breast. Some mothers rub a small amount of breast milk on the inside of the flange for a better fit.
Sit straight up so that as the milk flows into the horn shaft you are able to lean forward to allow the milk to flow into the bottle.

Generally, pumping takes about 10 to 15 minutes if you are pumping both breasts at the same time. When finished, make sure the labeled milk container is placed in a secure cold place such as a refrigerator. Many pumps come with special containers (and freezer packs) for storage when you are away from home.

Breast milk storage guidelines (per the La Leche League):

At room temperature: 10 hours
In a refrigerator: up to eight days
In a freezer compartment inside a refrigerator: two weeks
In a freezer with a separate door: three months
In a separate deep freeze: six months