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Expressing Breast Milk 89
practise (perhaps in the bath) so that the mother raises the prolactin and fat and volume levels and
can find what works for her. As a guide, the may be useful for long-term expressing.
mother should be instructed to try the following
steps: Expressing milk for newborn
infants
1. Place your first finger under your breast,
towards the edge of the areola, with your thumb It is important to start expressing as soon as
on top of the breast opposite the first finger. possible after birth for infants who cannot be put
These should then be in about the same position to the breast. Mothers who have infants in
as the baby’s mouth. You may be able to feel the Neonatal Intensive Care Unit (NICU) should be
knobbly sinuses underneath the areola. encouraged to express at least 6–8 times in 24
hours, including at least once during the night.
2. Keeping your fingers and thumb in the same From 2–3 days after birth, milk production is
places on your skin, press them together for two related to milk removal and if milk remains in the
seconds and release. A hard squeeze will be breasts too long, there is a build-up of a protein
painful and not effective. called the ‘feedback inhibitor of lactation’, which
may decrease the milk supply.
3. This press and release action should be repeated,
keeping the thumb and the finger in the same Storing expressed breast milk
place and taking care not to slide your finger
and thumb up or down the breast. After expressing into a sterilized container, the
container should be covered with a tight-fitting lid
4. Once you have acquired the technique, press and labelled with the date (NICE 2008b). It should
and release every few seconds, building up a then be put into the fridge or freezer as quickly as
steady rhythm. The exact rate and rhythm possible. Breast milk stored in a fridge retains the
needed to express milk efficiently varies from properties more effectively than freezing.
woman to woman.
In a fridge
5. The milk may take a minute or two to flow. Breast milk should be stored at the back of the
When it does it will drip or spurt from the fridge where it remains coldest. It should not be
breast. Collect it in a sterile, wide-mouthed stored on the door of the fridge where it is more
container – a measuring jug is ideal. likely to be warmer. It can be stored for up to five
days if the parents are confident that the fridge
6. It is important to rotate your fingers around the remains at 4°C or lower. This cannot necessarily be
breast to ensure that milk is expressed from all guaranteed in a domestic fridge that is frequently
the lobes. opened. Hence in a busy household it may be
preferable to freeze the beast milk if it is not going
7. With practice it is possible to express from both to be used within 48 hours.
breasts at the same time.
In a freezer
Using a breast pump Breast milk can be stored for up to two weeks in the
freezer compartment of a fridge or for six months
It is best to establish a good breastfeeding routine if in a domestic freezer, at minus 18°C or lower.
possible before beginning to use a pump. There are
three main types of pump available – hand, battery In hospital
and electric. There are many varieties for personal Storage times within hospital guidelines should be
preferences and circumstances. For mothers with followed.
infants in special care it may be necessary to hire a
hospital-grade electric pump.
Simultaneous pumping may be recommended in
some circumstances. This is expressing both breasts
at the same time. It is thought that this significantly
