Expressing

If you have decided to breastfeed, you’ll probably need to learn how to express.  There is a bit of an art to it, but once you’ve got the hang of it, it can be a real Godsend as it allows you to go out or even get some sleep whilst someone else feeds your baby (such as daddy).

When to start

The advice is to wait until your baby is 6 weeks old before expressing, as this is when breastfeeding becomes ‘established’. Established breastfeeding is where your milk starts to let down in time with your baby’s feeds. Some women describe the milk let down as a squeezing sensation in the breast.

It is possible to start before 6 weeks, but there is a risk that your milk supply will be over-stimulated and your breasts will become engorged. The other risk is that your baby becomes confused about the difference between nipple sucking and teat sucking – they are apparently quite different actions. To help deal with this problem, see ‘what bottles to use’ below.

Which breast pump

Unless you are planning on developing the muscles in your hands, an electric breast pump is much preferable to a manual one. MoorMums recommends the Medela branded pumps. We have found them to be very good. However, different pumps suit different people so if you’ve been given a different one, give it a go and see how it works for you.

It is worth getting a breast pump second-hand rather than new. They can be very expensive if you then decide that expressing isn’t for you or if you don’t like that particular brand. Remember that all the equipment should be sterilised before every use.

How to express

Have a go at expressing after a feed. It is best to choose a time when you’re not too frazzled and not in a rush, just to get used to how your pump works and how expressing feels. People usually have more milk in the morning, so you may want to have a go after a morning feed.

Essentially, you just put the pump on your nipple and turn the machine on, or manually pump. The milk won’t flow straight away, you need to wait a bit for the ‘let down’ reflex to kick in. It works best if you are relaxed and if you can also be looking at your baby (a photo will do) at the same time. With a manual pump, you will need to build up a bit of a rhythm before the ‘let down’ reflex starts.

Once you have started to ‘let down’, the milk should spray out (like a shower head). The pump will release a dribble of milk into the bottle on each pump. As you express, that dribble will eventually slow down to just a few drops. This is time to stop if you don’t want to over-stimulate your breasts. You can then move on to the other breast.

WARNING: As when feeding, your breasts tend to work together. So when expressing on one side, you could very well get milk pouring out of the other side. You may want to have a pad or cup (depending on how much milk you have) ready to catch it.  If you sterilise the cup, you could add what you collect to the main bottle.

How much milk

It depends very much on the individual as to how much milk you’ll be able to get from expressing. Because breastfeeding works on a supply and demand principle, when you first express, you may not get very much milk at all (maybe a teaspoon full). But, if you express regularly, this will increase the demand and therefore the supply will eventually increase.

Remember that you can mix milk that has been expressed at different times. This means that if you were to express after each feed during the day, you could add each amount of milk together (keeping them in the fridge between feeds) and you will hopefully have a whole feed by the end of the day – see ‘How much milk in a feed’ section later.

How does expressing work

With expressing, you are essentially feeding your baby your milk but without you needing to be there. However, your breasts will continue to expect to provide a feed every 3 or 4 hours. If this doesn’t happen, it can be quite uncomfortable and messy (as the milk starts to spray out everywhere). Again, this isn’t true for everyone, it very much depends on how much milk you have (and how good your breasts are at keeping it in).

Every time you (or someone else) feeds your baby some expressed milk, you will probably also need to express off a feed. This means that once you have built up a feed, you are always a feed in hand.

To build up a feed, simply express after each feed (or at least before the mid point between feeds – i.e.: if your feeds are every 4 hours, you need to express within 2 hours of the start of a feed. This ensures that your baby has enough milk when he/she comes to the breast for the next feed.

How much milk in a feed

The amount of milk your baby takes in a feed depends on how often you feed your baby and your baby’s weight. As a general guideline, your baby will require 2.5 fl oz of milk for every lb of body weight in a 24h period. So, if your baby weights 10lbs and feeds 5 times per day, you will need 5 fl oz for a feed.

How to sterilise

Once you’ve worked out how the pump works, it is time to do it for real! All the equipment – pump, bottles, teats, bottle lids must be sterilised before every use. To do so, you’ll need to get a steriliser. These are available second hand for between £5 and £10.

For electric sterilisers, it works like a steamer. You put a bit of water in the bottom (80ml for Tommee Tippee steriliser) and switch it on. After about 10mins, the water has all boiled off and the equipment is sterile. Always wash your hands thoroughly before getting the equipment out. The equipment should stay sterile for 3 hours after the end of the cycle as long as the lid of the steriliser is kept shut.

WARNING: The equipment will be very hot when the sterilising cycle first finishes – beware of burning yourself in your eagerness to get it out.

How to build up your first feed

Express after each feed (starting in the morning) until you have built up enough for one feed (see ‘How much milk in a feed’ section above). Keep the milk in the fridge (at the back) as you build it up. Don’t be disheartened if you don’t get a lot of milk, this is quite normal. It is a sign that your body is producing just the right amount of milk for your baby.

How long to keep the milk

The milk will keep for up to 48 hours in the fridge (at the back, not in the door) or up to 3 months in the freezer (there are specially designed breast milk freezer bags). The amount of time the milk will keep depends very much on how cold your fridge/freezer is. To freeze the milk, decant into specially designed breast milk freezer bags. These are available from Boots (and other places).

To use frozen breast milk, either allow it to thaw in the fridge (and then use within 24hrs) or put the bag of milk into luke warm water to thaw (when it is warm use immediately).

What bottles to use

Although they are quite pricey, Tommee Tippee ‘Closer to nature’ are very good as they are supposed to be more like an actual breast. Again, these must be sterilised before use. They are available from most supermarkets.

How to feed from a bottle

Warm the milk to body temperature by placing the bottle into a bowl of hot water.  Be very careful that the milk isn’t too hot when you give it to baby as it could burn them.  To check, spray a little on the back of your hand.  If it feels neither hot nor cold, then it is about right.

Milk comes out more quickly from a bottle than a breast. As a result, you may want to hold your baby more upright than you would do to breastfeed. Your baby will probably need to burp more than with breastfeeding. Don’t worry if your baby doesn’t take all of the expressed milk, they will just take the amount they need.

WARNING:  Always throw away any unused milk rather than refreezing or putting back in the fridge.  This can be a little frustrating but it is preferable to a poorly baby.

More information

If you have any further questions about expressing, why not contact us or discuss it with other mums in the baby chat section.