Frequency of expressing breast milk. Pumping: how often should it be done?

Every mother knows how much benefit breast milk brings to babies, and especially newborns. The most important advantage of this type of feeding over artificial feeding is the activation of the baby’s immune forces. Breast milk is also completely sterile and is always heated to the right temperature, which greatly simplifies feeding the baby while traveling and outside the home in general. In addition, breastfeeding helps a new mother quickly recover after childbirth and significantly strengthen the emotional bond with her child.

Due to the inexperience of young mothers, it happens that breastfeeding brings a lot of disappointments instead of pleasure. Milk does not come, or there is very little of it, cracks in the nipples do not go away, or the child flatly refuses to take the mother’s breast - there can be many reasons, they become especially relevant in the baby’s first month.

To solve any of these problems, women often start pumping their breasts. It is worth noting that modern doctors advise not to overuse pumping, they recommend simply feeding the baby, following not the clock, but its requirements. In this case, the mammary gland will produce exactly as much milk as the baby needs.

At the same time, in order to help herself during inflammatory processes such as lactostasis and mastitis, a woman should express breast milk until the inflammation goes away. Soon the baby will begin to empty the breast during each feeding and the likelihood of illness will be reduced to a minimum. As a rule, this will take a month while lactation is established.

It is important to know when to stop

Many young mothers are concerned about the question: how long to express full breasts to avoid congestion? A couple of decades ago, experts answered this question unequivocally: to the end, so that the breasts become completely empty. Today their position is not so categorical: it is recommended to express the breast until it feels comfortable, so that the feeling of fullness and distension disappears.

If you adhere to the “to the last drop” rule, breast milk will begin to be produced with redoubled force, and there will be more of it than one baby can suck. With a high degree of probability, such tactics will lead to congestion in the chest.

How to prepare and express milk

Pumping itself is not pleasant for every woman. In order to overcome discomfort, you need to create a favorable environment: calm music helps some, cold tea helps others, many mothers also recommend back massage... In other words, as many women as there are, there are as many ways to deal with unpleasant physiological sensations.

By the way, it’s worth trying to express breast milk both with your hands and with a breast pump: there are approximately equal numbers of adherents of both the first and second methods. True, in the case of a breast pump you have to put in less effort, especially if the device is electric.

If the baby quickly and actively sucks the breast, you should not buy a breast pump, but if the child is not gaining weight well and sleeps a lot, the device will not be superfluous. As for the question of how long the procedure will take when expressing by hand and with a breast pump, the answer is the same: it will take approximately 15-20 minutes.

Secrets and subtleties of manual expression

Before expressing milk, you need to wash your hands well using antibacterial soap, and find a suitable container (for example, a bottle) with a wide neck, boil it well and place it near the breast. After this, you need to start the pumping procedure with two fingers: place the thumb above the nipple, the index finger under it, and then press on the areola on both sides. Pressing should be alternated with relaxing the fingers. When expressing, you need to carefully ensure that there is no pain. If they occur, the tactics were chosen incorrectly and need to be changed.

If the actions are correct, milk will drip from the breast, and if the ejection reflex is active, it will flow. After the flow decreases, you need to pump both breasts in turn for another 3 to 5 minutes to make sure that there is no excess milk left in any part.

It happens that the breast becomes engorged, soreness appears in it, the nipple becomes tight, and it is completely impossible to express breast milk. In this situation, you can use the pumping method using a bottle.

You must first pour hot water into a sterilized bottle, wait and pour it out. After the neck has cooled (ideally, its diameter should be approximately 3 cm), it must be tightly fixed to the areola of the nipple. After a couple of minutes have passed, it will retract into the bottleneck and milk will drip into the container. To avoid damage to the nipple, you will soon need to remove the bottle and express breast milk into a regular container.

Often mothers are interested in how much and under what conditions to store expressed milk. Breastfeeding experts answer this way: in the refrigerator - 4 days, and in the freezer - up to 4 months.

Frequency of the procedure

As for how many times a day to express, this is a controversial issue. So, with the arrival of milk, and with it a feeling of fullness in the breast, it needs to be expressed for 1-3 days, 1-3 times a day.

If the newborn is separated from the mother (this is still practiced in some maternity hospitals), after each feeding for an hour, missed by the child due to sleep or refusal, both breasts are expressed in turn for 10-15 minutes.

It is worth noting that when milk comes in and lactation is established, you need to gradually stop expressing your breasts, reducing the duration and number of procedures. This usually occurs within the first month of a baby's life, and it will take about a week to completely stop pumping.

So, until the baby is one month old and normal lactation is established, you may have to resort to pumping. However, doctors advise not to delay abandoning this procedure, so as not to provoke the development of inflammatory diseases associated with excess lactation.

There is no one right solution for all situations; each specific situation must be considered.
If the condition of the mother and baby is normal, if all the rules for a successful start of breastfeeding are followed, pumping will not be required.
In a situation where the baby is not feeling well, perhaps even in the intensive care unit, or the new mother is having problems with lactation, some amount of pumping will be necessary.

Situation No. 1
The mother gave birth to the child naturally, the baby was immediately put to the breast in the delivery room. He sucks well and actively. Milk comes to the mother on the third day, without fever or complications.

The baby has lost less than 10 percent of its birth weight. The baby feeds on demand, but at least every two hours during the day and once every 3-4 hours at night. A healthy mother and baby are discharged home, where on-demand feeding continues, the mother’s breasts do not become overly full, and the baby continues to actively feed.

Solution. In this case, the mother does not need to express her breasts either before or after feeding.

Situation No. 2
The baby was born weak, on the first day he hardly took the breast, perhaps on the third day he developed physiological jaundice and became drowsy. The baby has to be woken up to be put to the breast and fed.

Solution. It makes sense for a mother to begin stimulating her breasts with gentle pumping movements 3-4 hours after birth. First, try to feed your baby from both your left and right breasts. If he ate in less than 10 minutes, try expressing drops of colostrum for another 10 minutes and give them to the baby from a syringe without a needle. You may have to wake him up and shake him every 2 hours.

If the baby attaches well to the breast and suckles for at least 20 minutes, there is no need to express. But if the baby sucks sluggishly and quickly falls asleep, you may have to express milk for some time after feeding and give it to the baby.

When the baby gets stronger and begins to gain weight at the right pace, you will no longer have to pump. If at the age of two weeks the baby has not regained the weight at which he was born, even if you supplement him with expressed milk, this is a reason to urgently seek the advice of a pediatrician and a lactation consultant.

Situation No. 3
The baby was born much prematurely and is being fed through a tube.

Solution. In this case, it is important to agree with the hospital staff to ensure that the child is supplemented with mother’s colostrum and milk. The fact is that the milk of mothers who gave birth to babies prematurely has a special, unique composition that is just right for a premature newborn.

Even a drop of it will be precious for a child! Therefore, while your baby is in the premature ward, keep in touch with him by passing on your milk.

Express with your hands or with a good, modern breast pump (you can rent one); it is advisable to empty both breasts at the same time - this will allow you to maintain lactation while the baby is not yet able to latch on. Even if the hospital staff for some reason cannot feed your baby with your milk, you will know that when you are back together, the baby will receive the nutrition it needs.

Situation No. 4
The mother is ready and wants to feed, the baby is active and demands to eat, but the mother has received so much milk that neither the baby can latch on to the breast, nor the mother can touch it.

Solution. Pump before feeding until you feel relieved and put your baby to your breast as often as possible. If the mother’s condition is painful, the temperature has risen, then it makes sense to express until significant relief is achieved once a day. (The maximum number of complete pumping sessions is 2-3 times a day, if it became very bad on the first day of milk flow, or if lactostasis began).

It is very good to express while standing under running water from the shower or after a very warm, wet compress. It will be useful to apply it to the baby's expressed breast. Do not knead the lumps in the breast; the breast tissue already suffers due to swelling. By pressing on them, you risk further injuring your chest.

Massage yourself with soft, stroking movements, moving in a spiral from the base of the breast to its top. Touch the seals like a rosary or beads - with your fingers, towards the nipple.

You can shake your breasts finely and finely before pumping - this will allow the milk ducts to relax. Warm her up before pumping. After pumping, feed your baby and apply cold water for 7-10 minutes.

If you have to pump frequently to prevent lactostasis, be sure to call a lactation consultant; hyperlactation is not the most pleasant feeling for a mother; it is fraught with frequent stagnation of milk and an increase in temperature. Remember that additional or unnecessary pumping will only increase your milk supply!

And although babies are terribly happy about a good flow of milk, hyperlactation in the mother can lead to digestive difficulties in the baby. The baby will receive too much foremilk, sweet milk, and abdominal pain may bother him more often. You can cope with excess lactation by gradually reducing the number of pumping sessions, but you will need help and time.

Situation No. 5
Despite frequent feeding and a good start to breastfeeding, the baby is not gaining weight well.

However, the reflex of its release has its limitations, and it may stop coming out during pumping, even if there is still a lot of it in the chest. In the matter of pumping and feeding, the psychological mood and physical comfort of the mother are very important.

When we suspect insufficient lactation in a mother, we recommend checking that the baby is properly grasping the areola of the nipple during each feeding, and we also advise expressing, but not every time (after all, the number of feedings in the first weeks can reach 20 per day!), but 5-6 times per day.

There is another option that will help you do without pumping; then you need to feed the baby every hour and a half, shifting from breast to breast several times during one feeding. As a rule, these measures will be sufficient for most mothers; after 3-4 days, lactation returns to normal.

If the baby’s condition requires additional feeding, its volume is selected for each child separately, and the recommendations on the can of formula cannot serve as a decisive guideline in this matter. The mixture must be prescribed by a doctor.

When lactation improves, supplementary feeding is gradually abandoned, but they monitor whether the child is gaining weight well. When the amount of milk comes into line with his needs, he must stop pumping. The sooner you start “returning” the milk, the faster it will come back.

Situation No. 6
For some reason the mother is separated from the child.

Solution. It makes sense to express milk if you want to quickly reconnect with your baby after you return - continue breastfeeding or practice mixed feeding. If you receive medications that are clearly incompatible with feeding, you will have to throw out the milk.

By expressing 7-8 times a day, you will support milk production in the body. Ask those caring for your baby to feed him without the aid of a pacifier. Children learn well to drink from small cups even at the age of several days from birth, then there will be a greater chance that the child will not wean himself off the mother’s breast.

Situation No. 7
Your situation is not similar to any of the above, but you are breastfeeding on demand, your baby is gaining weight more than 25 g per day, your breasts, although sometimes full, do not cause discomfort, or your baby is coping with it just fine.

Solution. Continue your chosen breastfeeding strategy and express only when necessary or to store milk for future use.

Every woman who will soon become a mother thinks about whether she needs to express breast milk? Most often, the opinions of doctors and non-specialists differ. Nevertheless, this issue has been discussed for quite a long time.

Surely all women know that expressing breast milk can increase the strength of lactation and remove congestion in the breast. However, mothers are also sure that such a procedure takes place in a serious and rather sick condition, which is why not all women pump.

Some mothers perform the procedure once and realize that they are not ready to endure the pain, as a result of which they stop the process. Let's figure out whether you need to express milk? And if so, how to pump correctly?

Not everyone knows why to express milk and what will happen if you don’t express. Of course, each person decides for himself whether to express milk or not.

There may be several reasons for this process:

1. If you do not want the body to have stagnation of the mammary gland, leading to, then it is better to use decantation.
2. The baby stopped asking for breastfeeding during the breastfeeding break. Therefore, the mother needs to feed the baby her milk from special containers.
3. If you notice that the breast is very full and the nipple is in a tense state, then you need to help the newborn to latch on to the breast. To do this, you should do a little pumping so that the tension subsides, then the baby will be able to eat on his own.
4. If you have a busy work schedule or urgent matters, it is better to take care of your baby’s nutrition in advance. Expressed milk is much better accepted by the body than alternative formulas.
5. If the mother takes pills, then it is necessary to stop breastfeeding, and this procedure will help maintain lactation.
6. In case of insufficient lactation, there is also a need to express a lot.
7. If a mother feels pain in the chest, but there is no way to give the baby food, pumping will help.

It should be said that such situations occur in all mothers, so you need to familiarize yourself with all the features of this process in advance. First of all, you need to find out how much, when and how to express breast milk, so that the procedure brings only benefits, but does not aggravate the situation.

When and how often should you pump?

Let's take a look at the reasons, since it depends on them how often and how many times this process needs to be performed:

• In case of stagnation - once every 1-2 hours. During the milk extraction process, it will take as much as possible to reduce the density. The maximum time for such a procedure is half an hour. If you deviate from these instructions, you can easily injure the mammary gland.
• In order to increase the amount of milk secretion– immediately after each feeding and 1-2 times during the feeding period of the newborn. Typically, pumping takes 10 minutes after feeding and 15 minutes in between.
• If you feel that your breasts are full, you can pump more often for relief, but only if you feel pain. In this case, you should squeeze out a little milk to make it easier. Don't forget, the more you express, the more milk you will have next time. It is best to perform the procedure within 5 minutes.
• If you decide to take a break but still want your milk to continue flowing, then you need to pump once every 3 hours, while comparing the baby’s feeding regimen. You need to squeeze out such an amount of liquid so that when breastfeeding is resumed, the baby can eat. The process takes 20-30 minutes.
• If the mother wants milk to remain in reserve, then she should express herself a couple of times a day in between feeding the baby. You should independently choose the time and amount of expressed milk, and do not forget to compare the data so that the next time you eat food, the breasts have time to collect the required amount of fluid, and the baby does not feel hungry.

Cases in which pumping should not be done

In practice, there are also situations when pumping is not recommended.

This happens if:

• Your baby is almost always at the breast.
• The child takes food on demand, eats as much as he wants and when he wants.
• You want to wean your baby (there must be reasons for this).

What actions to take the first time

Most likely, the first pumping will take place in the maternity hospital. Don't worry if milk comes out in large quantities. This pumping will help the mother avoid further ones. And subsequent pumping at home should be done to prevent pain, which prevents the baby from latching onto the nipple.

It is best to adhere to this scheme:

1. Pull yourself together and don't get nervous.
2. Call a nurse who, if the technique is incorrect, will help you figure it out.
3. Be sure to monitor your feelings, as pain should not be present.
4. It is necessary to express milk only until relief, so that after this lactation does not become even greater.

How to express breast milk by hand

If you want milk production to occur in reserve, or decide to increase lactation, then you should familiarize yourself with how to express yourself correctly. Many women do not know the basic rules when giving birth to a child, as a result of which a large number of mistakes are made.

To prevent this from happening to you, you just need to carefully read the recommendations on how to express milk correctly:

1. Take a comfortable position and try to relax.
2. Keep a clean container near your chest.
3. Place your thumb on top of the halos and your index finger opposite. The other fingers should be positioned so that they support the chest.
4. Then press on your chest with your thumb and forefinger. You need to lightly and gently pull the nipple inside the breast.
5. Now you should begin this procedure, squeezing the breast behind the nipple and areola.
6. Each breast must be strained for 5 minutes, do not forget to alternate them. You can reduce each subsequent approach by 1 minute.

Don't worry if the milk doesn't come out right away, just continue the procedure. If the mother feels discomfort, then the technique of expressing breast milk is not applied correctly. If pain is not felt, then the process proceeds in the right direction.

What not to do:

• Squeeze your nipples as this will have no effect.
• So that the hand slides over the entire surface of the chest. Remove milk from the breast if it gets on it.
• Ask your husband to pump for you. This will harm your body.
• Watch how liquid is drawn into the vessel. Studies have shown that in the absence of this action, you can get even more milk.

The first couple of times, pumping will take about 30 minutes. This period of time will help collect all available milk. Before finishing, feel your breasts, they should become less dense.

Expressing with a breast pump

Some women pump their breasts with. Most often, this procedure takes place in two stages, the first of which is still manual expression of breast milk. It must be said that when pumping breasts that are soft to the touch or are completely full, the technique does not work in all cases.

Now there are many varieties of this technique, but you need to select it for each person independently, relying on sensations. For example, some people prefer the electric option, while others may find it rough.

What is better to express: with your hands or, Dr. Komarovsky:

Rules for feeding a baby with expressed milk

If you are going to feed your baby, be sure to heat the liquid to a temperature of 36 degrees. If the milk was previously in the refrigerator, then it must be immersed in boiling water or another heating method must be used.

If you stored milk in the freezer, you should put it in the refrigerator for a while before using it so that it becomes liquid. Then heat it as above.

Doctors say that it is undesirable to use a microwave oven to heat milk, since it kills all the beneficial elements.

You may notice that the milk has separated. To return it to its normal state, you need to shake the bottle a couple of times before use.

Shelf life of breast milk

It all depends on how you stored your expressed milk:

• Room temperature – no more than 6-8 hours. Take into account the fact: if the apartment is quite warm, then milk cannot be stored for more than 4 hours.
• Refrigerator – 2 days.
• Freezer – 1 year.

Mixing milk

Many people wonder whether it is possible to drink milk that was expressed a couple of days ago and the milk that you just squeezed out at the same time. It is best, of course, to express milk by hand into various vessels.

If the mother does not have this opportunity, then, subject to certain rules, mixing milk is possible:

1. It is best to combine expressed milk within 1 day.
2. Portions should be poured into different containers and then placed in the refrigerator to maintain an equal temperature.

Under no circumstances should milk of different temperatures be combined.

Most doctors say it's best not to mix liquids. Why? They differ in taste and composition. If you do not want the baby to completely refuse to eat, then it is better not to do this. We advise you to avoid this procedure if possible.

Thus, pumping is not difficult at all. Each mother can decide for herself whether she needs to pump. Thanks to this article, you can understand how to express breast milk correctly.

Learn the rules of how to properly express breast milk by hand and when to express breast milk. It is imperative to remember that the main factor on which the quantity and quality of milk depends is feeding on demand, and not every 3 hours.

When a woman begins to breastfeed her baby, she faces a whole host of questions. Expressing milk is one of them. A nursing mother usually has to listen to more than one point of view. Often women are encouraged to express breast milk. It is believed that pumping provides a greater flow of milk and enhances lactation. But is it really necessary to additionally stimulate the breasts, or maybe just the baby’s sucking is quite enough? In this article we will try to answer the question about the need to express breast milk.

So, is it necessary to pump for prevention?

Often, a breastfeeding woman may be advised to pump after each feeding. However, such pumping usually results in problems. Why is this happening? The more the mammary gland empties, the more milk it begins to produce. By pumping, a woman seems to be making a request for an increase in the amount of milk. But the baby is often not able to suck out as much; the “excess” milk remains in the breast. The woman expresses it again, thereby again making a request for an increase in the amount of milk. Thus, the mother begins to hyperlactate - excess milk. Excess milk often leads to mastitis - milk stagnates in the gland, does not drain well and provokes inflammation.

Another consequence of such pumping is that it tires the mother and makes her perceive breastfeeding as a very difficult and unpleasant process.

Are there situations when expressing milk from the breast is necessary?

In some cases, expressing breast milk is a necessity. You can’t do without this if:

• Mom and baby separated
• The baby cannot breastfeed
• The baby is premature or weak and cannot get enough milk
• If the mother resumes breastfeeding after a break or, for example, wants to feed her adopted baby
• In some cases, with stagnation of milk
• Mom, when the child is not yet 8-9 months old

In cases where mother and baby are separated or the baby is unable to breastfeed, expressing milk maintains lactation. To do this, you can express both breasts every 3 hours for 15 minutes each. You need to express the same amount if the baby is premature or weakened and cannot suck out milk effectively.

If feeding expressed milk is possible, it is given to the baby from a syringe without a needle.

If a mother has to go to work, and the baby is not yet 8-9 months old and the mother wants to breastfeed, then pumping is often indispensable.

Firstly, a few weeks before you are expected to go back to work, it is advisable to create a bank of frozen breast milk. In this case, the milk is expressed into suitable containers and stored in the freezer. The shelf life of breast milk can be 3-4 months in the freezer compartment of a refrigerator with a separate door, and 6 months in a separate deep freezer.

Breast milk can be expressed for freezing in different portions throughout the day, but in order to mix different portions of milk, the new one should be cooled to the same temperature as the previous one. In this way, it is possible to create a supply of breast milk over time.

However, even with such a supply, it is very advisable for a woman working outside the home to express her milk. This is necessary to maintain lactation and prevent milk stagnation. If there are suitable conditions for this at work, then the expressed milk can be saved and brought home, so that in the next absence of the mother it can be fed to the baby.

Sometimes mothers may need to express milk if it stagnates (lactostasis). This can only be done on the first day from the moment the lumps appear and only if the mother completely excludes recent breast injuries, is not sick with general diseases (colds, for example) and there is no damage to the nipples (abrasions, cracks), otherwise until a decision is made on additional If you are pumping, you should consult a doctor. It should be remembered that any stagnation of milk requires close attention! Therefore, it is advisable to contact a surgeon or an organization that supports breastfeeding as soon as possible if congestion occurs in the chest.

How to express breast milk correctly?

You can express milk from the breast with your hands or with a breast pump.
Whatever pumping method is chosen, it is advisable to first stimulate the oxytocin reflex. This is necessary so that the milk is more easily separated from the breast. Oxytocin is sensitive to positive emotions and warmth. Thus, the oxytocin reflex increases if the mother is close to the baby. It is easiest to stimulate milk secretion when the baby is sucking on one of the breasts, so in some situations, when the baby is sucking on one breast, you can express the other.

If the baby is not nearby, you can apply a damp warm compress to the breast, or do a light breast massage. You can also look at a photo of a child, or smell his clothes. In this way, the woman stimulates the milk ejection reflex.

Let's look at pumping methods in more detail.

If you choose the hand pumping method, then Dr. Newman, for example, suggests this method: we take the right breast with our right hand, and hold the container for collecting milk with our left hand. The thumb should be placed on the upper border of the areola, and the index finger on the lower border of the areola. After this, lightly squeeze your fingers evenly and pull them slightly towards the chest. Finally, express the milk using your fingers in a forward motion.

When pumping with your hands, you don’t need to put in significant effort, much less leave bruises on the skin of your breasts. Also, when squeezing, you do not need to slide your fingers over the areola, so as not to irritate the skin. The described movements must be repeated until the flow of milk weakens. Then the position of the fingers is slightly changed, moving them around the areola, and pumping continues. This is done until all the ducts that are located around the nipple are expressed.

If, some time after you start expressing, milk becomes difficult to separate, you can repeat the stimulation of the oxytocin reflex. Usually, with practice, a woman quickly understands how and where to put effort in order to express milk.

Also, once you get the hang of it, you can express both breasts at the same time, this saves time and allows you to express more milk at one time.

Double pumping takes 10 to 15 minutes per session (compared to 20 to 30 minutes for single pumping) and has been found to stimulate milk production more effectively than single pumping.

A mother can learn to express the second breast with her hands while the baby is suckling the first if the baby is well attached to the breast with the help of special or regular pillows, or sofa cushions.

Manual expression is quite effective. In parts of the world where breast pumps are not available due to their high cost, mothers always express by hand only. The effectiveness of hand expression increases if it is supported, encouraged by society and mothers are well informed about its techniques.

There are also special devices for expressing milk - breast pumps.
Examples of objects that helped mothers extract milk from the breast were mentioned in medical literature as early as the mid-16th century. At this time, references to “sucking glasses” appeared in the medical literature. This device allowed women to express milk from their breasts on their own, and was also recommended as a treatment during hot flashes and mastitis, or for expressing milk if the mother had sore nipples. In addition, "sucking glasses" were supposed to help stretch flat or inverted nipples.

Nowadays, many manufacturers produce various models of breast pumps. Although most of them work on the same principle, they vary in quality. Also, they are all slightly different from each other, just as the breasts of different women differ.

As a rule, when choosing a breast pump, mothers are guided by the fact that it can express milk quickly and in significant quantities. In an informal survey of more than two hundred mothers, a breast pump was rated extremely highly if it worked quickly (total pumping time of less than 20 minutes), expressed 60 grams or more of milk from each breast, and did not cause pain during pumping.

If mother and baby are separated for any length of time, electric breast pumps are usually most effective. Some electric breast pumps allow you to express both breasts at the same time, and adjust the pressure and speed of expression.

However, electric breast pumps also have disadvantages - since breast tissue is very delicate, they can be easily injured if the mother does not place the breast into the electric breast pump correctly. Therefore, if pumping causes pain, you should stop it and check whether changing the pressure or changing the position of the breast pump relative to the breast will bring relief.

There are also many models of mechanical breast pumps on the market today. They are cheaper than their electric counterparts.

To express milk using a mechanical breast pump, you need to place your breast in the breast shield (paying attention to the fact that the nipple must be strictly in the center). The funnel should fit tightly and evenly to the chest. When pumping, it is best to maintain a squeezing rhythm that resembles the rhythm of a baby's breastfeeding. Since the baby alternates between shallow and deep sucking during breastfeeding, when expressing with a breast pump, shallow, frequent squeezing alternates with slow and deep ones. It is often convenient for women to express while leaning slightly forward, after a light massage of the back and shoulders and/or to the sound of flowing water.

Attention! There are contraindications to the use of breast pumps. Do not express with a breast pump if your nipples are cracked or damaged.

It is also worth mentioning that breast pumps require special care. Before first use and after each pumping, all parts of the breast pump are disassembled and washed. For washing, specialized children's soap solutions are used. Then the parts are placed in a container of water, brought to a boil and boiled for some time (usually no more than three minutes). You can also use special sterilizers for sterilization. You can read more about caring for your breast pump in its instructions.

Please note the following: Even if a woman cannot express a significant amount of milk from her breast, this still does not indicate. The baby sucks milk from the breast better than any breast pump.

To summarize all that has been said, it can be noted that pumping is not the most harmless procedure and can carry with it many negative consequences if the mother pumps without reason or using the wrong pumping technique. However, the benefits of pumping at certain points in the life of a nursing mother cannot be denied. Therefore, it is advisable, as with any procedure, to approach expressing breast milk consciously, understanding why it is needed in a particular case. In most situations where pumping is still traditionally recommended and used, it is quite simple to properly organize breastfeeding.

If you have any doubts about the need to pump or are unable to organize pumping yourself, you can contact.

Literature:

1. Armstrong H., Low-tech problem-solving in a high-tech world. Presented at La Leche League 14th International Conference, July 1995
2. Auerbach K., Sequential and simultaneous breast pumping: a comparison. Int J Nurs Stud 1990 27(3) p:257-267
3. Bernard D., Hand-expression. New Beginnings 1996; 13(2) p: 52
4. Fildes VA., Breasts, bottles, and babies: a history of infant feeding . Edinburgh: Edinburgh University Press, 1986
5. Hill P. et al. The effect of sequential and simultaneous breast pumping on milk volume and prolactine levels: a pilot study. J Hum Lact 1996; 12(3) p:193-199
6. Jones E. et al. A randomized controlled trial to compare methods of milk expression after preterm delivery. Arch Dis Child Fetal Neonatal Ed 2001; 85 p: F91-F95
7. Mohrbacher N., Stock J., La Leche League International, The Breastfeeding Answer Book, Third Revised Edition, 2008
8. Newman J., Pitman T., The Ultimate Breastfeeding Book of Answers (Revised and Updated), NY, Three Rivers Press, 2006
9. Riordan J., Auerbach K., Breastfeeding and Human Lactation, Jones and Bartlett, Boston, 1999
10. Walker M., Breast pump survey, 1992

Alena Korotkova,
clinical psychologist,

Elena Nefedova,
lactation consultant

How to properly express breast milk by hand? In what cases is this necessary? What is the technique of the procedure and how to make it easier? What to do next with the resulting product and how to feed expressed breast milk? Features of manual expression in the formation of proper lactation and solving problems.

There are a lot of misconceptions about pumping while breastfeeding. They were formed historically, so they are still practiced not only in the outback, but also in families during the formation and maintenance of lactation. Among these misconceptions there are truly dangerous ones. Let's look at them in detail.

5 dangerous myths

Expressing breast milk is not a mandatory procedure for every breastfeeding woman. Experts from the international breastfeeding organization La Leche League insist on this. They also dispel the main myths that exist in this area today.

Myth 1: You need to express milk after every feeding.

Even 40 years ago, medicine was of the opinion that this should be done without fail. The reason for this is the approved principle of feeding according to the regime. According to it, it was allowed to put a baby to the breast no more than six times a day and only to one breast per feeding. Such rare breast stimulation led to frequent mastitis and the complete disappearance of lactation within three months. Pumping solved the problem and made it possible to maintain a woman’s health while maintaining lactation for a longer period of time.

Today, lactation consultants, when asked whether it is necessary to express milk after feeding, answer: only if there is a need for it. It may be dictated by the following factors.

• Not enough milk. Due to insufficient quantities, the child does not eat enough and does not gain weight. Pumping allows you to increase lactation by naturally stimulating it. Nature intended this mechanism to be self-regulating. That is, the flow of milk occurs exactly in the volume in which it was drunk.
• Need stock. Pumping allows you to build a “milk bank” in case you leave your baby for a while. Relatives or a nanny can feed your baby your milk.

Myth 2. You need to express until the last drop.

La Leche League expert Natalia Gerbeda-Wilson argues that this is not necessary. Moreover, it is simply impossible to express to the “last drop”. Milk does not enter the breast all at once, but flows into it constantly.

Myth 3. Even if there is enough milk, you still need to express it

This misconception only leads to an excess of milk in the breast, causing a feeling of fullness. You have to get rid of the milk by pumping again, and the process repeats again. If there is enough milk, there is no need to express it! Otherwise, the volume of lactation will be uncomfortably large for you and the baby.

Myth 4. Breasts must be expressed by hand after childbirth

This is also not necessary if your baby was born healthy and is nearby. Have you received any medications that would prevent you from starting breastfeeding immediately? Your baby will stimulate lactation much more effectively than pumping, and the process itself will become much more enjoyable and less traumatic.

Myth 5. You need to express with force.

One of the most dangerous misconceptions that causes injury to the delicate tissue of the mammary glands. It is impossible to squeeze milk out of them, no matter how hard you press on them. Moreover, there are no “reservoirs” in the breast itself where it would accumulate in large quantities. Valuable fluid is distributed evenly in the mammary gland and is located in its ducts.

The process of milk secretion is ensured solely by hormones. The work of both is important here.

• Oxytocin - it provides the very factor for milk flow. This factor becomes a consequence of the influence of “external stimuli”. These include the warmth felt by a woman’s skin when the baby is applied to the breast, the smell of the baby, and gentle stimulation of the glands. When the “oxytocin reflex” is achieved, milk begins to pour out of the breast on its own, without any effort.
• Prolactin is a hormone that controls the amount of milk and restores it to the volume that was removed from the breast.

With rough mechanical impact, the integrity of the breast tissue is disrupted. This becomes a risk factor for the development of lactostasis and mastitis.

Rules for hand expression

Modern medicine names 6 situations when you need to express breast milk. In other cases, this procedure will be useless and even harmful.

1. Relief from full breasts. If milk comes in abundantly, you can express it slightly. It is important to do this until you achieve a feeling of lightness and comfort. It is important to avoid excessive engorgement due to the risk of microtrauma of the mammary glands, soreness and injury to the nipples. You should express little by little, since additional “selection” of milk will only lead to increased milk production.
2. Inability to breastfeed naturally. If a child, for a number of reasons, cannot suckle on his own, in order to maintain lactation and establish breast milk feeding, it is important to express the valuable product. It should be used to feed the baby.
3. Mom's illness. If infectious mastitis develops or medications that are incompatible with breastfeeding are taken, it is necessary to maintain lactation by removing milk from the breast with your hands. The resulting product should be poured out. In the future, you will be able to continue breastfeeding.
4. Formation of lactation. In the first days, the volume of milk may not be enough for the baby. Additional stimulation of the mammary glands will allow the development of lactation.
5. Prevention of lactostasis. If lumps are found in the mammary glands, you need to gently massage these areas and express a small amount of liquid. Regular self-examination and light massage will be the best protection against the formation of stagnation.
6. Mom leaving. A woman’s inability to always be with her baby does not mean it is necessary to interrupt breastfeeding. Mom can express milk daily in the morning and evening for afternoon feedings. Or create a “power bank” if you plan to leave for several days.

In other cases, pumping while breastfeeding is not necessary. If the baby is eating well, growing well, and you are not bothered by chest discomfort, then the lactation process is ideal.

Marmet technology

How to express breast milk by hand? Marmet technology has been developed for an efficient and safe process. Despite its apparent simplicity, comprehending it is akin to art. This process is only superficially similar to sucking; in fact, for the body it is artificial and unnatural. To master it, you need to understand a few subtleties.

• The breast “gives” milk on its own. This happens when the level of “oxytocin factor” is sufficient. The best incentive for him is having a child nearby.
• Pumping may not produce much milk. Often a woman has no problems with feeding, but when she needs to leave and leave a “portion for lunch,” she cannot express even a couple of spoons. The fact is that the mammary glands need to be “taught” to release the product on demand. Only personal practice will help with this.
• There is no milk in the nipple. Therefore, it is pointless to stimulate him. The valuable liquid is located in the ducts of the gland itself, and it should be “pushed” to the exit by influencing the area around the nipple.
• To increase lactation, you need to express little by little, but often.. This is more effective than prolonged mechanical action and straining “to the last drop.”

The technique for correctly performing the procedure is as follows.

1. Wash your hands with soap and wash your breasts.
2. Drink warm tea, relax, place a towel soaked in warm water on your chest. Warmth and peace help the hormone oxytocin create a milk production factor.
3. Place the container near your chest and hold it with your left hand.
4. Place your right thumb on the areola above the nipple. It should be located at the “junction” of the nipple and white skin. Place your middle and index fingers under your thumb, at the bottom of the nipple.
5. Gently press your fingers on the mammary gland in the direction of the chest, wait a few seconds. Relax your fingers after milk appears. Repeat again.
6. Move your fingers to other parts near the nipple area. This will allow fluid to be evenly removed from all lobes of the mammary gland.

Do not apply significant force when performing the procedure. Movements should be soft and careful. Proper pumping is only painless, so if you experience discomfort, change the technique.

Fingers should not “fidget” over the skin, as this can lead to irritation and chafing. It is important to firmly fix them in place and apply gentle pressure. It may take you one, two, five minutes for the milk to appear. It is in the chest and will definitely appear! Therefore, continue with rhythmic movements. Once you're done with one gland, move on to the next one.

For painful nipple engorgement, try this technique from breastfeeding expert Jim Ketterman. It offers relaxed pressure on the nipples for the initial flow of milk. Place all fingers directly on the nipple and apply gentle pressure for three minutes. This will soften the breasts and make pumping painless.

Using expressed milk

In addition to the questions of whether you need to express after each feeding, and how to do it correctly, there are many others. Let's answer the main ones.

Do not heat breast milk in the microwave! Microwaves destroy active immune factors and reduce the quality of baby food. In addition, there is a risk of too hot “areas” in the container and burns to the delicate surface of the baby’s mouth.

Only practice and personal experience will help you master the technique of hand expression. When you need to learn quickly, a breast milk pumping service can help. Its specialists help nursing mothers at home or with consultations online or by phone. Reputable breastfeeding organizations such as La Leche League provide free consultations. In their opinion, using the correct technique of manual expression according to indications allows you to solve lactation problems, so it is important for every woman to know its features.

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