Breastfeeding gives your child the nutrients they need most in early childhood: but what happens when expressing breast milk is the only suitable method for your child? If this is the case, it’s important to set habits for safe breast milk storage.
In this article, Me and My Child explains how to express breastmilk—from using a breast pump to maintaining breast milk supply.
When Should I Start Expressing Breast Milk?
Ultimately, it’s your personal decision: if and when you decide to express breast milk. However, there are a few things to keep in mind that may help you make your decision.
It may be a good idea to consider expressing breast milk if:
- Your child is born prematurely
- Your child is unable to feed at the breast
- Your or your child is in the hospital
- You are returning to work or other commitments
- You are using a babysitter regularly
- Your breasts sometimes feel too full or uncomfortable
If you decide to start expressing breast milk, the most important thing is that you do what feels right for you and your baby. Speak to your GP about whether expressed breast milk is suitable for your child.
Guide to Expressing and Storing Breastmilk
If you do decide to express your breastmilk, there are a few different ways to do so. If you are unsure, it’s best to speak to your health care professional about the right method for you.
By following these simple tips, you can ensure that your breast milk stays fresh and safe for your baby.
Preparing to Express
Hygiene is vital when storing breastmilk. When expressing and storing breastmilk frequently, equipment needs to be washed at least once every 24 hours. If you are expressing breast milk once a day or less, clean your breast pump and equipment after each use.
Follow the below steps to prepare for expressed milk production:
- Wash your hands and make sure any equipment needed is sterilised, such as a bottle, cup and breast pump.
- Make sure you are relaxed and comfortable. Some women find it helpful to drink water, listen to music, disable the telephone, think about their baby or even look at a picture of their baby before expressing their milk to encourage the ‘let-down’ reflex. This reflex is initiated by the suckling infant and triggers the milk to be released from the breast.
- Massage your breasts before expressing breast milk to encourage the ‘let-down’ reflex.
Hand Expressing Milk
To help increase their supply, many mothers use the hand expressing method. With a little practice, you can easily hand express milk each day for your baby. This can be done in a few simple steps:
- Trigger the let-down reflex. Start by massaging the top side of your breast and stroking towards the nipple in a circular motion. Then massage the underside and repeat several times to ensure the whole breast is massaged.
- Place your thumb and index finger at the edge of the areola on opposite sides of your nipple.
- Gently push into your breast tissue. Push your thumb and index fingers towards each other using a rolling action, a similar action to doing a fingerprint using an ink pad.
- When the stream of milk begins to flow freely, the let-down has occurred. The let-down lasts between 3 and 5 minutes.
- When the milk flow slows down, switch to your other breast. Follow the same steps for the second breast. A secondary let-down can occur during feeding or expressing.
- You may need to move back and forth from breast to breast, and repeat the massage steps to release as much of your milk as possible.
Pumping Breast Milk
Breast pumps are devices that extract milk from the breasts. When Choosing a Breast Pump, it’s important to find one that will be comfortable for you to use.
While breast pumps are a convenient solution for many mothers, it’s not always easy at first. For some, it can be a bit of a learning curve. As breast pumps come in a range of sizes and types, it’s important to know how to get the most out of your device. Read and follow the manufacturer’s instructions carefully before use.
Types of Pumps
There are manual and electric breast pumps on the market: each with its own advantages and disadvantages. Regardless of the type of pump, it should be clean and sterilised with every use.
To begin using any breast pump, place the flat rim of the cup against your breast, so that the nipple is centred within the inner opening of the shield.
Manual pumps involve squeezing a handle; they allow you to control the cycle and suction. Gently work the pump’s cylinder to create a flow of milk from your breast. Continue working the pump until the breast is soft and you have collected half of the breast milk needed. Then change over to the other breast, repeating the process.
They can take practice to use, as you will need to learn the best rhythm to trigger milk let-down. Manual breast pumps may also be tiring to use for long periods.
Electric pumps have cycle speeds and suction levels to recreate a sensation similar to your baby’s sucking. Start with a low suction and gradually increase to find the level that is comfortable and most effective for you. They may allow you to single or double pump.
If you are using a double pump, you can express from both breasts at once. As with manual expression, you may find that you need to go back and forth from breast to breast until both are emptied.
How to Store Expressed Breast Milk
Safe breast milk storage is essential, in order to maintain its nutrients and prevent the growth of harmful bacteria.
When storing breast milk:
- Containers should be labelled with the date when the milk was expressed so you can use the oldest breast milk first.
- If you intend to freeze the milk, only fill the container ¾ full. The milk will expand when frozen.
- Freshly expressed breast milk can sit at room temperature (26°C or lower) in a closed container for 6-8 hours. However, it’s best to refrigerate breast milk wherever possible.
How Long Can a Breast Milk Supply Be Stored in the Fridge?
Expressed breast milk should be stored at the back of the refrigerator where it is the coldest (4°C or lower). It’s important to follow the below time frames when storing breast milk in the fridge:
|Breastmilk||Room Temperature (26℃ or less)||Refrigerator|
|Fresh||6-8 hours. Refrigerate milk if possible.||Up to 72 hours.|
|Previously frozen: thawed in fridge, not warmed||4 hours or less – use for next feeding.||24 hours.|
|Previously frozen: thawed outside fridge in warm water||For completion of feeding.||4 hours or less – use for next feeding.|
|Infant has begun feeding||Only for completion of feeding, discard after use.||Discard.|
How Long Can Breast Milk Be Stored In The Freezer?
For breast milk, freezer storage times will vary depending on its freshness and location in the freezer. Make sure you cool freshly expressed breast milk in the refrigerator first, and follow the below time frames:
|Previously frozen: thawed in fridge, not warmed||Do not refreeze.|
|Previously frozen: thawed outside fridge in warm water||Do not refreeze.|
|Infant has begun feeding||Discard.|
Can I Reheat or Defrost Frozen Breast Milk?
Yes, reheating or thawing breast milk is acceptable when the guidelines above are followed. Here are a few other tips to keep in mind when reheating breast milk:
- Expressed frozen breast milk may be thawed in the refrigerator where it can stay for up to 24 hours or in a container of warm (not hot) water.
- It should not be defrosted or heated in a microwave oven because that can cause the milk to be heated unevenly.
- Warm the milk by running under warm water or placing it in a container of warm water until it reaches body temperature (around 37°C).
- If breast milk is left standing you might notice the milk separating. Just shake the bottle gently to remix it.
Giving Your Baby Expressed Breast Milk – FAQs
Many new mothers have questions about expressing breast milk. Here are some of the most frequently asked questions, with answers from experts. For more information, talk to your healthcare provider or a certified lactation consultant.
How much breast milk do I need to express?
It’s best not to judge overall milk production based on the amount you express. Every mother and baby’s needs are different; the required amount is determined by your reason for expressing.
Some mothers will express large volumes at one time, whereas others may express small amounts more frequently (e.g. 30mL every 1-2 hours).
Can you store breast milk in a feeding bottle?
Breast milk should be stored in sterile plastic containers or in small, sterile plastic bags specially designed for storing breast milk.
Can you put warmed breast milk back in the fridge?
Thawed and warmed breast milk must be used within 4 hours. It must not be refrozen.
Can you reheat breast milk multiple times?
No, it is not safe to reheat breast milk multiple times. Once your baby has begun feeding on the milk, discard any that might be left over.