Exclusively Expressing: Sioned Hilton Offers her Expert Advice on Pumping and Expressed Breastmilk Part 2

Continuing our Exclusively Expressing series, we asked our Lactation Consultant, Sioned Hilton, to continue answering some questions from pumping mama, Lucy. In the second part of this focused Q&A, we explore the topic even further, gaining Sioned’s expert advice on mum to mum support, pumping schedules and breast milk storage.

Image with the wording Exclusively Expressing

As we continue into our exclusively expressing Q+A with our Lactation Consultant, Sioned Hilton, we explore more questions from new mum, Lucy about the topic.

In this instalment, we delve further into exclusively expressing, covering everything from mum to mum support, pumping schedules and breast milk storage.

Keep reading to find out even more of Sioned’s top tips!

1. What is best practice for bottle feeding? Is there a specific way I should be holding her both for technique and bonding?

When you breastfeed you hold her close, hold her hand, stroke her toes and fingers all of which help you to bond and trigger sucking reflexes. When you bottle feed you should imitate this, keeping eye contact, talking and cuddling your baby. Babies need to feel supported, contained and safe – so if your baby is held in the crook of your arm you are supporting that amazing relationship and brain/eye development.

 

2. There seem to be lots of Breastfeeding support groups out there, would I be welcome to join them? Would they be able to support and advise me? I worry that I will be judged and feel inadequate. 

Of course you should join, regardless of whether you are a pumping, mixed feeding mum. As a lactation consultant, I would welcome you and praise you – it’s tough being a pumping mum, you have overcome many barriers to still exclusively breastmilk feed your baby that is an amazing achievement.

There is unfortunately, a lack of information and knowledge around exclusively or occasional pumping – with many mums choosing or pressured to formula feed when the breastfeeding goes ‘tits up’. It takes courage, dedication and sheer hard work as a pumping mum, to meet your baby’s needs, pumping out and about. Your journey, story would be inspirational, many breastfeeding mums would value your experiences and you too can get tips and support on all those other bits such as weaning, growth spurts, night feeds that are talking points for all new parents.

 

3. I am finding it difficult to pump and feed at the same time now that my husband has gone back to work - is it necessary to still express and feed at the same time? It would make things much easier if I could pump when she sleeps, and I could pop her in a bouncy chair next to me. Is that ok?

Yes, as she grows and gets bigger her development is surging and she is a sponge to information. In the early weeks after birth the recommendations is 8 or more in 24, and pump in sync to her feeding cues, or immediately after a feed.

You can pump after you feed her or just before so that she has fresh milk, after milk is established you can see if you can tweak it to 6-7 pumping sessions, 6-8 etc. and monitor the volumes of 24 hrs – if you see a drop then you are a mum that needs to pump and drain breast frequently. If your volumes stay the same, then you can see if it is more manageable time wise.

Still carry on with the night pumping session and have no longer than 5 hours between sessions in the first months.

 

4. Are there any pumping schedules that I can work from? Will I expect to always be pumping at the same times throughout the day or will this change as my baby's needs change?

There are no fixed ones but in early weeks every 2-3 hours during day time, and at night time if you do last pumping session around 10pm – wake around 3 pm and then breakfast pump at 7am -  you only have one-night time pumping session. As supply establishes – you can then tailor to see if you can pump 3-5 hours apart (monitor your comfort and daily volumes).

You also pump to your comfort – there may be a time when you have an appointment or held up, so you may have to delay or pump earlier than usual, or if you are engorged, have mastitis you may need to pump more frequently to resolve and treat this.

5. I am storing my milk in the fridge and sometimes it looks like it has separated? Is it still ok to use?

When you leave milk to stand it will separate into skim and fat (crematocrit). The fat rises to the top and the skim (lactose, proteins and minerals are below) this has bluish tint to it.

This milk is fine to use just gently agitate before you use to disperse the fat molecules throughout the milk for her feed.

 

6. Sometimes the milk in the bottle looks as though it has gone off and has fatty lumps in it, is it ok to use still? It smells fine and I only produced it yesterday. 

Sometimes, the fat can clump together or as it is alive it has an enzyme called lipase that is present to digest the fat. In some cases, this can start to breakdown the milk when you store it and can make it go off – has a sour rancid smell. In this case it is likely that you need to use fresh milk or heat treat it to delay and deactivate the lipase. This is not the case here – just the fat sticking to the sides or top od bottle in storage.

 

7. How long can I leave my milk out of the fridge for?

The guide internationally is around 4-6 hours – fresh and room temperature. However, it does depend if it is fresh, or thawed. If it is in a hot room – summer near the window or radiator in winter.  If it is previously frozen milk and thawed, you are recommended to use it within 2 hours if left at room temperature. For out and about use an insulated cooler bag with freezer block and this mimics the refrigerator for up to 6 hours.

 

8. Can I mix my milks from different pumping sessions together in one bottle? 

Yes, you can as long as it’s within the same day. Cool the milk separately and then combine and store in refrigerator, or freeze.

 

9. My baby is about 3 months old now and I am really over producing milk and it's making me feel quite overwhelmed. I don't have any more room in my freezer and I'm not planning on donating at present. Is there a way that I can regulate my supply to help me pump just the right amount? (I can elaborate on this if it helps, my baby is now 4 months and I am now making the right amount - the message being doesn’t panic and stick with it)

Going back to that hormone feedback inhibitor of lactation. The more you drain the breast the more milk you make. If you experience over supply you can start gradually extending the duration between pumping sessions – tailor to your comfort, and or leave milk in the breast – e.g. if you pump on average 15 mins/breast – reduce to 10 mins, knowing that there is milk left will raise FIL and gently down regulate you. If it is a storage issue – as much as it goes against the grain and you don’t want to donate you can either discard it or start your weaning store - adding to potatoes that you have as left overs, cauliflower cheese etc. Taking sage tea can also reduce over supply.

 

10. I am really over producing, and I would like to drop a pumping session - how do I go about this? Should I be doing it?

If you are pumping every 3 hours in the day start to gradually increase the duration to 3-4 hours, then you may find that you go from 8 to 7 to 6 over a few days. As you have over supply you are more at risk of engorgement and mastitis so it just needs to be done slowly – it could take a few weeks for you to get to where you want.

11. I had in mind that I would like to continue to express until about 6-month mark to tie in with weaning. How do I go about this? Is there a method I should follow? 

Continue as you are meeting her needs with pumping, you may want to tailor the frequency to make it more manageable, continue with the night session.

Milk will still be her main nutrition source for her first year so you may still be pumping longer. As she takes more quantity of food and moves to 3-4 meals a day you can tailor her milk intake – offer cooled boiled water with a meal.

If you are considering mixed feeding – expressed and formula – introduce it slowly, watch how it impacts upon your milk production and comfort. She may be gassier and unsettled as you introduce new foods and possibly formula.

She will need to either have expressed milk or formula for her first year and then you can introduce full fat cow’s milk.

When you are down regulating your supply – take it slowly, extending time between pumping sessions, dropping a session every few days. You may then be down to 3 sessions a day. Drop the night or extend between last and first feed.

Once you get to a point you can partially pump both breast leaving milk in breast to raise FIL and mother nature will reduce milk production. As a pumping mum you have done this for many months so be prepared that you may still experience fullness and risk of mastitis as you wean. Take it a day at a time and look back on how amazing you have been as a breastfeeding mum to give this unique gist of mother’s milk to your baby.

We hope you enjoyed this series of posts on exclusively expressing, what would you like us to cover next?

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