Expressing Breastmilk: Your Questions Answered

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Our in-house Lactation Consultant, Sioned Hilton, shares an ultimate trouble shooting guide for expressing breast milk…

Many mums predict that they will need to express at some point during their nursing journey and may plan to purchase a pump early on – even before birth in preparation for a social event or going back to work.

Some plan to get breastfeeding established and then express when their partner does a feed, so that dad can have some intimate time with little one whilst mum has 5 minutes peace. Or sometimes a mum may need to express because her baby isn’t able to latch on and nurse.

Occasionally as many of us know, plans and expectations often take a different path and some mums find that they don’t get on with expressing It may be a combination of things so here are a few common difficulties mums have shared with us and some practical tips to help…

Not Enough Milk: “I thought I’d have more!”

The Facts:

  • In the first 2 weeks after birth your baby and your breasts have been programmed to activate and build your milk storage capacity, as well as production to meet what your baby needs.
  • Your baby will remove the available milk from the breast and will appetite regulate – often coming off when there is still milk in the breast. The feedback inhibitor of lactation and supply and demand will regulate your milk production
  • Every baby is different, some babies feed every 2-3 hours – 13 feeds a day which is normal. Others feed every 4-5hrs – 4 or five feeds a day.
  • Babies may have a variable feed pattern, one, both or a cluster of breasts at a feed
  • The range of milk volume is 54-234 mls a day which can vary from mum to mum. If your baby has just fed, often there is no milk available which means they have fed well.

Top Tips:

  • Check your breasts after you have expressed – if they feel full and you think milk is present check your pump vacuum, and breast shield size.
  • Think about what is normal for you. If you have fed within 45minutes previously, your breasts will not have refilled to it greatest capability – you will simply just be removing any milk your baby left at his last feed.
  • Realistic volumes: If you have a baby going through a growth spurt and/or is feeding frequently from both breasts you will have less milk available to express
  • If your breasts are full and engorged this can reduce the milk flow because of compression. To relieve this, hand express to soften, use a warm flannel and breast massage.


“My Milk’s Not Flowing”

The Facts:

  • You may find that you don’t get the same trigger for letdown when expressing, compared to when you nurse your baby. A breast pump is mechanical and not your infant. Breastfeeding is a conditional reflex  – your milk will not flow unless the letdown is triggered.
  • Letdown is triggered simultaneously in both breasts so it’s normal to leak when you are nursing off the other breast
  • Worry, apprehension and pain switches this letdown reflex off or impedes it and this means that the oxytocin isn’t squeezing the milk down the ducts. The breast milk supply will be slow or no milk will be available on expressing
  • You may also find your pumping technique may affect the flow of milk. A breast shield that is too big or small will compress the breast tissue and affect how the milk is removed.
  • Hand expression is also a useful tool in a mum’s breastfeeding kit when a mechanical pump is unavailable.

Top Tips:

  • If baby is feeding, try and express at the same time off the other breast
  • Has baby just fed really well? Try waiting an hour for your breasts to refill after the end of the last feed.
  • Check that your breast pump is assembled correctly: Check the valve, membrane and connections.
  • When expressing – smell an item of your baby’s clothing, watch a video or look at a picture of your baby, if your baby is crying this can trigger that let down too.
  • Cup the shield to create a seal – don’t push the shield into the breast tissue
  • Massage and stroke the breast towards the nipple to warm and stimulate – mimicking what your baby does when he nurses.
  • Relax and sit comfortably. Try listening to music.
  • Switch to expression phase as soon as let-down occurs
  • If you’re single pumping, alternate and switch breasts every 5 minutes until your milk flow stops.

 

“Why is Pumping Painful?”

This can be due to a high vacuum which you haven’t adjusted down to what is comfortable to you. Pain does switch off that let down so ensure you adjust the vacuum on your pump to find a comfort zone for you. You can also try a new breast shield…

Top Tips: Look out for:

  • Does your nipple rub the tunnel sides to the point of causing discomfort?
  • Do you see excessive areola being pulled into the tunnel?
  • Do you see any redness?
  • Is your nipple or areola turning white?
  • Do you feel unexpressed milk after pumping?

 

If any of the above apply, measure the diameter of the nipple to find the correct breast shield size for you.