Hand Expressing Breastmilk

All mothers should learn how to express their breastmilk. This can be taught during pregnancy and practiced soon after birth.
Expressing milk is useful to:
  • Feed a low birth weight or sick baby.
  • Relieve engorgement.
  • Maintain the milk supply when the mother is ill.
  • Relieve leaking breasts.
  • Leave milk for the baby when you go out to work.
  • Feed a baby while he learns suckling from inverted nipples.
Hand expression is the most useful method. Before expression it is essential to stimulate the oxytocin reflex to assure better breastmilk flow to the baby.
How to stimulate oxytocin reflex
The oxytocin reflex can be stimulated with good thoughts and feeling and by holding the baby on your lap and providing good skin to skin contact.
Stimulate your nipples by massaging the breasts gently towards the nipple and stroking the nipple and areola gently with fingertips, or gently rolling a closed fist over the breast, while sitting in a relaxed manner.
Method of expression

For expression of milk you should wash your hands thoroughly. Sit or stand comfortably holding a clean container near the breast.
Be confident, take a warm soothing drink, stimulate the nipple.The thumb and the
first finger should be placed on the areola above and below the nipple opposite each other (Fig. 11a).
The thumb and the finger should be pressed inwards towards the chest wall.Then the areola behind the nipple should be pressed between the finger and thumb so that the lactiferous sinuses beneath the areola are compressed. (Fig. 11b)
Pressure should be alternately given and released till the flow of milk starts.

If the procedure is painful, it implies that the technique is wrong. You should not slide the fingers along the skin
nor should the nipple itself be squeezed. Pressing or pulling the nipple cannot express the milk. Pressure should be given on all the sides to ensure expression from all segments of the breasts (Fig. 11c). The breast should be expressed for at least 3 to 5 minutes and when the flow slows, then express the other breast and repeat alternately.
To express milk adequately it, takes 20 to 30 minutes. It is important not to attempt expression in a shorter time.
Storage of expressed breastmilk
Breastmilk can be stored in a refrigerator for 24 hours and at room temperature for 8 hours. Refrigerated breastmilk should not be heated, as it will destroy protective substances.It should be brought to room temperature before being fed by a cup.


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