As if busy mums don’t have enough to do each day, finding some time to express can present another challenge to their time management skills. But of all the nurturing and loving tasks breastfeeding mothers can do, expressing their milk is one of the most worthwhile.

The World Health Organisation (WHO) recommends exclusive breastfeeding for 6 months as the optimal way of feeding infants. From then on, they should receive complementary foods with continued breastfeeding up to 2 years of age or beyond. When breastfeeding is not possible but a mother still wants her baby to have her breast milk, expressing offers a realistic alternative.

It’s fair to say that some mums don’t have any problems with expressing. They find the process simple and straightforward and get into a regular expressing routine which works for them.

Others can find it a real chore and although they understand it is beneficial, they really don’t enjoy expressing very much.

Why Would I Need to Express?

There are all sorts of reasons why mothers choose to express their breast milk.

Some of the more common are:

• In cases where a baby was born prematurely and needs to remain in hospital.
• When a mother and her baby are separated from each other, e.g. in hospital or during outings.
• When a mother needs to return to work but is still keen for her baby to drink her breast milk.
• When a partner is keen to feed their baby and give the mother a rest.
• When a mother needs to increase her milk supply.
• When her breasts are uncomfortably full.
• During periods of breast refusal or when breastfeeding is not possible.
• For maintaining a breast milk supply during short periods when the milk cannot be fed to the baby. This may sometimes need to happen when a mother is taking medication which is contraindicated during breastfeeding.

Using well designed equipment which is easy to use and maintains the sterility of the breast milk when expressing makes a real difference. Some women choose to hand express until they are comfortable with the process and then graduate to using a breast pump.

It is important that expressing is as comfortable as it can be.   Once a mother’s milk ejection reflex is activated during expression, the flow of milk improves.

“Letting Down” Can be Helped By

• Having your baby close by.
• Looking at photos of your baby, or watching a video of your baby if they are not present.
• Inhaling the scent of an item of your baby’s clothing just before expressing.
• Thinking about your baby and visualising them.
• Having a warm shower and doing gentle breast massage.
• Turning off your phone.
• Having a glass of water nearby.
• Making sure you are in a comfortable and private place.

When Should I Express?

Expressing both breasts at the same time is ideal, but this is not always possible.

• One option is to express one breast at the same time as your baby is feeding on the other breast.
• Expressing in-between breastfeeds or during the night.
• If you are at work, then during your meal breaks or lactation breaks.

N.B. Check with your line manager or Human Resource Department to clarify your entitlements. It is against the law in Australia for women to be discriminated against because of breastfeeding or needing to express their breast milk.

How Often do I Need to Express My Milk?

There is no one answer to this question. There are too many important variables, such as your baby’s age, size, weight and how many bottles of expressed breast milk they will need during your time away from each other.  Ideally, you could organise a “bank” of frozen breast milk rather than express as your baby needs it.

Frequency of expression also depends on how long you will be away from your baby and when you last fed them. If you are at work for an (average) eight hour period, then expressing at least once in this time would be reasonable. But this depends on your individual supply and comfort level and if you breastfed your baby just before you left for work and will do so again as soon as you get home.

How Should I Store My Expressed Breast Milk?’

When breast milk is freshly expressed into a sterile container it can be stored for no more than 72 hours (three days). It needs to be stored at the back of the refrigerator where it is coldest. When a baby is drinking a bottle of expressed milk, whatever is left needs to be discarded after that feed.

If you need to transport your expressed breast milk, you need to place the bottle (or container) in an insulated container. Ideally, this is in an Esky with a freezer brick.  If the milk has been frozen but already begun to thaw, it needs to be used within four hours and cannot be refrozen.

Once you are home, then the expressed milk needs to be placed into a refrigerator or in the freezer if it’s still frozen. Label your milk clearly with the date and time you expressed it.

References

http://www.who.int/nutrition/topics/exclusive_breastfeeding/en

NHMRC Eat For Health – Infant Feeding Guidelines Information for Health Workers 2012

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