Breastfeeding and expressing milk in hospital information sheet

Introduction

If you are separated from your baby due to medical reasons, you may not be able to breastfeed your baby straight away. However, this does not mean that you won鈥檛 be able to breastfeed later.

This information sheet is for educational purposes only. For further information regarding this topic, please talk to your health care team.

 

Expressing breast milk

Babies and young children who are unwell in hospital may not be able to feed straight away. Regular expressing allows you to give your baby your breast milk in other ways, such as with a bottle or feeding tube. 

It also means you have a supply of milk for when your baby is able to breastfeed. Early and frequent expressing is essential to keep up your milk volume when you are unable to breastfeed.

You can express milk by hand or using an electric pump.

Hand expressing

Hand expressing is a useful skill, particularly in an emergency, and is an important part of stimulating your breasts to make milk.

If possible, try to hand express within one hour of delivering your baby. Hand expressing takes about 20-30 minutes.

Step 1

Wash hands thoroughly.

Step 2

Start by gently stroking your breasts from armpit to nipple. This encourages milk 鈥榣et-down鈥� or milk flow.

Step 3

Cup your breast (with fingers 2-3cm behind the nipple) in a C-shape using your finger and thumb. Keep your thumb opposite your fingers.

Step 4

Press towards chest wall with fingers 2-3cm away from nipple.

Step 5

Compress the breast between your fingers and thumb without rolling onto your nipple.聽

Step 6

Release, then repeat.

Useful tips for hand expressing

  • Use a rhythm until your milk flow stops. We recommend press, compress, and relax.
  • Rotate your hands around the breast. Change the position of your fingers and thumbs, expressing until it feels soft.
  • Do the same on the other breast.
  • Switch back and forth between breasts as the milk flow slows. This will encourage further 鈥榣et downs鈥�, or milk ejections leading to more milk. 

Watch: - Global Health Media Project (YouTube)

Things to remember about hand expressing

  • Express every 3 鈥�4 hours, up to 6-8 times in 24 hours. 
  • If you鈥檙e struggling to sleep, wake up at least once to express overnight 鈥� we recommend this to be between 2am-5am.
  • Regular expression, including overnight, is very important to increase and maintain supply especially in the first 6-8 weeks.
  • Express for about 15 minutes on each breast.
  • Your milk can be collected in a sterile syringe or container. Breastmilk freezer bags laid flat can help increase storage space.
  • If you are expressing at home, keep the milk in your fridge or freezer and bring it to the ward in an Esky with ice bricks.
  • The aim is to reach about 500ml in 24 hours, by day 7.
  • It can take up to 6-8 weeks to establish your supply.
  • Once your milk supply has settled, you may not feel fullness anymore. This is normal and if expressing or breastfeeding is going well, does not mean you have less milk.

Using an electric breast pump

During your hospital stay, we鈥檒l provide you with an expressing kit that connects to an electric breast pump.

The pump mimics the natural sucking of your baby at the breast, stimulating the flow of milk. Using a breast pump once your milk has come in will help establish and maintain your supply.

It is important to gently use your hands before, during and after expressing with the pump. Use your free hand to stroke your breast, while holding the pump with the other. You can try this for the first couple of weeks. This may increase your milk volumes and make you aware of any lumps or tender areas that may need to be gently focused on during your expressing session.

After, when engorgement has reduced, you can double pump (express both breasts at the same time with two kits) to save time. This is especially important if you are exclusively expressing.

See also: Setting up the electric breast pump in hospital

Colostrum

Colostrum is the first milk to be made by your breasts after birth. 

It is rich and thick and is released in small amounts. You will notice only a drop or two, or just 1ml at a time. 

It can be that you do not have any milk in the first 24 hours after birth, especially if you are separated from your baby, have experienced birth trauma or another medical complication.

Express colostrum or milk every 3-4 hours, during the day and night, even if no milk comes out. Get advice if unsure.

Prenatal Expression

Ask your GP, midwife or obstetrician if you are able to safely hand express from 36 weeks into your pregnancy. 

It can be especially helpful for you and your baby if you have been diagnosed with any type of diabetes.

Increasing milk supply

If you are experiencing low supply, expressing in the early morning is important. This is when the hormone responsible for milk production (prolactin) is at its peak.

After using an electric breast pump, also hand express for a few minutes to increase stimulation to the nipple.

Regular, short expressing sessions are usually more effective than longer, irregular sessions.

If possible, enjoy plenty of skin-to-skin and cuddles with your baby. If not, staff can explain other ways of bonding with and getting close to your baby.

Techniques such as 鈥榟and hugs鈥�, using scent pads and cleaning your baby鈥檚 mouth with breast milk are examples.

Express while looking at your baby, or if in a private space, look at a photo of your beautiful baby with your baby鈥檚 scent pads nearby. Listen to music or a podcast. Cover the bottle to take your focus off of volume- nipple, breast and brain stimulation is the key.

Consider borrowing or buying a breast pump for at-home use if you don鈥檛 have one already. Please ask nursing staff for more information.

Labelling and storing expressed breast milk

All expressed breast milk (EBM) stored in our hospitals must be labelled. Staff will show you where to find the right labels for your ward.

Please label your EBM with your child鈥檚 hospital sticker and the date and time the milk was expressed. 

Freshly expressed EBM must be used or frozen within 48 hours of being bottled. 

Defrosted EBM must be used within 24 hours of thawing.

Consider the volume of feed your baby is getting when you store milk to reduce waste.

Looking after yourself

As a new parent, you are essential to your child鈥檚 recovery and growth. It is important to give yourself time to rest.

  • Try to take your admission day-by-day - expect some ups and downs.
  • Rest when you can.
  • Eat and drink well. A full stomach can aid in milk production.
  • The hospital can arrange hospital meals for breastfeeding mothers if needed.
  • Try to minimise your stress 鈥� excess stress may affect your milk supply. Accept help if it is offered.

Breast and nipple care

Speak to our nursing staff if breastfeeding/expressing is painful.

Watch for nipple damage. It鈥檚 important to discuss any nipple pain or irritation with a health care professional.

Redness and lumps, fever, or cold and flu symptoms could be signs of infection. 

Once you are discharged contact your local community breastfeeding clinic and/or breastfeeding peer support group, midwife, or the or 24-hour helpline for free advice (1800 686 268). 

You can also contact your GP, obstetrician, or a for advice. Check for costs involved.

Weaning and suppression

We have a wide range of information and resources available to support you in your decision to breastfeed/express, or to bottle feed.

Our clinical staff will support you if you decide breastfeeding or expressing is not for you.

If you decide not to breastfeed, we also have information available on weaning and suppression.

See also: - Australian Breastfeeding Association

Further resources