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Expressing milk

Expressing milk

Hand expressing can be useful:
  • To express colostrum or milk to give your baby, if they are unable to feed from the breast.
  • To relieve fullness or engorgement of the breast or blocked milk ducts.
  • To stimulate your breasts to produce more milk.
  • Some women find using a breast pump easier, some prefer hand expressing and some do both. Using a pump in the early days is not an effective way to collect small volumes of colostrum.

How to hand express

  1. Have a clean sterilised container to hand before you start.
  2. Cup your breast and place your thumb and finger about 2-3 cm from the base of the nipple.
  3. Using your thumb and the rest of your fingers in a C shape, gently squeeze this area – this shouldn’t hurt.
  4. Release the pressure and then repeat again and again, building up a rhythm. Avoid sliding your fingers over the skin. At first, only drops will appear, but just keep going as it will help build up your supply. With practice and a little more time, milk will flow freely.
  5. When the flow slows down, move your fingers round to try a different section of your breast and repeat. When this happens again swap to the other breast. Keep changing breasts until the milk is dripping very slowly or stops altogether.
  6. If the milk doesn’t flow, try a gentle breast massage, cuddle your baby or someone you love, smell your baby or loved one, or gaze into their eyes – this will help to release the hormone oxytocin (the “love hormone”) which releases the milk in your breasts.

Storage and use of expressed breast milk:

  • Expressed breastmilk can be kept for 4-6 hours at room temperature.
  • You can store expressed breast milk in a sterilised container in the fridge for up to five days, or in a freezer for up to six months.
  • Frozen milk is best defrosted slowly in the fridge. Expressed breast milk can be given straight from the fridge or warmed up by placing the bottle in a jug of warm water.
  • Once defrosted, use within 12 hours and do not refreeze. Dispose of any unused milk following a feed.
How to express breast milk
Breastfeeding network expressing guide Maximising milk production with hands-on pumping Breast massage with mastitis/breast engorgement
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Signs of good feeding/Needing support

Signs of good feeding/Needing support

Use the following charts and related links to determine how well your baby is feeding. Many breastfeeding problems can be resolved with adjustments to positioning and attachment. If you have signs suggesting that you may need support it is essential to seek help straight away. Many sources of support are available 24 hours.
Help with breastfeeding Nappy content
Newborn nappy content Effective breastfeeding in the early days Positions for breastfeeding Attaching during breastfeeding UNICEF UK Baby Friendly Initiative, Breastfeeding assessment tool
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Help with feeding your baby

Help with feeding your baby

If you have any problems with feeding your baby (including painful nipples or breasts, your baby not feeding as well as before) ask for help as soon as possible. Your community midwife team works seven days a week, and you can request additional visits or telephone consultations if needed. Breastfeeding is the healthiest way to feed your baby. If you decided not to breastfeed or have stopped breastfeeding, it is possible to restart. This can be difficult because your milk supply will naturally reduce once you are not breastfeeding, but it can increase again to meet your baby’s needs. Look for skilled support to help you. If your midwives are no longer visiting you, ask for help from your Health Visitor, your Children’s Centre or try a local baby feeding support group (your midwife or Health Visitor can give you details). Alternatively, especially out of hours, you can call the following telephone helplines provided by trained volunteers (they can help with breastfeeding or bottlefeeding problems): The National Breastfeeding helpline: Tel: 0300 100 0212 (9.30am-9.30pm) The NCT Breastfeeding line: Tel: 0300 330 0771 (8.00am-midnight) La Leche breastfeeding helpline: Tel: 0345 120 2918 (8.00am-11pm)
Contact my maternity unit
Tongue tie Finding a tongue tie practitioner Hidden cause of feeding problems UNICEF UK Baby Friendly Initiative, Support for parents Global Health Media breastfeeding videos Breastfeeding in the early days La Leche League GB Association of Breastfeeding Mothers Start 4 Life Breastfeeding Network – find a breastfeeding group Find a private lactation consultant
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When to breastfeed

When to breastfeed

Offer a breastfeed to your baby whenever he/she shows early cues that they are ready to feed, such as:
  • wriggling
  • rapid eye movements
  • hand to mouth movements
  • sucking their fingers, fist or blankets
  • rooting (turning head to the side and opening mouth)
  • hand waving
  • slight murmuring noises.
You can also breastfeed when your breasts feel full, when it is convenient for you (for example, when you want to go out) or when you want a rest or cuddle with your baby. To make sure your baby is getting enough milk, aim for at least 8 feeds in 24 hours from day 3 onwards, but most babies will breastfeed more frequently than this. Babies do not always feed at regular intervals and may cluster feed with short gaps in between feeds, followed by periods of longer sleep. Cluster feeding is normal, especially when your milk starts to come in – meaning your supply changes from the first colostrum to mature milk.

How often should my baby breastfeed?

In the first 2-3 days many baby’s do not breastfeed very often, however, try to offer the breast as often as possible, to see if they might be ready to feed. As a guide aim for:
  • first 12 hours at least 2 feeds in total
  • first 24 hours at least 3-4 feeds in total
  • day 2 at least 6-8 feeds in 24 hours
  • day 3 onwards at least 8 feeds in 24 hours.
These feeding patterns should be accompanied by regular wet and dirty nappies. See both these topics:
Nappy content
Signs of good feeding/Needing support
If you are concerned about your baby’s feeding contact your midwife, health visitor or local infant feeding group or helpline for advice and support. See:
Help with feeding your baby
Explore maternity units
The benefits of responsive feeding BFI happy baby leaflet
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Value of breastfeeding

Value of breastfeeding

Breastfeeding has health benefits for you and your baby. It provides nutrition, protects against infection, supports a healthy immune system, helps growth, development and bonding. Breastfeeding is about closeness and comfort as well as nutrition. If you need to take any medications, be sure to check that they are safe to take whilst you are breastfeeding. Sometimes medications can change the taste of breastmilk which may result in the baby refusing the breast initially. Contact your midwife, health visitor or local pharmacist or advice.
Start4Life An introduction to breastfeeding video Drugs in breastmilk Human milk – what’s in human milk?