Hand expression, pumping, and proper storage

Pumping and Proper storage

The first few weeks after your baby is born, your milk supply is all over the place. You will/have probably experience ‘engorgement‘. This is a painful and unpleasant experience. While your milk is being sorted out by ‘supply and demand’ bargaining between your body and your baby, you might want to relieve your swollen, full breasts by either pumping or hand expressing. You can store this extra milk in your fridge or freeze for later use.


Hand Expression

The Marmet Technique of Manual Expression*

This technique has been developed by Chele Marmet, a La Leche League Leader and lactation consultant who is the Director of the Lactation Institute in West Los Angeles, USA. As with any manual skill, practice is important.

  1. Position the thumb and first two fingers about 1 ” to 1 1/2″ behind the nipple. Use this measurement, which is not necessarily the outer edge of the areola, as a guide. The areola varies in size from one woman to another. Place the thumb pad above the nipple and the finger pads below to form a “C.” Avoid cupping the breast.
  2. Push straight into the chest wall. Avoid spreading the fingers apart. For large breasts, first lift and then push into the chest wall.
  3. Roll thumb and fingers forward as if making thumb and fingerprints at the same time. The rolling motion of the thumb and fingers compresses and empties the milk reservoirs without hurting sensitive breast tissue.
  4. Repeat rhythmically to drain the reservoirs. Position, push, roll; position, push, roll.
  5. Rotate the thumb and finger position to milk the other reservoirs. Use both hands on each breast.

*1978, 1979, 1981,1988 Chele Marmet. (LLLI.org)

To begin, find a comfortable, quiet spot and relax as much as possible to encourage letdown. A quick breast massage or leaning over and gently shaking your breasts can launch letdown, as can warm compresses. If your baby is close by, try cuddling with her (as long as she doesn’t mind being thisclose to milk she can’t have). Away from home? Look at her cute mug in a photo, or close your eyes and imagine her face, her smell, and her blissfully nursing away.

If you’re using an electric pump, use the lowest suction at first and then increase the juice when things get moving. Do be patient. It may take a few minutes (or a few days or even weeks) for you to get into a comfortable rhythm. Pump until the milk starts slowing down and your breasts feel empty, and be sure to clean the breast flanges after every use. (www.whattoexpect.com)

Choice of a Storage Container
When a baby is only receiving expressed milk occasionally, the type of storage container is not a major consideration; however, if a baby is receiving most of his nourishment from expressed breast milk, the type of storage container used should be considered carefully. Plastic containers are the best choice for storing breast milk in the refrigerator as more of human milk’s leukocytes or white cells adhere to glass. If the milk is to be frozen, glass is the preferred choice as it is less porous and offers the best protection. Most of the leukocytes in human milk are killed with freezing anyway. For this reason, milk that can be used within 8 days of expression should be refrigerated rather than frozen, because the antimicrobial properties of human milk are better preserved with refrigeration.

Another good choice for refrigeration or freezing is the milk storage bags that are designed specifically for human milk (Medela, Ameda, NUK, Tommee Tippee, Lansinoh, etc…). They are per-sterilized and are thicker (2-ply), coated with polyethylene, and lined with nylon which prevents the fat from adhering to the sides. Hard plastic containers of any kind are also good choices for both refrigeration and freezing. Other milk bags, sold specifically as bottle liners, are not as durable, making them an unacceptable alternative when freezing the milk as the seams may burst during the freezing process perhaps causing a leak during thawing. Also, one study found that there was a 60% decrease in the milk’s antibodies and a loss of fat that adhered to the sides of these bags. If this type of bag is still chosen, the milk can be better protected by placing the liner bags in a larger gallon size freezer bag or in a hard plastic container. (http://www.motherandchildhealth.com)

When milk freezes it expands, so it is necessary to leave about an inch at the top of the container to allow for expansion. For this reason, bottle caps or container lids should not be tightened until the milk is completely frozen.

It is important to remember to store your milk towards the back of your refrigerator. Storing your milk on the door can cause thawing of the milk which will start to break down valuable nutrients in the milk.

How long is milk good for once it is stored?

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