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  Expression and storage of breastmilk Download

All breastfeeding mothers should be encouraged to learn how to express breastmilk, although letting the baby suckle the breast directly is the most efficient way of extracting and stimulating the mother's milk supply.
Why Express? To relieve breast fullness in conditions like engorged breasts, oversupply, blocked duct, etc. To increase and maintain milk supply for preterm babies, working mothers etc. To provide breastmilk when mother & baby are separated. Methods of Expression 1. By hand 2. By breast pump
Preparation for Expression (Manual / Pump) - Be relaxed in a warm quiet room/area with a drink prepared, & your baby's photo nearby. - Use a clean plastic container for each expression. - Daily shower for personal hygiene. - Wash your hands with soap & water. (This is a very important step in preventing infection. Please see
- Apply warm compress to the breasts (e.g. with a warm towel) for a few minutes. - Massage your breasts by gently stroking with the fingertips, or gently rolling your closed fist over the breast towards the nipple for a couple of minutes, to enhance the milk flow. There are no right or wrong ways to massage, provided that you do it gently.
How To Express Breastmilk By Hand Place your thumb & forefinger on opposite sides of the areola, while the other fingers gently support breast. Gently feel for the small thickenings of milk sinuses beneath or around the margins of the areola.
First, press the fingers slightly inwards towards the chest wall. Then gently bring your forefinger & thumb together pressing behind the nipple & areola, and release. Repeat the press-release movements until the milk flow slows down.
Rotate the position of the thumb & forefinger around the areola to drain milk from all segments of the breast.
Each expression may take up to ~ 20-30 minutes. To maintain milk production, express every 3 hours during daytime & once at night, with a total of ~6-8 times/24 hours. If possible, ask for skilled advice & practical instruction beforehand, to ensure correct technique.
Use a new bottle for each occasion of expression. If possible, the bottle should contain the quantity of breastmilk, whivh is enough for one feed. How to Use the Pump (Manual Pump or Electric Pump)
Read the instructions carefully before use. (There are many types of breast pump in the market. Select the one with an adjustable suction force.) All breast pump accessories should be sterilized before use. Set the pump to the lowest possible setting at the start, and slowly turn the pressure up to comfortable level, if you need to .(A double electric one is most efficient.)
Preferably, get advice from a skilled professional before buying or using a breast pump.
Methods of Maintaining Lactation To maintain your milk supply, express milk every 2-3 hours during daytime, and once at night, with a total of ~ 6-8 times / 24 hours. More prolactin (milk producing hormone) is produced at night, so breastfeeding/expression at night is especially helpful for keeping up the milk supply.
How to Clean the Utensils? Proper cleansing of the pump and milk bottle is recommended after each use. Disassemble all parts of the breast pump/bottles, cleanse with mild detergent & rinse well. Immerse the parts in boiling water for a few minutes before use.
Methods of Sterilization Boiling Method 1. Immerse the milk bottle and all spare parts of the breast pump together with the tongs in a clean pot of water. 2. Water should be boiled for a further 10-15 minutes after boiling. 3. Use the sterilized tongs to remove the items from the pot.
4. If the milk bottles and the breast pump are not being used immediately, assemble all parts together in a clean container with a lid, and keep it in a cool place. 5. Re-sterilize the utensils after use, or if stored for more than 24 hours.
Antiseptic Solution / Tablet - Prepare the antiseptic solution in a clean and non-metallic container according to instructions. - Immerse all parts of the utensils in the solution. Refer to instructions for the required duration of sterilization.
Storage of Breastmilk Containers for Storing Breastmilk: - Use plastic containers with a tight lid. - Special breastmilk freezer bags can also be used.
Milk keeps in room temperature for about 6-8 hours. Refrigerated milk in a 2 - door fridge can be kept for 72 hours, or in a single door fridge for 24 hours. Frozen milk can be kept:-
- for 2 weeks in a freezer compartment of a fridge. - for 2 months in a self-contained freezer unit of a fridge. - for 6 months in a deep freezer.
Useful Guidelines All containers must be labeled with date & time before storage. Freeze milk in single feeding quantities (i.e. 60-120 mls) to prevent wastage. Do not add freshly expressed breastmilk to frozen milk. (Chill freshly expressed milk in the fridge for about half an hour before adding into frozen milk. The amount of frozen milk should be more than the chilled milk.)
Never store breastmilk at refrigerator or freezer doors where the temperature is unstable. It is best to thaw frozen milk by placing it in refrigerator, where the expresses breastmilk can be kept for 24 hours. If a quicker method is preferred, hold the container under running water. Thawed breastmilk stored in the refrigerator should be used within 12 hours. Never use microwave or a stove to warm the breastmilk. ( Hot spots in the milk can scald your baby!)
Never re-freeze thawed breastmilk. Use warm water to warm breastmilk before feeding (optional). Always use the earliest expressed breastmilk first, & leftover breastmilk must be discarded. Breastmilk normally separates into milk & cream on standing. Gently swirl the container to mix the milk before offering it to your baby.
Transportation of Expressed Breastmilk Expressed breastmilk can be transported in an insulated container, with cold packs or crushed ice in hot weather. Informational complied by the Family Health Service Department of Health
 
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Last revision date: 01 September 2006