Expressing breast milk
Prior to expression
Pumping mothers are recommended to wash their hands with soap and water, thoroughly prior to pumping. Reduced bacteria at the time of expression is associated with reduced bacterial growth during storage. In addition to hand cleaning, the benefit of breast cleaning beyond daily hygiene has not been shown. Breast washing with skin detergent was shown to be no more effective than water alone in reducing bacteria, and therefore only regular breast hygiene practices are recommended.
Breast milk expression can be achieved by hand or with a pump. The choice of pump depends on the anticipated frequency of expression, time constraints, cost and access to electricity.
When the baby cannot be fed at the breast or cannot effectively remove milk from the breast, the mum may require assistance to initiate, build and maintain a sufficient milk supply. Good management in the first two weeks post-partum is critical for the mum's long-term milk production. The following interventions are very important for the mum’s ability to produce adequate volumes of milk in the weeks that follow:
- Skin-to-skin contact at birth: this has been shown to improve breastfeeding duration and should be encouraged
- Teaching mums how to use their hands for breast massage
- Double pumping (simultaneous pumping) both breasts: this results in increased milk removal
- Removing milk early after birth: this is important – pumping within the first hour of birth helps to remove more milk than pumping within the first six hours, and it increases significantly milk production in subsequent weeks
- Using initiation technology (Symphony PLUS) after birth, followed by a 2-Phase pump pattern after secretory activation (milk coming in) is associated with increased milk production at days 6-13 post-partum
- Expressing frequently is also important. Pump-dependent mums who express their milk more than six times a day have greater milk production than mums who pump less frequently. Pump-dependent mums are recommended to pump approximately eight times per 24 hours
- Pumping between feeds: for mums who occasionally express milk for their breastfed baby and have an abundant supply, a pumping session can take place between breastfeeds
- Using breast shields that fit well, they should be comfortable, not compress the breasts or damage the nipples; a range of breast shield sizes are available if the tunnel is too tight
- Holding the breast shield gently against the breast: this will prevent the milk ducts from becoming blocked and support adequate breast drainage
After expression, clean according to Instructions for use.
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