There may be times when you want to express your breast milk, such as when you are apart from your baby. You can express breast milk by hand or with a manual, electric or battery-operated breast pump.
Expressing Breast Milk
The easiest time to learn hand expression is during a feeding. The let-down reflex has triggered the milk to flow in both breasts, making it possible to express milk from the side on which the baby is not nursing. Hand expression becomes easier with practice.
- Wash your hands.
- Prepare a container to collect the milk. A wide-mouth container or specially designed funnel works well. Wash the container in very hot, soapy water before use. It is not necessary to sterilize the container.
- If you are expressing milk without your baby close by, take a few minutes to gently massage your breasts down and out toward the nipple. If possible, apply warm, moist wash cloths to your breasts three to five minutes before expressing. Thinking about or looking at a picture of your baby helps stimulate a let-down reflex.
Steps for Hand Expressing:
- Support your breast between your fingers and thumb, which are placed about 1 to 1-1/2 inches back from your nipple. You may have to adjust this position forward or back to get the best results.
- Push inward, straight back toward your chest wall to get behind the milk ducts.
- Next, roll your thumb and fingers toward your nipple. This motion is not a squeezing or sliding motion, but rather a rolling motion as if you are making thumb and finger prints. Do not squeeze your nipple, only the areola.
- Repeat this process, rotating your hand around your breast.
- Switching breasts every few minutes will improve your results. It allows your milk to come down and collect in the ducts of the breast you are not expressing.
Expression With a Breast Pump
When can I begin to express breast-milk?
Your milk supply is being established in the first six weeks, so wait until your baby is about six weeks old before using a breast pump, unless recommended for a specific reason. In general, you express milk:
- In between breastfeeding, one hour before or one hour after a feeding.
- In the morning, when your milk supply is usually at its highest. For most women, expressing in the morning will produce more milk than in the late afternoon or early evening. Pump after baby has fed both sides, and do a short pump for about ten minutes. The advantage of this method is that it will not take milk away from baby, since it is done right after a feeding.
- If you are pumping in place of a feeding, such as at work or school, pump for 15-20 minutes. Pumping longer may make you sore, and generally does not take out any more milk.
Will I have enough milk for my baby if I am also expressing?
Breast Milk production is a demand-and-supply system. The more your breasts are stimulated and emptied, the more milk will be produced. You should not be concerned about not having enough milk, since the milk is made in response to stimulation, either by your baby nursing or expression.
When can I introduce a bottle?
There are many different opinions on this subject. The majority of health professionals recommend waiting at least four to six weeks before giving a bottle to reduce the chance that your baby will prefer the nipple and/or the fast flow of a bottle. Ask your healthcare provider or lactation consultant for recommendations. Keep in mind that adding formula supplements interferes with your milk supply and breastfeeding success.
There are many breast pumps available on the market today. Careful selection is very important. Look at the different features to see which one best fits your needs and desires. Before buying a breast pump, it may be helpful to contact a lactation consultant and/or your healthcare provider for assistance and recommendations. Insurance companies generally provide a free breast pump, with a few models to choose from. Contact your healthcare insurance or go through a third party vendor. Third party vendors are companies that provide breastpumps and contact your insurance company for you. They can be found online.
Many battery-operated pumps are available. Some women find them handy and easy to use. However, they are often not strong enough for long-term pumping needs. Battery-operated pumps also tend to be noisier than electric pumps. Look for pumps designed to release the suction now and then to prevent too much pressure.
Many electric pumps are available, including those with a double pumping attachment for pumping both breasts at the same time. Smaller, lightweight pumps are available for travel or work. Some have a built in battery that you recharge, and some have an optional battery pack to use when on the go. You can get an outlet strip that you can plug into a car cigarette lighter so you can use your electric pump in your car.
There are options for hands-free pumping, such as wearable collection cups and wearable pumps that fit into a supportive bra. You can also buy a pumping band: a garment like a bra that holds the pump flanges in place.
There is a difference between electric rental pumps and personal use breast pumps. For safety reasons, personal use breast pumps should not be shared or resold. Refer to manufacturer’s directions for use.
Storing/Defrosting Expressed Breast Milk
Milk storage guidelines are different for home and in the hospital. Ask for specific hospital instructions for milk storage if your baby remains or is remitted to the hospital.
There are plastic storage bags made especially for breast milk. To prevent breakage, be sure not to fill the bag or bottle to the top. Be sure to write the date of collection on the bag.
Breast Milk Storage Guidelines for Home
|Freshly Expressed Breast milk
|Thawed Breast milk
(Up to 77°F/25°C)
|Up to 6 hours
|Do not store
|Insulated cooler bag with ice packs
|Do not store
(39°F/4°C, back of refrigerator)
|Up to 5 days
|Never refreeze thawed milk
|Deeper Freezer (rarely opened) (40°F/20°C)
|Never refreeze thawed milk
Academy of Breastfeeding Medicine Protocol #8
Human Milk Banking Association of North America (4th Edition) 2019
- Breast milk expands when it freezes. Fill the bottle or bag to within one inch of the top to allow for this expansion.
- You may want to fill the container with 2 to 4 ounces so it will be about the same amount your baby will eat.
- Label the milk container with the date and time expressed.
- Use the oldest milk first.
- When transporting breast milk for use away from home, keep it cold until just before use. A small cooler with ice or frozen packs may be used to keep the milk cold during transport.
- Thaw breast-milk in the refrigerator overnight, at room temperature holding the bag or bottle under running hot tap water, or in a container of hot water. Defrost using the least amount of heat possible. NEVER MICROWAVE BREAST MILK, as it may create hot spots that could burn baby. It also destroys some beneficial vitamins and enzymes.
- Breast milk will often separate when cooled as the fat layer rises to the top. Mix the milk by gently shaking.
- Completely thaw defrosted milk before feeding.
- Some mothers report a slightly soapy smell to their milk after thawing, which is from changes in the milk fats. This is not harmful and can be given to your baby.
- If your milk smells or tastes sour, it should be discarded. If you have questions about the smell of your milk, contact your local lactation consultant for more information.