A Beginners Guide To Expressing Breast Milk

You've decided to breastfeed, but for one reason or another, you want to express the breastmilk and bottle feed, instead of nurse the baby. The reasons behind this could range from medical reasons to personal preference and a few reasons in between.


If you've come across this post because you want to learn a little about expressing, and figure out how to get started, I would like to offer a friendly hello, and welcome you into a community of people who see breastfeeding in a different light.


From a fellow pumping Mama to another, let me say that what you've decided to do is wonderful! It will be hard, and there will be times when your question your choice, but I personally think this is standard regardless of how you feed your baby. If you can get off to a good start, however, it will make those difficult days all the more worth it.


I've had two very different experiences with expressing. With my son, due to various reasons, I opted to express but didn't settle on this decision till about 2/3 months in, and I think at that point I just wanted him to eat! I was combi feeding him formula and breastmilk, and that was great, but my journey wasn't an easy one, and I ended up a low supplier.


When I had my daughter, although she seemed quite keen to latch, I realized I wasn't confident in what I was doing but I knew exactly what I needed to do, to pump! This time i went in headfirst, I stuck to a schedule, followed a few simple tips, and as a result, I was an oversupplier! I only wish I'd kept pumping past 7 months, but I think sometimes you just know when it's time to stop.


Since she was born, I've had a few people ask me for advice on expressing, and so I thought it was about time to put together a little guide to getting started.


I will include some links at the bottom of the post to some other useful sites.


Should I hand express Colostrum -

Colostrum is the liquid gold that your breasts start to produce at around 16 weeks. It's highly concentrated, full of protein, and nutrient dense. You can hand express is from about 36 weeks. You collect it in little syringes, label it and pop it in the freezer, then when you are getting ready to go into the hospital/preparing your home birth space, take it out of the freezer and pop it in the fridge. If you are giving birth in the hospital, give it to the midwife who is taking care of you.


If you are planning on expressing, it's good to have some colostrum prepared, as you can feed baby sooner, rather than waiting till you get the chance to start expressing post-birth. It's not essential for that purpose, of course. I didn't do this with my son, but I did start to hand express after he was born. With my daughter, I hand expressed the night before I went into the hospital, and then every continued to hand express in the hospital before I went into labour.


Having colostrum on hand and ready to go is great if there are any medical complications or concerns as well, such as jaundice, or in the event that you are not able to express in those first few hours, so they can still be fed your colostrum. Even if you intend to feed formula, it's worth doing this just to give them that first initial boost.



When Can I Start Using Breastpump?

You've had your baby - what's next? If you've had your baby at home, it's slightly different because you'll have your equipment at home. Let your midwife/doula know that's your intention so they can assist you in any way should you need it. If you're in the hospital, let the midwife who is delivering your baby know so they can arrange for the hospital pump to be brought to you.


From my own experience, once baby is born, continue to hand express colostrum until you are getting full syringes, then switch to the pump. You might find you get advised not to use a pump for the first 6 weeks, but this is just if you plan to nurse your baby, as it can create an oversupply. You don't want to use a pump prior to the birth either, as this can cause you to go into labour.


In between expressing, ensure you have plenty of skin on skin with baby too!


Pumping Routine

This is where I really went wrong with my son. I think because I just wanted him to eat, and the thought of being attached to a breast pump was pretty dismal for me initially - remember that I had had my heart set on nursing him - what I read online about expressing was just something I refused to believe. Surely I didn't need to do it that often? Looking back, I feel very naive. The time came when I realised my mistake and started to try and increase my supply. While I'm sure I could have done this, it never really worked. By the time my daughter came along, I was more confident and educated in expressing and had a much better idea of what I needed to do. I always feel guilty when I share the best pumping routine because you're already exhausted, but it's so so important. I think this is actually the most important tip there is.


Here it is... You must pump every 2-3 hours, till empty including at least once through the night, for the first 12 weeks, at least. Here's why -

  • You must mimic nursing. When a baby removes milk from its mother's breast and stimulates the nipple, it's signaling the breasts to continue to produce milk. A baby feeds every 2-3 hours (some more frequently) and so to keep up with the demand, you must signally your breast to continue to supply.

  • You must pump till empty because this tells your breasts how much you need. If you leave them half full, then it's signaling you only need half of that milk.

  • Even if you are making loads of milk, you must continue for at least 12 weeks. This is because it takes around 12 weeks for your supply to regulate, and you want it to regulate at making a good amount. Some take longer to regulate, and I personally recommend continuing this routine till about 18 weeks just to be sure. You also don't have to stop this routine, just because you've regulated, you can continue.

  • The night pump is essential. Most babies feed during the night, so you need to make sure that supply is there so you're making enough. Prolactin, the hormone that stimulates milk production, is highest in the night, between 2-5am.

This routine is so important, I can't stress it enough. Don't worry if you miss a pump here or there, the occasional won't do any harm, but if you repeatedly miss them, that's when you'll see a dip in your supply. If you miss one, just make sure you pump on time, or as soon as you can after, and continue as normal.


The night pump can be ab it of a gray area. If your baby is sleeping through, as long as you stick to a strict routine throughout the day, then it can be quite safe to reduce the night pumps. I pumped through the night for as long as I could manage but never did more than two-night pumps.


Also, while talking about routines, don't be put off pumping out and about or when you have visitors. Plan ahead instead!


How Long Should I Pump For?

You must pump till empty - the occasional short pump won't do you any harm and is better than missing a pump - and that can vary. You will never fully empty, you will always be able to squeeze a tiny bit more out. By empty, I mean that it's not flowing/spurting out, the drops have slowed right down. Once this happens, remove your pump, and do a little hand express to ensure you're as empty as can be. You can also do a little hand express at the start to get your letdown started.


What Equipment Do I need?

Mostly, you just need a pump, but there are extra bits and pieces you can get that will help!

  • Breast pump - While you can hand pump, and even use a manual pump, it's worth investing in a good electric pump. There are a few brands out there, so read the reviews and see which one you think might suit you. Ideally, you want a double electric pump, preferably one that can easily be made handsfree (I'll get to that in a moment) but from there the rest is really up to you. I used a Medela Freestyle They are pricey to buy new, and you can buy them secondhand. You can also rent hospital-grade pumps. I had a manual pump too, and a Haakaa pump. I would sometimes use these on an evening, it was hard work, but I found it just helped has it was more work for my breasts. It's not something you need to do though, but it's good to have something like this as a backup in case your pump breaks or runs out of battery when you're out and about.

  • A hands-free bra - You can make these out of old sports bras, but I found it was better to buy a couple of pumping bras, as I found it easier to get the pump in and out. It attached to a feeding bra, so I just had to unclip the cup of the feeding bra and clip the pumping bra in place. I got this one

Those are really the two essentials, however, there are a few bits you might want to consider keeping at your pumping station, or in a little bag or box that you can easily be moved around the house -

  • Spare bottles - both for a storing, but also in case you ever fill up part way

  • Freezer storage - bags, bottles, ice cube trays, whatever works best for you, just make sure you are labeling them and keeping track of what you're freeing.

  • A travel bag - Something you can store your pump and equipment when you're out and about, with a little insulated bit for the milk

  • A few cloths - to wipe yourself down, pumping can be messy

  • Nipple cream - A good nipple cream that is safe to use along with breastfeeding, to stop your nipples from getting sore. You can pick up a Lanolin Free Nipple Cream over in the shop!

  • A compress - one that can be hot or cold, as both can help increase your supply, and ease sore boobs. This can be something as simple as flannel, or you can buy specific pads that you put in the microwave or freezer.

A Few Pumping Top Tips

  • Track your output in an app, or even a notebook

  • Take photos of your accomplishments and celebrate them!

  • Eat well, and plenty - lots of oats, yummy comfort foods, and chocolates

  • Your breastmilk changes to suit what the baby needs, so continue that skin on skin and don't be alarmed if it changes colour or consistency.

  • Be proud of what you're doing -it's not easy

  • Make sure you are relaxed, comfortable and feeling happy when you're pumping, stress can reduce your supply

  • Keep baby, or at least photos and videos of baby, nearby, it helps!

  • Work out a routine for feeding, cleaning bottles, etc with your partner

  • Learn to hold your baby when you're expressing

  • Drink lots of water and always have a drink handy

  • It's okay to combi feed, and it's okay to only breastfeed for a short period of time

  • Take it a day at a time

  • Remember that you ARE breastfeeding, don't let anyone dismiss what you're doing.


Useful Links


Collecting colostrum

KellyMom

La Leche League

Exclusively Pumping


There are some great communities on social media as well, so check those out. I will do a follow on post at some point, about extended expressing.






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