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The Rotunda was the first maternity hospital in dublin to get the national baby friendly hospital award

Continuing to Breastfeed


Growth spurts

Babies grow all the time. However, they do have growth spurts, which occur around three, eight and 12 weeks. At this time the baby feeds more often and this increases your milk supply. This usually lasts for about 24 – 48 hours and then the feeding pattern returns to normal.

mother breastfeeding baby

Reasons for expressing milk

You may want to express milk if:

  • your breasts are too full for the baby to attach;
  • your breasts feel full and uncomfortable;
  • your baby is too small or sick to breastfeed; or
  • you will be away from your baby for more than an hour or two.
You can express milk:

  • by hand;
  • using a hand pump; 
  • using an electric pump.

Whichever way you choose, when you express your milk it may take a minute or two to start flowing. Milk can be continuously expressed from one breast only for a few minutes before the supply slows down or appears to stop. Milk should then be expressed from the other breast, then go back to the first breast and start again – about ten minutes on each breast altogether. Keep changing breasts until the milk stops or drips very slowly.

When expressing, you can encourage your breast milk to flow by trying some of the following.

  • Try to be as comfortable and relaxed as possible. Sitting in a quiet room with a warm drink may help.
  • Have your baby close by. If this is not possible have a photograph of your baby to look at instead.
  • Have a nice warm bath or shower before expressing, or apply warm flannels to your breasts.
  • Gently massage your breast. This can be done with your fingertips or by rolling your closed fist over your breast towards the nipple. Work around the whole breast, including underneath. Do not slide your fingers along your breast as it can damage the skin.
  • After massaging your breast gently roll your nipple between your first finger and thumb. This encourages the release of hormones, which stimulate your breast to produce and release the milk.
  • As you get used to expressing your milk you will find that you do not need to prepare so carefully. Just like breastfeeding, it gets easier with practice.

Hand expressing

This is a free and convenient way of expressing milk and is particularly useful if you need to relieve an uncomfortable breast. These instructions are a guide but the best way to learn is to practise so that you find what works best for you. With practice it is possible to express from both breasts at the same time.

Techniques for hand expressing

Each breast is divided into around 15 sections, each with its own milk ducts. It is from these ducts that you express the milk. It is important that you rotate your fingers around the breast to ensure that milk is expressed from all the lobes.

1. Place your index finger under the breast at the edge of the areola, and your thumb on top of the breast opposite the index finger. You may be able to feel the milk ducts under the skin. If your areola is small, you may need to move your fingers away from the edge of the areola. Your other fingers can be used to support the breast.

2. Keeping your finger and thumb in the same places on your skin, gently press backwards towards the chest wall. Press your thumb and finger towards each other, moving the milk towards the nipple.

3. You should not squeeze the nipple, as this is not effective and could be painful. Be careful not to slide your fingers along the breast as this can damage the delicate breast tissue.

4. Release the pressure to allow the ducts to refill.

5. Repeat steps 2 and 4.

Once you have a good technique steps 2 and 4 take no more than a few seconds. You are then able to build up a steady rhythm. This results in the milk dripping and perhaps spurting from the breast.

Pumps

There are a number of different pump designs; some are operated by hand, some by battery and some are electric. They all have a funnel that fits over the nipple and areola.

Electric pumps

Electric pumps are fast and easy because they work automatically. They are particularly good if you need to express for a long period, for examplelady extracting breast milk with pump if your baby is in the neonatal unit. If this is the case, then you should try to express a minimum of six to eight times in 24 hours including once during the night, to maintain supply.

It is recommended to massage the breast prior expressing and always hand express for a couple of minutes at the beginning and the end. It is possible to express both breasts at the same time using some electric pumps that have a dual pumping set. This is quicker than other methods and may help you to produce more milk.

Follow the manufacturer’s instructions very carefully if you use a pump. Whichever method you choose, it is important that you wash your hands thoroughly before you start. You must wash all containers, bottles and pump pieces in hot soapy water before you use them, and you must sterilise them if your baby is very young, in hospital or if you are sharing equipment.

Storing breast milk at home

You can store breast milk in the coolest part of a fridge at a temperature of 2° - 4°C for up to five days. If you do not have a fridge thermometer, it is probably safest to freeze any breast milk that you do not intend to use within 48 hours. You can store breast milk for one week in the ice compartment of the fridge, up to three months in a drawer freezer or for six months in a chest freezer. If you have a self–defrosting freezer, store the milk as far away as possible from the element.

When freezing breast milk for occasional use at home, you can use any plastic container provided it has an airtight seal and you can sterilise it. Remember to date and label each container and use them in date order. If you are expressing breast milk because your baby is premature or ill, ask the staff who are caring for your baby for advice about storage containers and how to store your milk.

You can thaw frozen breast milk slowly in a fridge. Standing the container in warm water will also thaw frozen milk. You can store thawed breast milk in a fridge and use it for up to 24 hours. Once it has warmed to room temperature, you should either use it or throw it away.

You should never refreeze breast milk. Don’t defrost breast milk in a microwave because it may heat up unevenly and your baby could then burn their mouth on a hot spot.

Breastfeeding support groups

In the Rotunda we have a breastfeeding support group, which usually meets every Thursday morning at 11.30 am but please ring to confirm that the session is going ahead. If you have any problems with feeding at home the lactation midwife in the hospital is only a phone call away at 01 817 1700, Monday to Friday.

There are community support groups in your area and meetings are usually held in the local health centre. Your public health nurse will tell you the date and time.
 

For further information and support, please contact:
La Leche League in Ireland  www.lalecheleagueireland.com
Cuidiú Irish Childbirth Trust  www.cuidiu-ict.ie
HSE Breastfeeding Support Network www.breastfeeding.ie
Friends of Breastfeeding www.friendsofbreastfeeding.ie


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