Why Express by Hand?
Expressing milk by hand can be more useful than using a pump, it can also be used to help the baby to attach to the breast. Hand expressing can help prevent painful engorgement and it is particularly useful for milk in very small quantities – e.g Colostrum. It can also be used for clearing blocked ducts and best of all it’s free as no equipment is needed!
Storing expressed breastmilk
Breast milk should be expressed into a sterile container if the baby is under 6 months old.
For healthy term babies it can be stored at room temperature for upto 6 hours or at the back of the fridge (not the door) for 5 days at 4° or lower.
In the freezer at -18° for up to 6 months.
For preterm or vulnerable babies, check with your local Neo Natal Unit for guidance as storage is likely to be more cautious.
How to Express by Hand.
Firstly, roll your nipple between your finger and thumb to make it stand out. Make a C-shape with your thumb and either your index or middle finger, and cup your breast. (Picture 1) Feel back from the nipple to where the breast tissue feels different, about 2-3cm from the nipple as shown in the above image. You may feel a change in the breast tissue at this point, sometimes it feels “knobbly”, sometimes slightly firmer. You are now touching the skin above the dense, milk-making tissue.
Then, holding your finger and thumb in this c-shape, press back towards your rib cage, as in the second image. This brings your finger and thumb back into the dense, milk-making tissue, away from the ducts near the nipple.
Finally, bring your finger and thumb appear together, so that they press into the milk-making tissue, and milk will begin to appear in droplets. (Picture 3) Use a sterile cup or bowl to collect it, and try to build up a rhythm. Try not to slide your fingers over the skin, as this will hurt and it will be more difficult to express milk. When the flow slows down, move your finger and thumb around the breast or express from the other side, and you can keep changing breasts until the milk slows or stops.
Practice Makes Perfect!
If you are doing this when your milk supply is not yet established, you may need to repeat these three actions a few times to get the colostrums to flow. You can keep moving your finger around or use the other hand to take milk from all around the breast, but the technique should remain the same each time. If your milk supply is established, the milk may spray out in several different directions.
If you are not able to breastfeed your baby directly, you need to start expressing as soon as possible after the birth, preferably within 6 hours. Keep doing it at least 8 times in every 24 hours, including at least once at night, until baby is feeding properly.
Images – Mum, Louise / Photographer Patrick Shanahan
Text – Helen Shanahan (Midwife, Lactation Consultant, Infant Feeding Coordinator and NCT Counsellor)
Copyright – Real Baby Milk CIC
This information was downloaded from www.realbabymilk.org