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Best Practice of Expressing and Storing Breastmilk

There’s no doubt going to come a time in your breastfeeding journey when you may not be able to be with your baby for their feeding. Whether it's just a dinner out, you're heading back to work, or your baby can’t breastfeed due to latching issues, knowing how to express and store breastmilk can ensure your little one still gets nutritious breastmilk even when you can’t be with them.

Having some breastmilk on hand when you need it gives you a little bit of freedom while allowing a partner or other caregiver to get involved in the feedings too.

Expressing means removing the breastmilk from your breast to store it for when you can’t be with your baby to nurse – it's also referred to as pumping. You can express milk by hand or with a hand or electric pump. If your milk has already come in and you’re in the habit of breastfeeding, expressing your breastmilk should be easy and painless.

Survey data even indicates that as much as 85% of breastfeeding mothers express milk at some point before their baby reaches four months of age. That’s because there are so many situations that may arise where you cannot be near your baby around the clock. Knowing the best ways to express, store, and feed breastmilk will prepare you when one of those situations comes up.

A mother handling expressed milk
Expressing and storing breast milk is very important if you cannot stay with your baby at all times

Expressing Breastmilk (Reasons, Methods and Best Practices)

There is no research that shows the best time to introduce a bottle to your baby, so you can begin expressing and feeding milk whenever is best for you, no matter if your baby is ten weeks or ten months old! However, as we wrote in a previous blog post, a good rule of thumb is to wait until breastfeeding is completely established and then introduce a bottle. In this way, you will limit the chances of nipple confusion.

How often you’ll need to express your breastmilk relies on a lot of factors, like the reason behind why you’re doing it. If you want to build up a stash of breastmilk for when you return to work or the occasional night away while still nursing your little one, it’s best to start slowly by introducing an extra pumping session. This will train your body to increase supply so you can store and freeze that milk for later. Do this a few weeks before returning to work or a few times before you’ll be away, so you have an 'emergency stash' of breastmilk on hand.

If outside factors influence your decision to express breastmilk, like your baby isn't sucking correctly or your child is in the NICU and cannot be with you, you'll likely be exclusively pumping. This means that you'll need to express milk around the clock to ensure you have enough supply to match your baby’s needs. While milk intake varies widely, research has shown the average amount of milk a mother pumps at each session. The key is to stay tuned in to your baby, so you have enough breastmilk to meet their growing demands.

Expressing milk by hand is one method you can use to remove milk from your breast. This can be the most effective way to relieve pressure from a clogged duct or engorgement. To effectively use your hand to express milk, first, be sure to wash your hands, then place your thumb on top of your breast above the nipple with the other fingers below the nipple, forming a ‘C’ shape. Gently roll both your thumb and fingers forward towards your nipple until milk begins to empty from your breast. To see for yourself, UNICEF put together this video that demonstrates the best way to express milk by hand.

Pumping using a hand pump or electric pump is much more effective if you’re regularly or exclusively pumping because it will draw the milk from your breast faster and more efficiently (although not as effectively as breastfeeding). Follow your pump's instructions closely and always wash the parts after each use to avoid mould and bacteria buildup.

When you’re expressing breastmilk, you want to try and be as relaxed as possible as this will help stimulate milk let-down. A warm washcloth, shower, or bath can also help.

A picture is worth a thousand words, and just looking at your baby can help get your milk flowing. Have a picture of your baby nearby, or simply think of your baby to encourage your let-down reflex.

When you first start expressing your breastmilk, it might be frustrating and time-consuming, so try not to be discouraged if you're having difficulty at first. Just like breastfeeding, expressing milk takes practice and consistency. If expressing your milk is difficult or painful, reach your midwife, healthcare provider, or lactation consultant for support.

Proper Procedures for Storing Breastmilk

Once you've expressed your breastmilk, you can store it at room temperature, in the fridge, or in the freezer. There are strict guidelines for how long you can store milk safely. It’s often best to think of the rule of 4s, which means you can store freshly expressed or pumped milk up to 4 hours at room temperature or up to 4 days in the refrigerator. When you freeze expressed milk, using within six months is preferred, but it's safe for up to 12 months.

Following safe practices is paramount to ensuring your baby gets the most nutritious, healthy milk you can offer. That's why it's so important to use only designated containers for storing breastmilk. You can purchase breastmilk storage bags or use clean, food-grade containers made of plastic or glass with tight-fitting lids for storage.

Labelling your storage containers will guarantee that you follow the storage guidelines above (and it's also valuable for your childcare provider), so be sure to include your child's name, the volume, and the date on each container.

Storing breastmilk in small quantities at first will help you avoid waste while you determine how much your baby takes in at each feeding. Experts recommend starting with 60 to 120 millilitres (2 to 4 ounces) so that the milk can thaw quickly and be combined with other stored milk if your baby needs more. These small quantities can also help provide a supplemental feed or “snack” if your baby is extra hungry or going through a growth spurt.

Breastmilk does expand when it freezes, so leave a little space (about one inch) at the top of your container to account for this. If you intend on freezing the breastmilk, it’s best to freeze it right away to maintain the quality of the milk.

When travelling, it can be challenging to maintain the strict temperature requirements for storing breastmilk. However, you can use an insulated ice cooler with ice packs to keep up to 24 hours. When you arrive at your destination, immediately refrigerate or freeze the milk.

Feeding Breastmilk at Home or Away

Your baby will have their preferences on whether they like to drink their milk cold, at room temperature, or warmed. Regardless, you'll need to properly thaw your frozen breastmilk so that it maintains all the health benefits and stays safe for your little one.

The best way to thaw breastmilk is in the fridge, so it defrosts slowly. You can get it out of the freezer and place it in the fridge the night before you plan to use it, or you can defrost it right away by holding it under warm (not hot) running water. Never re-freeze milk that's already been thawed.

If your baby prefers cold milk, you can feed it directly from the fridge, or you can warm it up using a bottle warmer or by placing the bottle in a jug of warm water until it reaches your desired temperature.

Don’t use a microwave to warm or thaw breastmilk as it can heat unevenly and cause hot spots that can burn your baby’s mouth.

Always follow the proper temperature storage guidelines for breastmilk, even after it’s been thawed. That means that defrosted milk can be stored at room temperature for up to 2 hours or in the fridge for up to 24 hours (remember, never re-freeze breastmilk after thawing). If your baby only drank a partial bottle, you must use the milk within 1 hour or discard it.

Safety First while Expressing, Storing, and Feeding Breastmilk

Always use proper cleaning techniques to ensure your hands, breast pump, and bottles are safe for your baby. Your bottle and breast pump parts should be carefully taken apart, cleaned, and sanitized after each use and stored in a clean, dry environment.

Remember that germs can multiply if parts are not cleaned properly, and it's important for you and your baby that every part that touches your breast, breastmilk, and your baby's mouth is clean and safe.

The AAP recommends that your baby receive breastmilk as their sole source of nutrition for the first six months of life. Expressing, storing, and feeding pumped breastmilk offers a valuable source of nutrition for your growing baby even when you can't be there.

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