Expressing your Breast Milk - Buckinghamshire Healthcare NHS Trust

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We continually strive to improve the quality of information
given to patients. If you have any comments or suggestions
regarding this information booklet, please contact:
Head of Midwifery, Women & Children’s Directorate
Buckinghamshire Healthcare NHS Trust,
Stoke Mandeville Hospital, Mandeville Road, Aylesbury
Buckinghamshire, HP21 8AL
Maternity Guidelines Group: Jul 2010, V4 Oct 2014
Divisional Board: May 07, Oct 2010. O&G SDU V4 Nov 2014
Clinical Guidelines Subgroup: not required
MSLC: Jan 07, Sep 2010
Equality Impact Assessment: Jan 08
Patient Experience Group: Feb 08
Women & Children’s Directorate
How can I help to reduce Healthcare Associated
Infection control is important to the well-being of our patients
and for that reason we have infection control procedures in
place. Keeping your hands clean is an effective way of
preventing the spread of infections. We ask that you, and
anyone visiting you, use the hand sanitiser available at the
entrance to every ward before coming into and after leaving
the ward. In some situations hands may need to be washed
at the sink using soap and water rather than using the hand
sanitiser. Staff will let you know if this is the case.
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If you require a translation of this leaflet please call the
Breastfeeding Co-ordinator on 01296 315799
Author: C Sparks
Issue date: February 2015
Review date: February 2018
Leaflet code: WZZ1388
Version: 4
Expressing your Breast
Patient Information Leaflet
Safe & compassionate care,
every time
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If you choose to express it is better to wait until breastfeeding is well
established. However hand expressing is a helpful skill to learn in the
early days in case it is needed.
If you are separated from your baby or your baby is reluctant or
unable to breastfeed it is important to ideally:
• start expressing within 6 hours of birth;
• express 8-10 times in 24 hours;
• express once at night.
This will help to stimulate and maintain your milk supply.
All breast milk collected is beneficial to your baby. Initially the
volume of colostrum can be as little as 1ml but will increase as you
continue to express regularly. The most appropriate method of giving
your breast milk to your baby will be discussed with you at the time.
Hand Expressing
Before you start
• Wash your hands thoroughly.
• Ensure any equipment for collecting and storing your breast
milk has been washed in hot soapy water and sterilised
immediately before use.
• It is helpful to have a clean, damp cloth and dry tissues
close by in case there are accidental splashes or spillages
of milk which can occur particularly with hand expressing.
To encourage your milk to flow:
• Find a warm, comfortable and relaxing place to sit.
• Hold your baby ideally with skin to skin contact or have him/
her nearby or have a photo of baby which you can see.
• Apply warm flannels to your breasts or have a warm bath.
• Gently massage all areas of your breasts being careful not to
slide your fingers along the breast as this can cause skin
damage - see below. Spend a few minutes massaging the
breast/s before moving on.
Wycombe Breastfeeding Clinic
Tuesday & Friday 10am-1pm Beaconsfield Children’s Centre,
Holtspur Way, Holtspur HP9 1RJ
Tel: 07798520830 (answer phone)
If you are experiencing breastfeeding problems which require regular
expression of your milk — electric breast pumps may be hired from
Aylesbury and Wycombe Breastfeeding Clinics
Other sources of help:
National Breastfeeding Helpline:
NCT Breastfeeding Helpline:
0300 100 0212
0300 330 0771
Breastfeeding Network Supporter line:
0300 100 0210
La Leche League Helpline:
0845 120 2918
Association of Breastfeeding Mothers Helpline: 0300 330 5453
Lactation consultants of Gt. Britain:
Ardo Breastpump Hire:
Medela UK Ltd Breastpump Hire:
01823 336362
0161 766 0400
Local breastfeeding support: Details from your health visitor,
midwife or “Breastfeeding support for you” leaflet available
from the Buckinghamshire Healthcare NHS Trust website:
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Try to use a fresh storage container each time you collect milk. If
necessary, newly collected milk may be cooled and added to
previously stored milk collected on the same day.
Label your milk container as breast milk with date and time of
Expressed milk should be kept in the back of the fridge (rather
than in the door) above and away from meat products, eggs or
uncooked foods.
Remember—the more often your fridge is opened the more
likely the temperature will rise.
Using stored breast milk
• Ideally defrost frozen breast milk in the fridge. If needed quickly
try defrosting under cool, then warm, running water. Thawed milk
warmed to room temperature must be used straight away or
• Never use a microwave for defrosting or warming breast milk. It is
heated unevenly and could burn your baby’s mouth.
• Stored milk may separate out. Shake gently to mix before use.
• Thawed breast milk should never be refrozen, or reheated.
Useful Contact Numbers
If after reading this leaflet you have any further queries regarding the
expression of breast milk, the following may be useful:
Rothschild Ward (SMH)
Community Midwives Office (SMH)
Community Midwives Office (WH)
01296 316158
01296 316120
01494 425172
Aylesbury Breastfeeding Clinic
Monday & Thursday 10am-1pm
Parentcraft Room, Claydon Wing, Stoke Mandeville Hospital
Tel: 01296 315799 (answer phone)
Roll your nipples between your first finger and thumb.
And/or gently roll your closed fist
over your breast towards the
Use your fingertips in gentle
circular movements
Find the milk ducts:
• Place your thumb on top of your breast and your first finger
opposite on the underside of your breast.
• Your thumb should be at a 12 o’clock position and the first finger
at a 6 o’clock position.
• Starting as far back on the breast as is comfortable, gently ‘walk’
the thumb and finger towards the areola and nipple until you feel a
change in texture (usually 2-3 cms away from the nipple).
To express
• It will help to lean forward slightly.
• Keep your first finger and thumb in the same place on the skin
and gently press backwards towards the chest wall (for larger
breasts lift first).
• Holding that position roll your first finger and thumb together. This
will help to ease the milk out of the milk ducts.
• Release the pressure to allow the ducts to refill with milk.
• It is important that your breast is kept dry and that your
fingers do not slide across your skin.
• It may take a little time for the milk to flow.
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Repeat rhythmically to drain the breast
• Repeat the technique above until the milk slows down.
Rotate the thumb and forefinger position to milk the other
areas of the breast. You might need to change hands to do
When no more milk can be expressed, repeat on the other
breast. Keep switching breasts whenever the milk slows
down. This usually allows milk to flow down to the ducts
Expressing from both breasts at the same time, whether by
hand or pump, is said to increase milk volume and reduce the
time taken. Remember to pause for 30-60 seconds
when the milk slows down.
Expressing using a manual or electric pump
It is useful to hand express prior to using an electric pump
as it may reduce the time it takes for the milk to start flowing.
Correctly assemble all sterilised equipment.
Place funnel centrally onto nipple and areola.
Switch on and increase suction gradually to the maximum
comfortable level. If it is uncomfortable then the suction is too
• Swap breasts each time the milk slows down. This allows the milk
ducts to refill with milk.
• Always remember to switch the pump off before removing the
funnel from your breast.
• Stop after 20-40 minutes or when the milk stops flowing.
baby settles into a breastfeed. Some dual phase pumps do this
Support your breast if necessary.
Ensure suction dial is turned to its lowest setting if relevant.
Some pumps have ways of varying the speed, this tries to mimic
the way a baby feeds—quick sucks at the start of a breastfeed
followed by slower sucks as the milk flow increases and the
• Expressing from both breasts at the same time, whether by hand
or pump, is said to increase milk volume and reduce the time
taken. It can be helpful to pause for 30-60 seconds when the milk
slows down.
Storing your breast milk at home
The lower the temperature of your fridge, the longer you can safely
store your expressed milk. Here is a table as a guide:
6 hours
Fresh breastmilk
Fridge: 5-8°C
Fridge: 0-4°C
3 days
5 days
if temperature rises above 4° C after 3 days; use within 6
hours or throw away)'
Freezer: ¯18° C or lower
6 months
Defrosted in fridge
12 hours
Previously frozen
Defrosted outside fridge
Use immediately
• Always wash your hands before expressing and handling
breast milk.
• Always use a sterile plastic container with a sealed lid to
store your breast milk. Specially designed pre-sterilised bags
are also suitable.
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