You might want to express your milk for several reasons:
your baby cannot breastfeed
your baby is taking a while to breastfeed
to increase your milk production
baby is not latching on the breast or keeps slipping off
your baby is making your nipples sore
you want someone else to feed your baby, or you want to leave your baby with someone
returning to work
relieve engorged breasts
Pumps/hand expressing
You can use your hand to express milk, or you can buy or hire a pump. Your choice of a pump will depend on your reasons for expressing.
In the first few days when you are still producing colostrum, expression by hand is more efficient than pumping. The small amount of colostrum you produce in the first three days of your baby's life gets usually stuck in the funnel on its way to the bottle. Therefore hand expression into a small syringe or cup works better.
If you need to increase your milk production or your baby cannot feed directly from the breast then consider a double electric pump. It will be money well spend as double pumping will save you so much time and sleep. You can either buy (e.g. Medela swing maxi or Spectra S1 double breast pump) or hire (Medela Symphony breast pump). Cheaper way of double expressing is to use electric single pump on one breast and Silicon breast pump on the other (Natural Bond or Haakaa)
For occasional pumping, a small electric or hand pump will be sufficient. You can also just hand express. My favourite electric hand pump is 'Little Martin's pump' or Medela swing.
Check that your pump flange fits you comfortably. If too much areola is pulled into the tunnel, it can cause soreness as the sides of the funnel are rubbing against your skin. If the tunnel is too tight, it can stop the milk flow. Some pumps have only one size funnel, but Medela pump for example has three different sizes.
When buying a pump watch out for a pump with separate controls for suction and cycling.
Cleaning the pump
If your baby is a healthy and full term, you don't have to sterilize your pump. Washing it once every 24 hours with warm soapy water and rinsing with clean water will be enough. Between pumping, you can store your pump in a clean plastic sealable bag and clean container with a lid at the back of your fridge.
Tips for expressing:
Relax (The hormone oxytocin causes the milk in your breasts to be released - the letdown. If you feel very tense and stress, it is difficult for the body to realize oxytocin. To help your body realize oxytocin, have your baby close to you while pumping. Touching, looking at your baby or having skin to skin with your baby will help your oxytocin to flow. Relax your shoulders and take a deep breath, listen to your favorite music, watch TV, dim the lights etc. Try not to worry about how much milk you are producing.
Use your hands (massage the breast for few minutes before you put the pump on)
Combine hand expression with pumping (research shows that combination of hand expression and pumping significantly increased milk supply. You can either hand express before you starts to pump or after pumping.
Massage your breasts during pumping or try breast compressions*
If you have a pump, which allows you to adjust its suction strength, use a setting which feels comfortable. You don't want pumping to become painful.
If you have a pump, which allows you to adjust cycling speed, start with quick sucks and once milk starts to flow, reduce the speed. Increase the speed again once milk flow starts to slow down. Aim for at least 3-4 milk releases during the session. If you are doing the single pumping, switching between breasts, several times can help trigger milk releases.
How often should you express?
If you need to establish milk production without breastfeeding your baby in the early days:
express 8-10 times per 24 hours including at least once during the night to mimic a baby's natural feeding pattern.
you can pump every time your baby feeds
once your milk production is established, you may find that you can maintain your milk supply with fewer expressing sessions.
little and often is more effective than long sessions
express until milk flow stops, then have a short break and come back to it
cluster pumping (lots of pumping sessions close together) can help you increase your milk production
If you are expressing to increase milk production, or because your baby isn't yet feeding well at the breast, do it after of between feeds. Well-drained breasts will stimulate faster milk production.
Expressing when you are out
most shopping centers have a baby feeding room
there is always Mother Care store (if you are in the UK) somewhere close which has a baby feeding room
in the car
changing room in a clothes shop
don't forget the batteries and scarf
*Breast compressions
This technique can help your milk to flow faster when your baby
is only sucking without drinking, which will encourage a baby to breastfeed actively and take more milk.
Drinking (“open mouth wide—pause—then close mouth” type of suck—see the video clip bellow) means baby got a mouthful of milk. If baby is no longer drinking on his own, you may use compressions to “turn sucks or nibbling into drinks”, and keep baby receiving milk.
Compressions also simulate a letdown or milk ejection reflex (the sudden
rushing down of milk that mothers experience during the feeding or when they hear a baby cry—though many women will not “feel” their let down). See video clip bellow.
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