Expressing and storing milk

When and how to express milk from your breast/chest either by hand or by pump and how to store milk.

Expressing your breastmilk

Expressing is where you remove milk from your breast/chest either by hand or by pump. There are lots of reasons to express milk including: 

Your breasts/chest feeling uncomfortably full, painful or engorged (sick support)
You want to boost your milk supply 
You are separated from your baby  (pre-term or sick baby on NICU)
Short period of time away from your baby or returning to work

If your baby is struggling to suck well or get a good latch you can read about positioning and latching at the NHS website/Start for Life - Breastfeeding positions. (opens in a new tab) You can also contact the IFT or your community team for support.

If you have any queries please email the Infant Feeding Team at cuh.rosiehospitalinfantfeedingsupportline@nhs.net or speak to your midwife.

Urgent advice: Please be aware

If you use any syringe to collect colostrum and feed your baby; it is crucial to always remove and dispose of the lid before feeding. Always ensure that you check all syringes for lids, as different syringes have varying types of lids that may not be as obvious as the purple caps, with some being clear and harder to see. 

Expressing by hand

Some breast/chest feeding parents find it helpful to massage their breast/chest before expressing. You may find it helpful to work from the outside of the breast/chest and massage towards the nipple. Try to take care not to drag your skin. You can try making circular motions, stroking with your fingers or rolling with your knuckles. 

To start expressing: 

Make a ‘C’ shape with your thumb and fingers. 
Start at the nipple and gently feel back 2 to 3cm towards the chest wall or until you find a change in breast tissue texture.  
Once you find the change in texture, gently compress your breast between your thumb and fingers.  Repeat this in a rhythmic movement. Some people find pressing towards your torso as you compress helps the flow of milk. 
You may need to do some trial-and-error to see how far back from your nipple you need to compress. Everyone is different! 
Keep the milk flowing for as long as possible. When the milk flow slows, you can re-position your fingers and thumb (like you’re moving them around a clockface). You can then express a different area of your breast. Try to express all areas of your breast, and alternate between breasts.

Below is a video showing how to hand express breastmilk.

Hand expression video - Unicef UK Baby Friendly Initiative

Link: https://www.youtube.com/watch?v=K0zVCwdJZw0

Expressing by breast pump

A pump can help you take milk out more easily, especially if you need to express more often.

See below the types of breast pumps.

Type of pump	How it works	Best for	Advantages	Things to consider
Manual	How it works you squeeze a handle to create suction	Best for Occasional expressing	Advantages Cheaper Quiet Easy to carry	Things to consider Can take more effort Slower than an electric pump
Electric pump	How it works Uses a motor for suction, can be single or double	Best for Regular expressing, returning to work, building a supply	Advantages Faster, less effort Double pumps save time	Things to consider More expensive Needs a power source
Hospital-grade electric pump	How it works Stronger motor, usually double pump	Best for Frequent expressing If baby is on NICU	Advantages Very effective Good for establishing supply	Things to consider Bulky Costs more to rent or buy.

What pump should I use?

If you are thinking about expressing your milk, you might be wondering what type of pump to use. There are different options, and the best one for you depends on your needs and how often you plan to express.

Things to think about:

How often will you express?

Now and then: a manual pump or hand expressing might be enough
Every day or many times a day: an electric pump (single or double) or a hospital-grade pump may be more useful.

How much time you have?

Double electric pumps can save time by expressing both breasts at once.

Where will you use it?

Manual pumps are easy to carry and quiet
Electric pumps need a power source or batteries

Your comfort:

Some people find certain pumps more comfortable than others. A well-fitted flange is important to avoid pain and help milk flow.

Cost:

Pumps can vary in price. Manual pumps are usually cheaper. You can hire a hospital grade pump directly from the supplier if needed. If your baby is on NICU please speak to the NICU infant feeding team. The postnatal ward also sells breast pumps.

Types of pump

Manual

A manual breast pump may be more suited for use when only needing to express occasionally.

Electric

There are 2 types of electric breast pump: 

Hospital grade - this type of pump is best for ensuring a full supply if baby is not feeding well at the breast/chest, you are exclusively pumping or if you are separated from your baby.  

Standard electric pump - this type of pump is most suitable if you are combination feeding, expressing regularly for storage or the occasional bottle.

Silicone breast pump with suction chamber

These style pumps should be used with caution as they can increase milk supply and contribute to an over supple. These pumps are good for collecting milk from the opposite side that baby is feeding from and are useful to collect milk for the occasional bottle. 

Battery powered pumps 

These pumps are most suitable to use if you are combination feeding, expressing regularly for storage or the occasional bottle. You should be mindful of the battery availability as then the battery is running low the power in the pump will be decreased and may not drain the breast appropriately.  

If your pump is a wear in pump, be mindful not to use these for a prolonged period as this may contribute to blocked ducts if creating pressure in one area of the breast for an extended period. 

Flange fitting and sizing

The Flange (also called a breast shield) is part of the pump that goes over your nipple and breast. It is important to have the right size flange. If it is too small or too big, it can cause:

Sore nipples
Less milk coming out
Swelling or rubbing

A well-fitted flange should feel comfortable. Your nipple should move freely in the tunnel without too much pulling or rubbing.

If you are using a pump, please ask your midwife to support with choosing the correct flange size and using the pump.

We are here to help

Expressing milk can feel tricky at first, but it often gets easier with time. If you have any questions, please ask- we are here to support you and your baby.

Storing your milk and defrosting

Information on storing and defrosting your milk can be found on the NHS/Start for Life website - Storing breast milk. (opens in a new tab)

Sterilisation

You should always clean your feeding equipment with warm soapy water before sterilising them. This ensures all milk and dirt is removed before making them safe for baby to drink from.

You can find information on how to sterilise all feeding equipment, whether you are using expressed breast milk or first infant formula on the NHS/Start for Life website - How to sterilise equipment. (opens in a new tab)