How long can you not pump your breasts? Expressing breast milk correctly - what is important to know. How often to express breast milk

15.05.2019

Breastfeeding mothers have to resort to pumping for a variety of reasons. And quite often the procedure is carried out by hand. How to express the mammary gland with your hands correctly and what nuances should be taken into account with this type of expression?

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The procedure can be carried out anywhere, as well as at any time convenient for the mother, since it does not require additional devices.
Mom independently controls the pressure on her breasts.
The method does not require additional financial expenses.
The procedure is more pleasant for the breast than contact with a breast pump.

Manual pumping is available at any time and does not require special devices, which are its main advantages

Minuses

Equipment

Massaging your breasts before expressing will help you express your milk faster. Moreover, it is very beneficial for a nursing mom.

Massaging your breasts before pumping will make the procedure easier

The hand expression technique is shown in the following figure.

Manual pumping allows you to adjust and finely feel the force of pressure on the chest

Prepare a sterile container and wash your hands well, and get into a comfortable position. After that, place your hand on your chest so that your thumb is above the nipple on top of the areola, and the rest of your fingers are under the nipple. Press gently on your chest with your fingertips. The pressure should come from the base to the areola and then to the nipple.

Make your movements glide and keep your fingers on your chest. First, drops of milk will appear from the nipple, and then it will begin to flow out in trickles.

Many women find it convenient to press on the areola with the fingers of both hands. You shouldn't put too much effort and you shouldn't squeeze the glands too much. Also, do not pull on the nipples and press on them - this will not help to express more milk, but on the contrary, it can cause cracks.

Express milk from one gland for at least 5 minutes. When the milk stops coming out of the breast, move your fingers to another position or start expressing the second breast (you can return to the first one later).

What to do with lactostasis and stagnation?

Expression with lactostasis is aimed at alleviating the condition of the mother. First, a woman should knead her breasts for about 15 minutes. Movements must be accurate and performed in a circle. Rub the chest with the tips of four fingers.

Massaging the breast before pumping not only facilitates the procedure, but also serves to prevent congestion

Breast massage is very beneficial for any breastfeeding mom, don't forget about it.

Remember to massage your breasts before pumping.

You can also take a shower (stand under warm water), drink warm tea, and massage your back in the thoracic spine.

Warm bottle method

Some mums benefit from the warm bottle method.For its application, take a glass bottle with a volume of one to three liters, the diameter of the neck of which is at least 4 centimeters. The glass is heated by dipping the bottle into hot water or pouring water inside, and then the neck of the container is cooled. The neck of the bottle is applied to the areola lubricated with petroleum jelly so that the nipple gets inside it. This will pull the nipple inward and let the milk flow into the bottle. When the milk flow becomes weak, the nipple should be removed from the bottle.

The warm bottle method requires less effort to pump. Monitor your feelings. Stop pumping if you have pain or discomfort

Watch the following video of the Union of Pediatricians of Russia, where a specialized mammologist demonstrates breastfeeding techniques and talks about important nuances.

Like breastfeeding, pumping takes patience and practice. Mom quickly develops the necessary skills and can soon receive the amount of milk she needs from her breast.
To facilitate hand expression, the mother needs to induce milk flow to her breasts before the procedure. To do this, you can apply a warm wet cloth to your breast, go to a warm shower, drink a warm drink 10 minutes before the procedure, massage your breasts, think about your baby.
The easiest way to express milk from one breast is when your baby is sucking on the other, as the inflow occurs simultaneously in both breasts.

If you feel pain while expressing, then you are doing something wrong. When hands are struggling to express, it is best to see a specialist who can help with breastfeeding.

How to properly express breast milk by hand and should you do it? This question worries mothers who are breastfeeding. If you feed the baby on demand, then he himself regulates the amount of milk produced (how much he drinks, so much will arrive) and expression is required only when necessary.

When is expression required

The breast is abundantly filled with milk and becomes firm.
Taking medications that pass into breast milk and harm the baby, while the mother wants to maintain lactation and start feeding after the medication is discontinued.
Lactostasis.
Cracked nipples.
Mastitis.
To maintain lactation during the period of separation between mother and child.
If the baby is premature and has not yet developed a sucking reflex.
The baby refuses to breastfeed and feeds only from a bottle.
We need to stock up on milk.

Advantages of manual pumping over breast pumps

Breast milk is expressed by hand or by a breast pump. Hand pumping has several advantages:

available;
physiological;
increases lactation;
can be used in any conditions;
does not injure the mammary gland, subject to the technique;
painless.

Disadvantages:

experience and practice is needed;
the process takes at least 20 minutes.

A breast pump can quickly pump out a large volume of milk, but a high-quality device is expensive, the pumping process is painful (you need to get used to it), there is swelling of the nipple and areola, the risk of bruising.

Rules for expressing breast milk

If you need to get rid of the feeling of fullness in the breast, then you need to express a little until the feeling of relief and softening of the breast.
To get full milk (front and back), pumped for at least 20 minutes.
Do not discontinue the procedure if the milk is dripping. You have to wait and it will go trickling again.
You can express milk from one breast while your baby is sucking on the other. This makes the process easier.
Manual expression is performed by alternating mammary glands. After emptying the first, they take the second, and after 5 minutes they return to the first. This method produces more milk and does not skip the "back" fat portion.
The procedure is performed every 2-3 hours, which corresponds to the interval between attachments to the baby's breast.
You can not squeeze and pull the nipple: the milk ducts are damaged.
It is contraindicated to slide your fingers over the skin and squeeze it.
Milk is expressed in a clean, boiled water or sterile container, before that hands are washed with soap.

How to prepare for pumping

Hand pumping is done in a calm, relaxing environment. Before proceeding, you need to drink two glasses of water or warm tea, take a shower, do a breast massage, which helps to improve milk flow.

Massage is carried out with fingertips, making circular movements of small amplitude. They start from the axillary region, gradually reaching the areola. Thus, the entire mammary gland passes through movements from top to bottom and in a spiral. Finish with stroking the breast towards the nipple, then move to the other mammary gland. Movements should be soft and delicate. The massage allows the flow of milk to resume if it stops.

Psychological techniques help to get more milk and speed up the process:

mental representation of the streams of a river flowing into the sea;
physical contact with the child;
contemplating a photo of a baby while expressing or remembering him if the child is not around;
listening to relaxing music or sounds of nature (noise of water, rain) through headphones.

Hand pumping: technique

Every breastfeeding mother should know how to express breast milk by hand correctly. This art is easy to master. Hands are the best breast pump. If you follow the technique, then the process of hand pumping will be easy and painless. Procedure steps:
Place your hand on your chest so that the thumb is on top, and the rest are below (clearly opposite the large one), at a distance of 2-3 centimeters from the nipple.
Press simultaneously with your thumb and fingers on the breast tissue in the direction of the chest, then roll your fingers forward to push the milk out of the milk ducts. If soreness appears, then the technique is violated. Repeat these movements until the milk runs out, then move to the next area.
To effectively empty your breast, you can think of it as a clock face. First, the fingers are located at 12 (thumb) and 6 (other fingers) o'clock, then we shift them at 13 and 7 o'clock. Thus, the entire mammary gland must be traversed.
Milk may not appear immediately. First it appears drop by drop, then it stands out as a jet. The woman should carry out the manual expression procedure herself.

Rules for storing and freezing breast milk

Breast milk retains its properties and does not deteriorate under the following conditions:

at room temperature the shelf life is 4-6 hours in a sterile, tightly closed container;
in the refrigerator for 8 days;
in a freezer for up to 6 months at a temperature of at least -13 degrees Celsius.

In the general compartment of the refrigerator, breast milk is placed as deep as possible; it cannot be kept in the door.

For storage, use a special container, which is sold in pharmacies. These are plastic containers and bags, glass cups and bottles. High-quality containers are sealed and tightly closed, sterile, equipped with a measuring scale.

Glass and plastic containers with transparent thick walls better preserve the nutritional and immune components of breast milk. Disposable plastic bags are used for freezing. They save space in the refrigerator, but are best stored in an extra container to avoid damage. The bags change the taste of the milk and this is the disadvantage.

Features of freezing breast milk:

before freezing, the milk is cooled in the common compartment of the refrigerator;
it is imperative to indicate the date and time of freezing on the container;
if plastic bags are used, they are not completely filled, leaving space in the upper part (milk expands when
freeze and tear the bag filled to failure);
freeze in portions of 60-80 ml;
defrosted milk can be stored in the refrigerator for up to 24 hours.

Thaw breast milk in warm water. Do not heat in a microwave oven or on a stove, as this destroys the beneficial properties.

Expressing breast milk by hand is the most common, affordable and cheapest method of expressing. True, the process takes quite a long time, but it does not require any additional equipment and devices, except for a sterile container for breast milk. If you do not express milk often and your baby is exclusively breastfeeding, then manual expression is sufficient. Hand pumping is especially suitable for breast engorgement and lactostasis. If you have to express milk regularly, it is preferable to use a breast pump - to use the hardware method of expressing.

Technique for manually expressing breast milk

How to properly express breast milk with your hands.

Wash your hands thoroughly and prepare a clean bowl (cup) for expressing with a wide neck, having previously washed and then sterilized by boiling or doused with boiling water.
Find a comfortable position (sitting or standing). Position the cup at chest level so you don't have to bend over. If you are leaning, the back muscles will be especially tired during expression.
Supporting the chest from below with one hand, stroke the other hand towards the nipple.
Place your thumb over the nipple on the border of the areola and your index finger below the thumb. Support your chest with the rest of your fingers. In this case, the thumb and forefinger are located opposite each other, forming the letter "C".
Press lightly with your thumb and forefinger, first on your chest towards the ribcage, and then bring these two fingers together in a ringlet, pressing on the areola area. When emptying your breasts, you must press on the lactiferous sinuses below the areola. Sometimes sinuses can be felt during lactation. They look like peas or beans. If you feel them, you can click on them.
Press and release, press and release. The procedure should not be painful. If the procedure is painful, then the pumping technique is incorrect. Milk may not appear at first, but after a few presses it starts to drip. It can flow in a stream if the oxytocin reflex is active.
Move your fingers around the circumference of the areola (press on the sides of the areola) to ensure that milk is expressed from all breast segments.
Rubbing the skin with fingers and squeezing the chest should be avoided. Finger movements should be more like rolling. You should not squeeze the nipple itself. Pressing on the nipples of milk will not work. It is the same as if the baby was sucking on the nipple alone.
Express one breast for at least 5-6 minutes until the flow of milk slows down; then you should carry out the same procedure with the second; then both again. You can express each breast with one hand or change them if you are tired. Expressing milk properly takes 20 to 30 minutes, especially in the first few days when milk production is low. It's important not to try to express milk in less time.

Hand pumping errors

Pain when expressing... Expression technique is correct if you do not feel pain in the breast.

Straining in an inclined position... During expression (20-30 minutes) in an inclined position of the body, the load on the muscles of the back increases, which can provoke the appearance of back pain.

Squeezing (squeezing) the nipple... There is no milk in the nipple itself. When rubbing the nipple, milk cannot be fully expressed, but cracks may occur if the breast is injured.

Knead and rub the mammary gland it is impossible, it can cause its inflammation. Expressing too much can damage the inner breast tissue and cause mastitis.

When expressing to relieve engorgement Express just enough milk to feel comfortable. Expressing more milk can provoke more milk production.

Don't give up trying to pump at the first unsuccessful attempts, be patient. If you are expressing for the first time, consult with your doctor or breastfeeding consultant beforehand to show you how to express correctly.

Young mothers have many questions about pumping. When to do it, why, how and should you pump at all? Should I use a breast pump or is it better to express by hand? Let's figure it out together.

Why pump?

With normal lactation and competent organization of feeding the baby, there is no need for pumping. Mothers and grandmothers may strongly advise you to express the remaining milk after each feed, but these are just relics of the past. The recommendations of modern pediatricians and experts on hepatitis B are opposite: the baby normally sucks as much as he needs, and the same amount of milk is produced for the next feed. The mode of feeding on demand, which is now recommended for mothers, assumes that the baby will receive its portion of milk.

However, pumping becomes necessary in some situations:

when the baby is weak and it is difficult for him to suck milk from the breast (it becomes necessary to feed the baby with expressed milk from a bottle);
in case of (milk stagnation) in a nursing mother;
with insufficient production of breast milk, lactation crisis;
with an excess of breast milk, the crumb begins to choke, so it cannot suckle;
if the mother is taking medications that prohibit breastfeeding, but wants to resume lactation after completion of treatment;
when mom needs to go somewhere else she goes to work;
if you need a supply of breast milk.

When to pump?

Expression makes the glands work harder and produce more milk. So you shouldn't abuse it.
If the mother is going to go somewhere or go to work, it is recommended to start pumping in advance so that the mammary glands "get used" to the new regimen and the required volumes. If possible, at the time of separation from the baby, if there is a rush of milk, it is also useful to express to reduce the risk of milk stagnation.
If you have excess milk, it is recommended to express a little before feeding. This will reduce the volume of liquid milk ("front"), so the baby will stop choking and will immediately pick up the breast.
If you are worried about lactostasis, you need to express milk until the symptoms are relieved - pain and swelling are relieved. Then the mother should often apply the baby to her breast to prevent further stagnation of milk.
In case of insufficient milk production, pumping should be strictly after feeding - this stimulates the work of the glands.
When taking medication, pumping should be carried out in the usual feeding mode - at the moments when milk rushes.
It is convenient to store milk when the baby skips a feed - for example, he sleeps longer than usual ().
If milk flows when parting with the baby, it is useful to express it to reduce the risk of developing lactostasis.

How to pump?

You can use breast pumps, which are manual and electric, or manually express your breast. The devices perfectly collect the "front" milk, but they do not always cope with the "back" milk. It is thicker, which makes it harder to pump.

The manual method is much more efficient. Place your thumb and forefinger on opposite edges of the areola, separate them from the skin and slide them inside the breast, stimulating the milk canals, not the nipple. With the other hand, you can knead the base of the chest in parallel. After several taps each time, move your fingers around the areola to cover all the lobules of the breast. Do not press hard, rub the skin. With the correct procedure, pain should not be felt.

When breast engorgement and hard nipples are painful when expressing, the warm bottle method is recommended. You will need a bottle with a wide neck that easily wraps around the nipple and areola. Pour boiling water into the container. Then wait a little and attach the neck to the areola area. As the bottle cools down, the nipple will be drawn in and the milk will flow out.

The warm bottle method is convenient but does not drain completely. Therefore, it is best to end the procedure with normal manual pumping. The chest will already be softened, so there will be no soreness.

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How do you stock up?

A nursing mother should make sure that she always has at least a modest supply of expressed milk. This will help out in case of an urgent departure, illness and other unforeseen situations, when you have to temporarily part with a baby.

At room temperature up to 25 °, breast milk is stored from 3 to 6 hours, in the refrigerator - 24 hours, and in the freezer longer - from 1 to 3 months. Therefore, to create a long-term supply, it should be frozen in special containers or sachets. Before being sent for storage, breast milk should be kept in a sealed container for about half an hour so that it retains all its valuable qualities. Each portion of milk must be packaged separately, indicating the date of expression, so you can control its freshness.

There is an opinion among young mothers that in order to improve lactation, a woman needs to constantly express milk from her breast. Instead of spending more time on the newborn, such women are forced to express their breasts after each feed. However, breastfeeding consultants believe that this is not necessary at all, since the baby himself regulates the lactation process best. Excessive pumping can lead to hyperlactation, which can cause a lot of inconvenience and problems. Let's try to figure out whether it is necessary to express milk, in what cases and how it should be done.

When should you express milk?

It is believed that a child, sucking a certain amount of milk from her mother's breast during feeding, gives the female body a kind of signal about how much of it should be produced in the future. If the baby begins to eat worse, then the amount of milk produced also decreases. Thus, wise nature has provided for the natural regulation of the lactation process.

With normal lactation, when the baby is fed on demand and he sucks milk well, captures the nipple correctly, the mother and baby are healthy and feel good, additional pumping is not required.

However, there are situations in which it is necessary to extract milk from the glands. Let's consider the main ones.

During the onset of lactation, milk should be expressed after feedings to regulate milk production. After the baby is born, milk arrives quite intensively, and if the baby does not have time to completely suck it out, then it will be produced in less quantity for the next feeding. Therefore, you should express the remaining milk, otherwise it may burn out over time. And when the newborn's appetite improves, there will be nothing to feed him. The main thing in this case is not to overdo it and not cause hyperlactation, therefore, milk should not be squeezed out completely, but only until the breast becomes soft. Otherwise, you can come to a vicious circle, when with each feeding, more milk will be produced, and it will be necessary to strain the breast more and more. It is believed that normal lactation should be established within a week after childbirth, and during this period, you can strain out 2-3 times a day.
In the case of lactostasis, when the milk ducts are blocked and lumps form in the breast, which then become very painful and can cause a rise in temperature, you should manually express milk from such areas. It can take several days to break up such lumps, but if this is not done, then mastitis will begin - an inflammation of the breast. Once the patency is restored, pumping can be stopped. In the future, you should make sure that the child sucks each breast well, and if this does not happen, strain it yourself.
During the period of illness of the woman in labor, when she needs to take antibiotics or other drugs that can harm the newborn, the baby is not applied to the breast, and milk is expressed manually to maintain lactation. Doctors recommend pumping 6-10 times during the day, with a daily interval of 3-4 hours and at night for 6-7 hours. After you finish taking the medication, you can continue to breastfeed your baby.
If the baby is born prematurely or with any pathology in which loads are contraindicated for him (and the sucking process is physical labor for the baby), then he is fed from a bottle with expressed breast milk. If, for some reason, the newborn is not placed on the breast immediately after birth, pumping should be started within 6 hours after birth. At first, only a few drops of colostrum can be drained out, but this will signal the body to activate milk production.
Sometimes, due to the overcrowding of the gland with milk, it becomes very hard and the baby cannot normally capture the nipple. In this case, you can eliminate the swelling of the gland by expressing a little milk before feeding, and then applying the baby to it.

Instructions for nursing mothers on the correct expression of breast milk with lactostasis

How to pump properly?

Milk can be expressed manually or with breast pumps, which in turn are mechanical and electrical. When using a breast pump, it must be carefully cleaned and sterilized before each use to eliminate the risk of pathogenic bacteria developing on its surface. The use of breast pumps by women with cracked nipples is prohibited.

When using a breast pump, make sure that the nipple is located exactly in the center of the funnel, and its edges are firmly attached to the breast skin. Breast pumps are more effective with full breasts, and less efficient if the breasts are soft. In this case, women combine pumping: first, they use a suction device, and then manually suction.

Before hand pumping, you should do a little breast massage.

This will cause the pituitary gland to produce oxytocin, which will dilate the milk ducts of the glands and facilitate the movement of milk.

In the process of expressing, no effort should be made, all movements should be smooth and light so as not to damage the milk alveoli. You need to express milk for about 20-30 minutes. If a woman does not have experience of independent expression, she should, while still in the hospital, seek help from a midwife or nurse, who will show what movements should be used to massage the glands while expressing milk.

The phenomenon when the mother's body produces more milk than the baby needs is called hyperlactation. To eliminate it, you should reduce the number of pumping. However, this should be done gradually so as not to provoke lactostasis.

The body receives a signal about excess milk production within 24 hours. Therefore, you first need to give up expressing after night feeding, and during the day to express milk completely so that the breast is soft. After three days, it will be possible to refuse from one more pumping and so gradually bring their number to 1-2 per day. In this way, it will be possible to get rid of excessive production of breast milk in 1-1.5 weeks.

Mother's milk: causes of disappearance and prevention

How to store milk

Expressed milk should be stored properly. Of course, you need to collect it in a carefully washed and preferably sterilized container. And if it is necessary to keep it for a long time - milk must be placed in the refrigerator.

Unlike artificial mixtures, human milk contains a large amount of protective antibodies that inhibit the development of pathogenic bacteria. Therefore, you can safely leave it out of the refrigerator for 2-3 hours before the next feeding, without fear for its quality. If you plan to store milk for a longer time, you need to put it in the refrigerator. And milk that is planned to be stored for more than two days should be frozen in the freezer.

Every woman should master the techniques of hand pumping as early as possible, as sooner or later it will be useful to her in the process of breastfeeding her baby. In order to learn how to do this correctly, it is advisable to seek help from a medical professional or a more experienced mother. By carefully monitoring the condition of the breast and the process of milk production, you can significantly extend the duration of breastfeeding, which will be of great benefit to both the newborn baby and his mother.