What happens if you don't express milk. Pumping: How Often Should You Do It?

24.08.2019

Is it necessary to express breast milk or not? This question probably torments almost every young mother. Someone adheres to the advice of experts, someone has his own point of view. But, one way or another, the question of pumping has remained open for many decades. After all, all women know that expressing breast milk can increase the strength of lactation and prevent congestion in the breast. But everyone also knows that this process is quite painful. Not every woman can force herself to pump, as it is quite difficult and sometimes painful. Having tried to do this once, a woman after that can once and for all abandon this undertaking. So is it necessary to express milk or not, and how to do it right?

When not to pump

In fact, daily pumping is not necessary if:

You do not leave the baby for a long time without a breast.
If the baby eats on demand, eats as much as he wants and when he wants.
If you are not planning to wean for any reason.

When pumping is necessary

Expression of breast milk may be required if:

The child does not take the breast well.
Breast milk is produced in such quantity that the baby is not able to take the full breast.
You have a blocked milk duct.
The child eats by the hour, and the amount of milk is not enough to feed him.
You leave the baby without a breast for a long time and are forced to.

Many mothers believe that it is possible to achieve an increase in lactation during breastfeeding only through pumping. However, an on-demand baby is able to increase his milk supply by himself, he will simply increase the frequency of feeding. To understand how pumping affects a woman's milk supply and health, we need to understand how milk is produced and what mechanisms trigger this production.

Milk flows heavily from the breast

There are a lot of alveoli (milk sacs) in the breast, in which breast milk is stored. From these sacs, milk ducts depart, which merge near the nipple. Directly in front of the nipple are dilated ducts that narrow as they enter the nipple. When the baby takes the breast, he compresses the dilated ducts with his mouth, and milk begins to flow into the nipple and into the baby's mouth.

To continue this process, the oxytocin reflex must turn on. It is he who affects how much milk will be produced. It comes into action at the moment when the baby stimulates the nipple or when the mother worries about the baby and hears his crying. At this point, the hormone oxytocin begins to be released, which "pushes" breast milk out of the storage bags. A woman, feeling the production of a hormone, explains this with a rush of milk. At the time of the tide, milk from the woman’s breast begins to flow on its own, without the participation of the crumbs. And at this time, the child may refuse to take the breast, which supplies milk under pressure. Then the mother will need to express a small amount of milk and only then breastfeed the baby.

What to do if milk comes poorly and is almost gone

To start the process of producing oxytocin, it is often enough to stimulate the chest a little. But there are a few tricks that can also help you get a rush of milk during a feed. So, if you do not have enough milk, you need to do the following:

Relax and imagine how milk comes out of a million storage bags, flows through the milk ducts and enters the baby's mouth.
Some time before feeding, drink warm liquids. It does not matter what you drink, and most importantly - how much.
Have a family member give you a back and neck massage.
Just chat with your own baby, pet him and cuddle him. sometimes the amount of milk depends entirely on how much time you spend with the baby.
Take a warm shower or put a cloth dampened with warm water on your chest.

There are many other methods that will help to establish lactation without expressing milk. Each of them must be selected individually. The murmur of water helps someone “cause” milk, but stimulation of the nipples helps someone. Therefore, each woman herself must look for the right option, since there is no one recommendation for everyone.

Pumping by hand

If you need to make a supply of milk or you decide to increase lactation by pumping, then you need to know how to do it correctly. Many young mothers after childbirth do not know how to do this, how much time is needed for this procedure, how much milk is needed and how much can be expressed. Therefore, they often make a number of mistakes. To prevent this from happening, you just need to listen to the recommendations on how to properly express milk.

Milk, most likely, will not flow immediately, but only after a few clicks. If you feel pain, then you are using the wrong pumping technique. If there is no pain, then the procedure is carried out correctly.

How not to express:

You can't squeeze your nipples. No matter how much you put pressure on them, milk will not go.
Do not let your hands slide over your chest. Wipe your breasts with a tissue if milk gets on them.
You can't trust your husband or girlfriend to pump. They can harm the mammary glands.
Do not look into a glass of pumped milk. According to studies, this helps to pump more milk.

In the early days, pumping can take about half an hour. During this time, you will be able to properly express all the milk. After pumping, feel the breast, if there are no seals in it, then pumping can be completed.

Expression with a breast pump

Some women find it more convenient to pump with a breast pump. Usually it is used together with the manual method, decanting the breast first with the hand, and then with this device. It is only worth noting that the breast pump does not always take soft and crowded breasts.

The modern market offers many options for breast pumps. However, they must also be selected individually. Since the electric option may be too rough for some, and for some, a manual breast pump is a pain.

How often and how much to express milk

The frequency and amount of pumping directly depends on a number of factors.

So, to maintain lactation, pumping every three hours will be enough. If you want to increase the amount of milk, then you need to express your breasts every hour or even more often. But after the process is established, pumping may become less regular. And after six months it can be stopped completely.
To establish lactation, if the baby is not yet able to breastfeed, it is necessary to start pumping already in the first 6 hours after birth. And then do it regularly - once an hour. After the baby gets stronger, you can reduce the number of pumping.
In order to make a supply of milk, you need to express it as often as possible, every one to two hours. And at the time of your absence, it is also necessary to express so that the milk does not “burn out”, and lactation is preserved.

To express or not, how often it needs to be done and how, it is up to each woman to decide for herself. It is only worth remembering that the main factor on which the quantity and quality of milk depends is feeding on demand, and not every 3 hours. Therefore, if you have no contraindications to feeding, and your baby is able to take the breast, then you can forget about pumping. Nature has thought of everything for us, the child will provide himself with milk. Mom can only adhere to the daily routine, relax and receive positive emotions.

Pumping after feeding was considered mandatory for another 20-30 years in Russia, nurses in the maternity hospital and antenatal clinics told how and when to express after feeding. Why is it advised to interfere with the natural process of lactation, what benefits will this procedure bring, and how obligatory is it? Is it necessary to express milk after each feeding if there is stagnation or little milk when it is really necessary? Let's look at some common situations. And here is the opinion of pediatricians and breastfeeding consultants.

1. Lactostasis, breast engorgement - this is when it is necessary to express breast milk. At the same time, you need to express milk after feeding the baby, you can use a sterilized breast pump or hands - this is more convenient for anyone. You should not express until the last drop, but until it becomes easier. If the temperature is raised, it often happens when the colostrum passes into milk, until it drops and the pain passes. You can also take "Paracetamol" or "Ibuprofen", this will improve well-being. But do not forget about mechanical emptying of the breast.

2. If the baby cannot grasp the nipple correctly, with the so-called tight breast. In this case, pumping after each feeding is not relevant. It is necessary to empty the breast a little, on the contrary, before feeding. Do not be afraid that the child will not have enough milk. On the contrary, there will even be benefits, since he eats more hind, fatty milk that is not rich in carbohydrates. This means that the stomach will suffer less. Gas formation, colic are often associated with the abundant use of foremilk by the child.

3. With lactase deficiency. When a baby lacks the enzyme lactase, which is designed to break down lactose, the sugar found in mother's milk. We have already begun to write a little about this in the previous paragraph. Signs of lactase deficiency - frequent gas formation in a child, colic, crying during feeding, tightening the legs. The point of pumping before breastfeeding is to remove the lactose-rich foremilk so that the baby gets more tummy-friendly hindmilk. But you don’t need to express much at all, so as not to provoke lactostasis.

4. If the mother has little milk or there is a high risk of lactation loss. For example, this can happen when mother and child are not together. If the baby is premature. Or almost no breastfeeding at all. This measure will serve both to maintain lactation and will become the prevention of lactostasis. Then you need to pump as a whole more often. It is necessary that the breast is stimulated at least 1 time in 3 hours in order to maintain lactation.

But is it necessary to express breast milk after feeding, if the baby sucks well, it just seems to mom that she has little milk. You can judge whether there is enough milk by the weight gain of the child. If they are more than 500 grams - everything is normal. Do not try to "fatten" the child. But if you really want him to add a little more - you just need to apply it to your chest more often. So, it is not necessary to express milk after each feeding, and more milk may not always improve the baby's appetite.

With age, literally from 3-4 months, the child begins to be interested in something else besides the breast. This is the time of a growth spurt, when the baby already knows how to hold his head well, roll over, and some nimble even get on all fours and start to crawl. Babies usually gain less weight during these months. They may breastfeed less often and for less time. Many mothers, seeing that their baby sucks her breast for literally 5 minutes, after which she turns away from her crying, they begin to express milk in the mornings and at nights, when there is usually a lot of it. But the fact is that such behavior of the child is more often a kind of manifestation of his independence. He just doesn't want to eat right now. Where it would be more correct to make feeding the child the most comfortable for him. You can turn off the lights, the TV, remove all factors provoking the attention of the child. And then he will eat much more willingly.

If a breastfeeding mother is low on milk, doctors may recommend pumping milk periodically. Namely, they are advised not to express themselves every time, but in the morning. In the evening, supplement the baby with expressed milk in the morning. Breastfeeding experts rate this measure as safe, but only if it is used for a limited amount of time, while the mother is trying to establish lactation, she puts the baby to the breast as often as possible. By the way, in the evening, all women normally have slightly less milk than in the morning, but this is not critical. It is explained by daily hormonal surges, a feature of the body.

Constantly expressing milk after feeding does not make sense for any purpose. It is even rather harmful. After all, as you know, demand creates supply. And thus, a woman will provoke hyperlactation in herself. The condition is more than unpleasant.

There are many myths and misconceptions around breast pumping. Now medical workers do not recommend getting involved in such a procedure, however, in some situations, a nursing woman cannot do without it.

The most accessible and most natural technique is hand pumping. That's why new parents need to know how to express breast milk with their hands and when to really do it.

Breastfeeding is certainly a natural process, so the composition of milk secretion and its volume adjusts to the needs of a particular newborn.

If a woman constantly puts her baby to her breast (especially at night with the maximum release of the hormone prolactin), the glands are emptied. But in certain cases, expressing milk will help normalize a woman's well-being.

Optional conditions

Before pumping the breast, the mother needs to consider whether she really needs this procedure. Breastfeeding experts are skeptical about the necessity of artificial stimulation of the mammary glands, considering the following reasons far-fetched.

Mandatory conditions

There are few cases in which it is permissible to express milk, but every new parent should remember them. This will eliminate unnecessary procedures and help you make the right choice.

In other situations, expressing milk with natural feeding is not necessary. If the child eats well, is not hungry, develops normally, the mother feels fine, unnecessary procedures will only harm.

Two main hormones are responsible for the process of formation and secretion of milk secretion. It is from their “work” that the course of lactogenesis depends, the woman’s nutrition or heavy drinking practically does not participate in lactation.

Oxytocin. This hormonal substance provokes the flow of milk under the action of certain "irritants". For example, oxytocin is activated when a newborn is attached to the chest, smelling a native baby, and stimulating the glands. If oxytocin is released, the milk flows on its own, without requiring any effort.
Prolactin. A similar hormonal substance is designed to control the volume of milk secretion. It "calculates" the amount of milk removed from the breast and returns the same amount. Due to this, the breast during lactation is practically not emptied.

Breast pumping will be effective if these hormones begin to act. To “turn them on” and cause the flow of milk to the glands, it is necessary to carry out preliminary preparation.

It may include the following activities:

applying towels to the chest, previously soaked in warm water, or standing under the jets of a non-hot shower;
drinking warm weak tea or any other liquid (it is important that the drink is warm);
light and gentle massaging of the mammary glands;
stimulating the flow of milk, for example, by tilting down.

When performing these activities, the mother should think about her beloved newborn baby. The ideal option is to sit next to the baby in order to better feel it.

The influx of milk secretion will be more effective if one breast is offered to the baby, and the other is decanted. This technique is good because the milk, when sucked by the baby, will flow into two breasts at once.

Marmet and other pumping methods

How to express after childbirth and "get" milk with your own hands? To simplify the process of pumping, breastfeeding experts offer several methods, each of which has its own characteristics.

It is specially designed for breastfeeding mothers. Since this procedure is not entirely natural for the female breast, it is necessary to carefully study all the intricacies of the process and follow the following steps.

In addition to the Marmet technique, there are other techniques that help get milk from their mother's breasts. They are usually used if the previous method did not bring results.

The warm bottle method

A similar method is used if the nipple is in a tense state, and the mammary glands are inflamed. In such situations, it is extremely difficult to get milk, and it’s impossible to attach a baby.

A bottle is used to express milk with your hands or relax your chest to such an extent that the child can take the nipple in his mouth. This container with a neck width of at least 4 centimeters must be heated with boiling water, and the upper part should be cooled.

Then, the peripapillary area must be lubricated with petroleum jelly and a container should be applied to it. The papilla will begin to retract into the bottle and the milk will flow out. As soon as the jets become weak, the bottle is removed.

Nipple squeeze method

If the nipples begin to coarsen, and pain is felt when they are pressed, a special method will be required, which involves the primary secretion of milk.

To implement this method, it is necessary to place all the fingers directly on the nipple and press on it for three to four minutes. Such actions soften the mammary gland and make the pumping process less painful.

Possible errors

Expressing breast milk will be effective and painless only if you follow all the steps correctly. During the procedure, the following errors are possible.

To erroneous actions, breastfeeding experts also include the refusal to decante, if during the very first procedure the woman felt pain or did not receive milk. It is necessary to try - to choose the right time, the best posture and a favorable mood. In this case, the return of the white product will not keep you waiting.

Before expressing milk secret, a woman should understand how to use it. This will help the recommendations of specialists in natural feeding of newborns.

Do not heat up expressed milk in the microwave. Such a product turns out to be unevenly heated, and this is fraught with the presence of excessively hot parts in the container and a burn of the oral mucosa.

Expressing milk by hand is a procedure that can only be mastered after some time. If a woman who is breastfeeding is unable to drain her breasts, a doctor or natural feeding expert should be consulted for advice. And although experts recommend not to get involved in such a procedure, pumping will allow the mother to stock up on a useful product and prolong breastfeeding as much as possible.

Hello, I'm Nadezhda Plotnikova. Having successfully studied at SUSU as a special psychologist, she devoted several years to working with children with developmental problems and advising parents on raising children. I apply the experience gained, among other things, in the creation of psychological articles. Of course, by no means do I pretend to be the ultimate truth, but I hope that my articles will help dear readers deal with any difficulties.

The birth of a child is the most important event in the life of parents. Along with it come new joys and worries that have never been encountered before. A special responsibility falls on the shoulders of the mother, because if she decides to breastfeed the baby, she must monitor her nutrition, the baby's reactions and the correct application. In addition, there are a lot of related nuances. Especially often, young mothers are worried about the question of whether it is necessary to express milk after each feeding.

Pros and cons of expressing breast milk

The opinion of most modern breastfeeding experts on the issue of pumping is the same - it cannot be used regularly and constantly. This point of view is based on the knowledge that the female body produces exactly as much milk as is necessary to feed the baby. This is inherent in nature itself, as well as in other mammals.

Arguments for expressing milk regularly

Supporters of mandatory pumping after feeding are of the view that the child should be fed in accordance with the regimen, that is, up to 8 times in 24 hours. Only in this way will milk be produced by the female body in sufficient quantities. Feeding according to the regimen involves the complete sucking of milk by the baby, which means that there will be no excess left.

If you feed at will, the baby may not suck it out completely, which means there will be excess, signals will go into the hormone system, and there will be less milk. To maintain lactation, you will have to express every “incomplete” feeding so that there is enough milk next time.

Thus, the answer to the question of whether it is necessary to express after each feeding in this interpretation is positive - yes, if you want to maintain lactation. But in practice, women are often so tired of doing this all the time that fatigue and nervous tension lead to a refusal to breastfeed.

Arguments Against Regular Expression of Milk

When a child is guided by his own needs, he will never demand the breast exactly 6 times a day after a certain time. In the first 7 days of his life, he sleeps much more and rarely eats, but in the second week the number of attachments exceeds 8 times a day. However, he is not always hungry. This is a way to calm down, eliminate discomfort, which is not always explained by the feeling of hunger.

The body of a woman is not designed to accumulate milk, it will produce it constantly with proper stimulation. Such stimulation will be feeding on demand. There are practically no risks associated with the loss of lactation, which means that the question of whether it is necessary to express milk after each feeding is answered in the negative. There will simply be nothing to express, but there is an opportunity to acquire hyperlactation when the body decides that there is not enough milk.

Do I need to express milk after every feed? there are arguments for and against this procedure, each woman should decide for herself whether she needs systematic breast emptying, it is necessary to consult a pediatrician and a mammologist

The need for regular expression of breast milk

With the existing freedom of choice, there are cases when it is necessary to express milk regularly:

when the mother and the newborn are separated, if desired, to maintain lactation;
if necessary, mothers leave the child for a while;
with symptoms of lactostasis;
with diseases of the child that make it difficult to apply;
after childbirth, when milk begins to come in large quantities.

Immediately after childbirth, it is necessary to express both after feeding and between them, but not completely. Pumping should bring the relief of a full breast, but not give the body a chance to take it as a sign of lack of milk.

Rules for pumping when milk comes in

After childbirth, the baby is applied to the breast on demand. Hourly feeding and separate stay of mother and newborn are almost a thing of the past. At the same time, you can also apply according to the needs of the mother herself, when she feels that the breast is full and it is time to feed.

There are situations when the child is sleeping and does not want to be applied, and in the meantime there is a lot of milk. Then mom can express it. As a rule, such pumping is permissible up to 3 times a day. Similarly, you need to act after feeding, if the baby has eaten very little.

It is also necessary to express during hot flashes within a month from the date of birth. Gradually, lactation will improve.

Expression of milk when mother and baby are separated

Pumping after each feeding is relevant in a situation where the child is not constantly with his mother. In this case, the self-regulating system "mother - baby" does not work, which means that efforts must be made to maintain lactation.

During feeding, it is important to attach the baby to the breast correctly, to feed from both breasts to stimulate the flow of milk. If the child ate very poorly and did not eat, then after feeding it is necessary to express.

If on the 4th day after birth there is still no milk coming, then you need to express up to 8 times a day with 8 feedings.

After a week of joint stay of mother and child, the need for pumping disappears.

There are several ways to express milk:

manual;
using a breast pump.

Each mother chooses the option that suits her. The first method is economical, but the second is faster and less labor intensive, unless you have opted for a manual breast pump.

Remember that the question of whether to pump after each feed should be decided individually with a doctor or lactation consultant. Breast milk is important for the baby, so you need to properly adjust lactation. Excessive pumping, as well as insufficient, lead not only to disruption of the feeding process, but also to mother's health problems.

The process of expressing breast milk is a delicate procedure, since if the schedule is not adjusted, feeding can contribute to stagnation and the appearance of serious complications in the form of hardening of the mammary glands. When considering the question “Should I express milk after every feed?” pediatricians share several opinions.

The procedure is best done with obvious indications:

severe stagnation of milk, when the baby does not suck out the prescribed dosage, which can lead to the development of lactostasis and the need for anesthesia to decompress the breast;
stopping the production of breast milk in a woman (the need for stimulation).

Most often, the baby independently regulates the flow of breast milk, since it arrives in exactly the amount that is necessary to saturate the growing body. Therefore, there is no need to pump with a normal feeding schedule.

Pros and cons of expressing milk

Expressing breast milk after breastfeeding has its advantages and disadvantages. The main advantages of the procedure:

pumping contributes to the production of breast milk if the mother is at a distance from the child (study, work, visit the hospital);
expressed milk is used to feed premature babies who have not yet developed a sucking reflex; the process is carried out carefully, as the baby may choke;
the procedure is necessary if milk stagnation is observed during the first feedings, since during this period the diet is normalized;
when taking medications, pumping is the only way to prevent unwanted substances from entering the baby's body;
a small weight gain by a baby implies pumping to increase lactation. Sometimes the child sucks weakly and does not eat up, which leads to increased irritability and tearfulness.

However, the process has the following disadvantages:

pumping is considered one of the provoking factors in the development of mastitis and milk stasis;
pumping increases milk, which causes the need for a constant procedure;
fatigue of a young woman from constant pumping.

In what cases is it necessary to express

Considering the important aspect of why it is necessary to express milk after feeding a newborn implies situations in which the procedure is mandatory:

forced separation of mother and child if a woman wants to keep breastfeeding and not wean him from the breast;
babies born prematurely or weakened do not suck out the proper amount of milk, so they need additional stimulation of lactation;
the possibility of resuming lactation after a short break;
physical activity of a woman with a baby up to 9 months old.

There is no need for pumping if the child is actively eating and at the same time milk stagnation does not form in the chest, which can cause unnecessary discomfort.

How much milk to express

The question of whether it is necessary to express milk before feeding, and in what quantities, involves consideration of various aspects:

maximum pumping is recommended to stimulate breast milk production.
pumping milk into the supply must be preliminarily controlled, since a woman must approximately calculate the amount to saturate the baby.
if a woman has stagnation of milk in her breasts, then doctors recommend decanting a small amount to alleviate the general condition. In this case, it is necessary to apply the baby to the breast as often as possible to establish a general nutrition schedule and eliminate the discomfort that has arisen.

Current practice suggests that pumping is not necessary. During the normal process of breastfeeding, milk is supplied in the amount necessary for the baby and does not cause additional stagnation in the breast.

How to choose a breast pump

The breast pump can be used if there are clear indications for use:

stimulation of the mammary glands immediately after the birth of the baby, since during this period there is an irregular stay of milk in small quantities insufficient to saturate the newborn baby;
the period of the lactation crisis (periods of lack of breast milk). The best way to maintain lactation is constant stimulation with a breast pump;
with stagnation in the chest and the development of mastitis. It is necessary to consult a doctor, since pumping must be carried out carefully according to the prescribed instructions;
long separation from the child (treatment in a hospital, forced trip). Under such circumstances, the pumping device will stimulate lactation and will not affect the amount of breast milk.

The industry presents a wide range of pumping devices depending on the mechanism of action (mechanical and electric breast pumps).

According to the famous pediatrician Dr. Komarovsky, you do not need to immediately buy an expensive breast pump, but it is best to purchase a device for a modest price. Sometimes a device may not be needed as breastfeeding is self-sustaining.

pump action breast pump

The model has a simple device in the form of a plastic nozzle on the chest and a pump for expressing. The device is one of the first, and the principle of operation is to compress the pump and create a special vacuum that creates the pumping process.

Such breast pumps have a clear advantage in the form of low price and convenient use.

Piston breast pump

Piston breast pumps have a device in the form of a nozzle with a silicone gasket and a piston handle. Also included is a bottle for expressed milk.

The woman attaches the device to the breast and fixes the nipple, and then presses the lever for further implementation of the procedure. The device models are easy to use.

Electric breast pump

Electric breast pumps are the latest development. The device is based on the fact that a special motor is built into it, which independently performs all the actions performed by a woman when using a model of this type.

The advantage of electric breast pumps is that when using them, you can choose an acceptable speed for a more comfortable procedure.

Electronic breast pump

Electronic breast pumps have a high level of equipment with innovative methods, but at the same time they are an order of magnitude higher than devices of a different principle of operation. This device allows simultaneous pumping of both breasts with regulation of speed and release of nutrients, which is convenient if the parents had twins.

Speaking about the advisability of buying such a breast pump, it all depends on the family budget and the need for pumping. In order to establish breastfeeding, it is quite enough to purchase a simpler model of the device.

Among the popular brands of breast pumps are such companies as: Philips, Chico, Canpol babes, Medela.

When using a breast pump, you must follow the recommendations for operating the device:

preliminary light breast massage before the actual pumping procedure;
tight attachment of the nozzle to the nipple;
pressing a lever or pump when using a mechanical device;
pumping speed setting in an electric or electronic breast pump.

After pumping, the device must be disassembled into its component parts, rinsed in hot water, dried and put into a storage container in accordance with the proposed instructions for use.

How to store expressed milk

In order to maintain the sterility of expressed milk, it is necessary to properly store it under certain conditions in special sealed containers. They can be purchased at a pharmacy or prepare a special pre-sterilized container.

How to store expressed milk:

freezing for long-term storage of milk. Before this, the strained mass should be in the refrigerator for 2 hours. Freezing date must be marked on the container.
when using expressed milk for several days, it is best to store it in the refrigerator for maximum preservation of all useful substances.
the use of expressed milk during the day involves its storage at room temperature in a tightly closed and sterilized container.

To defrost breast milk, you must first put the container in the refrigerator, and then gently melt it in a water bath.

In the refrigerator, expressed milk can be stored for about 24 hours at a temperature of 4 to 6 degrees. Freezing has a shelf life at -18-20 for 3 months.

At a temperature of 20-25 degrees, the shelf life of milk in room conditions is no more than 6-10 hours.

Expressing breast milk according to all the rules allows you to maintain lactation in the event of obstacles. The procedure requires compliance with all conditions and in some cases contributes to the normalization of the diet of a newborn baby. Therefore, the question of whether to express milk before or after feeding depends primarily on the reason for using the device.