Expressing and storing breastmilk
It is useful for all breastfeeding families to be aware of how to express breastmilk which can be beneficial in a range of different situations such as colostrum harvesting, tempting a baby to feed, relieving engorgement, returning to work and for social reasons where an expressed milk feed may be preferred.
Antenatal Expressing of Colostrum – expressing your milk before baby is born. Rarely mums need to express before 36 weeks, this must be discussed with your midwife.
Reasons why it is beneficial to hand express to harvest colostrum in pregnancy (from 36 weeks).
- To empower you to have an active role in the care of your newborn baby
- You will already know how to hand express should any issues arise such as your baby
- learning to feed effectively or neonatal hypoglycaemia (low blood glucose)
- If you are a mother with diabetes, in the first few hours of life your baby may have a short period then their blood sugars are low and they will need extra milk
- If, in the early days, your baby needs extra milk for medical reasons, they can receive your breastmilk as opposed to artificial formula to supplement breastfeeding
- To prevent the risk of low blood glucose levels in the newborn.
You can hand express breast milk from 36 weeks gestation (DAME Study) unless there are any contraindications, for example, certain medications that you may be on.
Please discuss this with your midwife or doctor as many medications are compatible with breastfeeding.
Based on Diabetes & Antenatal Milk Expression Trial, contraindications include:
- Any history of antepartum haemorrhage (bleeding) or placenta praevia (placenta covering or <2cm away from your cervix)
- Cervical suture in place
- Multiple pregnancy
- Any concerns about your baby’s wellbeing, for example, fetal growth restriction
- A known fetal anomaly detected on ultrasound scan
- Serious maternal mental health issues
- Any other serious maternal obstetric or medical issues, for example, pre-eclampsia.
You can gently hand express once, twice or three times in 24 hours.
When to express breast milk in the antenatal period
- From 36 weeks gestation breast milk can be collected 2 – 3 times daily and kept in the same syringe. Syringes should be capped and kept at the back of your fridge (Max 4C) – never in the fridge door.
- At the end of the day the syringe(s) of colostrum should be sealed in a breast milk storage bag and frozen. Each syringe should be labelled with your name, time and date of expressing.
- Colostrum can be stored for 2 weeks in the ice compartment of a fridge or up to 6 months in a freezer (-18C).
- If your breastmilk is frozen, then the best way to transport it in is in a cool bag with a cool block inside it.
- If admitted for induction of labour your midwife will assist you to express fresh colostrum for your baby and you only need to bring your frozen colostrum in once your baby is born.
- Don’t forget to bring 1 – 2 syringes in with you on the date of your Caesarian section and keep in your cool bag until ready to use when your baby is born. You are responsible for your colostrum and further syringes can be brought up if needed once your baby is born by a relative or defrosted and used within 24 hours.
How to hand express
This short clip, produced by the Unicef UK Baby Friendly Initiative, provides an overview of hand expression and how to hand express successfully.
More information can be found in the PHA booked, Off to a good start.
Expressing milk with a breast pump
Choose the right pump:
Select a breast pump that suits your needs and preferences. There are manual (hand-operated) pumps, electric pumps and hands free options available. Consider factors such as frequency of use, portability, and ease of cleaning.
You may be able to have a loan of an electric pump if you are needing to express as part of a required feeding plan for your baby. If you are choosing to express for personal reasons you may also be able to hire a pump rather than having to buy one. Your midwife, health visitor or a local breastfeeding peer supporter can give you details of pump loan/hire services near you.
Prepare yourself and your equipment:
Wash your hands thoroughly before handling the pump. Ensure that all parts of the breast pump are clean and assembled correctly according to the manufacturer’s instructions.
Find a comfortable position and stimulate Let-down:
sit in a comfortable chair with good back support and have your baby close if possible. Gently massage your breasts to stimulate let-down. Relaxation techniques may help such as deep breathing, music or whatever makes you feel relaxed.
Breast massage:
Start by massaging your breast for a few minutes – this helps with the let-down reflex. It can help to look at a photo of your baby.
Position the pump:
Place the breast shield (flange) over your nipple, ensuring a proper fit. The shield should be cantered over your nipple and create a seal against your breast without causing discomfort or pinching. You also need to check that the funnel (the part that goes over your nipple) size is an appropriate fit for your nipples. The pump should never cause bruising or catch your nipple as it’s sucked into the funnel.
Start pumping:
Turn on the breast pump and begin pumping using the lowest suction level. Gradually increase the suction strength to a comfortable level that mimics your baby nursing pattern. Pump both breasts simultaneously or alternate between breasts depending on your preference and pump type. Setting the strength to high straight away may be painful or damage your nipple.
Cleaning and maintaining your pump:
After each use, disassemble the breast pump and wash all parts that come in contact with breastmilk with warm soapy water. Rinse thoroughly and allow to air dry or sterilise according to manufacturer’s instructions.
Follow the manufacturers instructions for the pump you are using.
For more details of pumping considerations please see Expressing & Storing Milk – La Leche League GB
Using a breast pump video:
It is recommended to follow the manufacturers guidelines for each different pump. Most of the main pump manufactures have videos to support the instruction manuals and it is encouraged that the guidance above is considered when watching these videos.
Storage of expressed breast milk
You can store breast milk in a sterilised container or in special breast milk storage bags.
Once you have finished expressing you can store your milk at room temperature for 4 hours however if you are not going to use it in this time then it is recommended to follow the guidance below.
Your expressed milk can then be stored:
- in the fridge for up to 8 days at 4C or lower (you can buy fridge thermometers online) – if you’re not sure of the temperature of your fridge, or it is higher than 4C, use it within 3 days
- for 2 weeks in the ice compartment of a fridge
- for up to 6 months in a freezer, if it’s -18C or lower
Breast milk that’s been cooled in the fridge can be carried in a cool bag with ice packs for up to 24 hours.
Storing breast milk in small quantities will help avoid waste. If you’re freezing it, make sure you label and date it first.
Breastfeeding network – Expressing and storing breastmilk
Defrosting frozen breast milk
It’s best to defrost frozen breast milk slowly in the fridge before giving it to your baby. If you need to use it straight away, you can defrost it by putting it in a jug of warm water or holding it under running warm water.
Once it’s defrosted, give it a gentle shake if it has separated. Use it straight away. Do not re-freeze milk that’s been defrosted.
Once your baby has drunk from a bottle of breast milk it should be used within 1 hour and anything left over should be thrown away.
Warming breast milk
You can feed expressed milk straight from the fridge if your baby is happy to drink it cold. Or you can warm the milk to body temperature by putting the bottle in a jug of warm water or holding it under running warm water.
Do not use a microwave to heat up or defrost breast milk. This can cause hot spots, which can burn your baby’s mouth.
Donating expressed milk to the Human milk bank
The Western Trust Milk Bank opened in August 2000. Since then it has helped thousands of neonatal babies all over Ireland.
The bank also helps babies with major gut or heart problems by providing milk to their home. Through the generosity of its donors, the milk bank provides very special help for the nation’s most vulnerable babies.
