There may be times when you want to express your breast milk, such as when you are separated from your baby. There are many ways of expressing breast milk, either by hand or with a manual, electric, or battery operated breast pump.

Expressing Breast Milk

Hand Expression
The easiest time to learn hand expression may be during a feeding. The let-down reflex has triggered the milk to flow in both breasts and therefore the milk can be expressed from the side on which the baby is not nursing. Hand expression becomes easier with practice.
Hand Expression Instructions

Breast Pumps
There are many breast pumps available on the market today. However, careful selection is very important. Not every pump works for every woman. Research has shown some may actually harm the breast tissue. It is best prior to purchasing a breast pump to contact a lactation consultant and/or a physician for assistance and/or recommendations.

Battery-operated Pumps
Many battery-operated pumps are available. Some women have found them convenient and easy to use, although they are often not strong enough to sustain long-term pumping needs. Battery-operated pumps also tend to be noisier than electric pumps. Look for pumps that are designed to intermittently release the suction to prevent excessive pressure.

Electric Pumps
Many electric pumps are available with a double pumping attachment for the convenience of pumping both breasts at the same time. Smaller, lightweight pumps are available for travel or work. In addition, battery packs and adapters are available, which allow you to obtain power for the pump by plugging into your car cigarette lighter.

Storing/Defrosting Expressed Breast Milk

Small disposable bottle bags or plastic or glass bottles (four oz.), may be most convenient for storage of expressed milk. Be sure not to fill the bag to the top to prevent breakage. Look for bags made especially for storing breast milk.

Guidelines for Storing Expressed Breast Milk

1. Whether to refrigerate or freeze fresh breast milk depends upon how soon you will use it. Follow these guidelines:
   • Fresh pumped milk can be stored at room temperature for up to ten hours. Once breast milk has been refrigerated or frozen and then brought to room temperature, it will only be good in room temperature for ½ hour.
   • Fresh pumped milk may be refrigerated for up to five to seven days. Smell or taste your milk for freshness before offering it to your baby.
   • Fresh pumped milk can be stored in the average freezer for up to six months depending on the freezing capacity of your refrigerator. If ice cream stays frozen solid, your freezer is adequate for storing milk for six months. If ice cream stays soft, your freezer is adequate for storing milk for only three months. Milk can be stored in a deep freeze (20 degrees Fahrenheit) for up to 12 months. Store milk in the coldest part of the freezer, away from the door.
   • Fresh pumped milk that has been refrigerated for up to 48 hours may be frozen. (DO NOT FREEZE milk that has been refrigerated for longer than 48 hours.)
2. Breast milk expands when it freezes. Fill the bottle or bag to within one inch of the top to allow for this expansion. If using a bag, fold the top of the disposable bag over and fasten with a twist tie or rubber band.
3. Label the milk container with the date and time expressed.
4. If large quantities of milk are easily expressed, fill several plastic bottles or bags rather than one big bottle. The baby will only be taking a few ounces in the beginning, so do not waste your precious milk.
5. When transporting breast milk for use away from home, keep it cold until just before use. A small cooler with ice or frozen packs may be used to keep the milk cold during transport.
6. Use the oldest milk first.

Defrosting

1. Thaw breast milk at room temperature, or in a bowl of hot tap water. Defrost using the least amount of heat possible. NEVER MICROWAVE BREAST MILK as it may create hot spots and destroys some beneficial vitamins and enzymes.
2. Breast milk will often separate when cooled as the cream rises to the top. Mix the milk by gently shaking.
3. Do not feed defrosted milk to your baby until it is completely thawed.
4. Discard any milk that smells or tastes sour.
5. Once frozen milk is thawed, it is only good in the refrigerator for 24 hours.

Frequently Asked Quesitons

When can I begin to express breast milk?
Your milk supply is being established in the first two to three weeks, so wait until your baby is about three weeks old before you use a breast pump, unless recommended for a specific reason.

In general, you express milk:

• In between breastfeeding. (One hour before or one hour after a feeding.)
• After your baby has finished breastfeeding.
• In the early morning when your milk supply is usually at its highest. For most women, expressing in the morning will yield more milk than in the late afternoon or early evening

Will I Have Enough Milk for my Baby if I Am Also Expressing?
Breast milk production is a supply and demand system. The more the breast is stimulated, the more milk will be produced. Since the milk is made in response to the stimulation, either by breast pumping, expression or a baby nursing, you should not be concerned about not having enough milk.

When do I introduce a bottle?
There are many different opinions on this subject, but the majority of health professionals recommend waiting for at least four weeks before giving a bottle to minimize the chance of your baby preferring a different nipple and/or the fast flow of a bottle. If you are breastfeeding frequently, every 1 to 3 hours per 24 hours (8-12 times per 24 hours), there is a no need to give water in a bottle. Ask your health care professional for his/her recommendation. Please keep in mind that when formula supplements are added, it interferes with your milk supply and breastfeeding success.