This information aims to help you to use your electric breast pump well so that you can provide your breastmilk for your baby. An electric breast pump is not the same as the sucking action of a baby. If your baby is feeding well, he will be better at getting all the milk from your breasts. Because of this, expressing breastmilk may take a little longer than breastfeeding your baby.
There are many reasons why mothers express breastmilk for their babies.
- You may work or study outside the home where you cannot be near your baby.
- Your baby may not be able to suck, due to prematurity or other problems with sucking.
- Your baby may be in hospital and you cannot be there for every feed.
- You may need to go to hospital and you may not be able to take your baby with you.
- You might be using a breast pump to increase your milk supply, relactate or induce lactation.
As well as reading the information here, you can contact a Australian Breastfeeding Association breastfeeding counsellor on the Breastfeeding Helpline on 1800 686 268.
Your breastmilk is a unique gift only you can give to your baby. It is the normal food for your growing baby. Breastfeeding also protects your baby from illness and infection. Even a small amount of breastmilk provides important nutrition and health protection for your baby.
How often should you express?
If you are expressing for a newborn baby, try to express often, between 8-10 times in 24 hours. Hand expressing is usually easier until your milk comes in (usually a few days after your baby is born). At first you will get a small amount of milk. This is normal, as your newborn baby has a stomach that only holds a small amount (about a spoonful) of milk. Premature babies need even less. The more milk you take out of your breasts, the more milk you will make. You may find it easier to express for shorter periods at first but more often. The number of times you express during the day is more important than the length of time spent expressing. Many mothers find a routine of expressing every 2-3 hours during the day, with a session just before going to bed, works for them. Others find they need to learn their own routine. Milk supply and response to expressing vary between mothers, so you may have to try different timing to find a pattern that suits you. Each session may be up to 20-30 minutes, or until milk no longer flows out but just drips. Some mothers set an alarm to express at night, however others find this too tiring. Do what your body tells you is best for you.
How breastmilk is made
An important factor in making milk, and being able to express breastmilk, is the let-down reflex. This causes the milk to be released from the milk glands. When your baby sucks at your breast, nerves send a message to your brain, which causes the hormone oxytocin to be released. The let-down reflex happens when this hormone causes the cells around the milk glands to tighten and squeeze the milk out.
It is possible to start this reflex without a baby sucking, but it can be slowed by pain, tension or stress. When expressing, you can help the let-down reflex work by: relaxing (especially your shoulder and chest muscles) and taking deep breaths; listening to quiet music; thinking about your baby, a photo sometimes helps; placing a warm (not too hot) face washer over the breast; massaging your breast with smooth strokes from the chest towards the nipple and drawing your nipple out gently between your fingers; sitting in a comfortable position; perhaps making sure the phone is turned off or the answering machine is set to take any calls; your toddler (if you have one) is safe and you have a warm or cool drink handy. As milk is removed from your breasts, more milk will be made. Your milk supply will depend on how often you express along with how well the breasts are drained.
If you have been expressing every feed for your baby, then before you are fully breastfeeding him you may need to adjust the number of times you express to equal the number of expressed milk feeds he is having. This will help to adjust your milk supply to meet your baby's needs. Your baby may need to learn to milk the breast well, so take each feed as it comes. Many mothers find talking to a trained Australian Breastfeeding Association counsellor on the Breastfeeding Helpline very helpful in providing support and information at this time.
Using the breast pump - Helpful suggestions
- Assemble the clean electric breast pump kit using the maker's instructions. There will be written instructions with the kit and you would have been shown how to put it together by the counsellor from whom you hired the pump. If you have any questions please ring the counsellor so you know you have it connected properly.
- Set the pump to the lowest suction setting. Try to start your let-down by using some of the ideas listed opposite. When putting on the breast cup, make sure the nipple is in the centre and that the cup has good skin contact all around to stop air leaking in. If your nipple hurts when you start expressing with the pump, stop and check to make sure the nipple is centred in the breast cup and the suction is low.
- For the first few times you may find it helps to keep the session short, then lengthen the session gradually. Some mothers find it useful to change breasts several times during the session. If you use a double pump kit, the session will be shorter than expressing with a single kit. Once you are comfortable with using the pump, you can increase the suction setting. Make sure it is still comfortable for you. Keep the kit upright while you are expressing to prevent milk from going into the tubing. If milk does go into the tubing, stop the pump and rinse the tubing with water. It is best not to use the pump when the tubing is wet, particularly in pumps where the tubing connects to the inside of the pump. It can draw moisture into the pump and cause damage. In pumps with a closed kit, slight dampness or moisture in the tubing should not be a problem. However, after expressing with wet tubing, take the kit apart to allow all parts to dry.
- In the first few days or so after the birth, you will make only small amounts of first milk, called colostrum. It is usually best to express this by hand. You will find that you will have a lot more milk a few days later, once the milk comes in. An electric breast pump is then very useful. The milk supply settles down within a few weeks to be the right amount to meet the baby's needs. The mother of a premature baby makes slightly different milk to the mother of a term baby, because her milk is more suited to her baby's level of maturity. Be guided by your medical advisers for your baby's feeding needs. You will be able to express more milk as you get used to expressing.
- While you still have colostrum in your breasts, the milk will have a yellow colour and may look rather creamy. It will form layers on standing. The colour of colostrum from different mothers can vary a lot; so don't be surprised if yours looks quite different to another mother's. This is quite normal. As your milk supply increases, the colour of the milk becomes more bluish-white. It still forms layers on standing, with the creamy layer at the top. Milk may look different at different times of the day and this also depends on how long it has been since you have expressed or fed your baby. The colour of the milk can vary widely and it can be quite normal for your milk to look very different from another mother's; your milk is right for your baby.
- Some mothers find that after expressing for many weeks their milk supply decreases. This is because a baby is better at getting the milk from the breast than a pump. When you are able to feed your baby at the breast, you will find that with frequent feeds, your supply will soon increase. If you are unable to feed your baby at the breast, expressing more often will help to increase your milk supply. After a week or so, you may be able to return to your previous expressing schedule. It can be helpful to finish off each session with a few minutes of hand expressing. This will help to empty your breasts and help increase your milk supply. If your supply is decreasing despite your attempts to increase it, you may wish to contact your breastfeeding counsellor to discuss other ideas.
- When you hired the electric breast pump you were given the phone number of an Australian Breastfeeding Association counsellor. Please write her contact details on the front of this leaflet and call her if any of the following happen:
- the breast pump is not working (please check the instructions first)
- your milk supply seems to be dropping
- you feel the pump is not helping you, or
- you need someone to talk to about breastfeeding or breastmilk.
Please contact her at least once a week to let her know how you are getting on and whether you still need the hired breast pump.
A mother's own expressing equipment does not need to be disinfected or sterilised for a healthy, term baby.1
If you are expressing several times a day for a healthy baby, your expressing equipment should be rinsed well in cold water after each use to remove the milk. Store it in a clean, closed container. If you have a fridge, you may simply store the unrinsed expressing equipment in there, in a clean, closed container or plastic bag. If you cannot store your expressing equipment in the fridge between sessions, have extra parts, so you are not always rinsing and washing. This information is consistent with the National Health and Medical Research Council's breastmilk storage guidelines (see ABA's Expressing and storing breastmilk website article). For example breastmilk may be stored for up to 6-8 hours at room temperature and up to 72 hours in the fridge.
The expressing equipment should be cleaned really well at least once every 24 hours while it is in frequent use.2 If the expressing equipment is only being used once a day or less, clean it after each use.
Thorough cleaning is important to make sure you have removed all milk from the breast pump parts and storage containers.
1. Wash your hands well with soap and water. Dry them on something clean — a new paper towel or a clean, unused cloth towel.
2. Take apart all containers and the breast pump so that every part can be cleaned well. Rinse in cold water to remove milk from all the parts.3
3. Take care to remove all traces of grease, milk and dirt with a small amount of dishwashing liquid and hot water. Use a brush kept just for this purpose.
4. Rinse at least twice in hot water.
5. Drain bottles and containers upside-down on clean paper towel or a clean cloth towel. Cover while they air dry. Before putting away, ensure no water droplets remain in the containers or on any parts. If any water remains, dry carefully.
6. Store the dry kit in a new plastic bag, plastic wrap, more paper towel or clean, covered container until next use.2,3
Except for the sterile expressed breastmilk bags or new plastic bags, all containers and breast pump parts used to collect or store breastmilk will need to be cleaned before use.
In areas where there are different water supplies for drinking and washing, use drinking water to wash and rinse the pump equipment.
If your baby is sick, be guided by the advice of your baby’s medical team about cleaning your equipment. Also, if you and/or your baby have thrush or you have any type of infection on your nipples, you might need to disinfect your equipment after cleaning it. Talk to your medical adviser, child health nurse, lactation consultant or an Australian Breastfeeding Association counsellor for suggestions.
For further information on breast pumps, see the Which pump is best for you? article on this website.
Breastfeeding: expressing and storing breastmilk booklet
Breastfeeding: Expressing and Storing Breastmilk covers all aspects of expressing and storage of breastmilk including hand/pump expressing, when to hire/buy a pump, long term milk expression, and correct storage and handling of breastmilk.
1. Academy of Breastfeeding Medicine 2010, Clinical Protocol #8: Human Milk Storage Information for Home Use for Full-Term Infants. Retrieve from http://www.bfmed.org/Media/Files/Protocols/Protocol%208%20-%20English%20revised%202010.pdf 27/10/15.
Pittard WB 3rd, Geddes KM, Brown S, et al 1991, Bacterial contamination of human milk: Container type and method of expression. Am J Perinatol 81:(25-27).
2. Gilks J, Price E, Hately P, Gould D, Weaver G 2012, Pros, cons and potential risks of on-site decontamination methods used on neonatal units for articles indirectly associated with infant feeding, including breast pump collection kits and neonatal dummies. Journal of Infection Prevention 13(1):16.2.
3. Jones F 2011 (3rd ed), Best practice for expressing, storing and handling human milk in hospitals, homes, and child care settings. Human Milk Banking Association of North America.
- Australian Breastfeeding Association booklets: Breastfeeding: expressing and storing breastmilk; Breastfeeding: your premature baby; Breastfeeding: and your supply and Breastfeeding: women and work, all available from the Australian Breastfeeding Association.
- Breastfeeding … naturally 3rd edition. Australian Breastfeeding Association
The book Breastfeeding ... naturally is sent to you free when you become an ABA personal member!
If you need further help
The Australian Breastfeeding Association has breastfeeding counsellors available throughout Australia on the Breastfeeding Helpline who are able to help mothers with any questions about breastfeeding. Call us on 1800 686 268 any time!
The information in this article is available to download as a handy pamphlet - just click on the file above.
© Australian Breastfeeding Association Reviewed October 2015