Expressing for your newborn

Congratulations on the birth of your baby! If your baby can’t feed from your breast yet or is having trouble attaching, you may need to express.  

Colostrum is the first milk you will make and it’s very important, especially if your baby is premature or sick. Start expressing as soon as you can after the birth and express every few hours. At first you’ll only get a few drops of this precious ‘liquid gold’ but it's just what your baby needs. 

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You will only be able to express a very small amount, maybe only half a teaspoon, if you express in the first few days after birth. This is why newborn babies feed so often in the first few days, and why you need to express often if your baby is unable to feed at the breast, or too sleepy to feed often.

Colostrum is thick and small in volume, so hand expressing may work better than a pump in the first day or so. To begin with, you may like to collect the drops of colostrum with a small syringe or teaspoon. A midwife or your partner may help you express your breasts by hand if you are unwell. 

Try to express as often as you can. A newborn will want to feed at the breast about 8 to 12 times in 24 hours, so that’s how often you'll need to express to have the same amount of milk ready for your baby. Expressing the colostrum, and then milk, from your breasts often will help you to build up your supply. Find out more about how your breasts make milk.

If your baby is able to suck at your breast, it will be important that you get help with attaching as soon as possible. Your baby will be able to remove your colostrum and breastmilk more easily than you can express it.  

When you take the available colostrum, and then milk, from your breasts often, your breasts will learn to make more for your baby. This is known as 'supply and demand'.

Around 3 to 5 days after birth your milk will ‘come in’ and you’ll notice the colour start to change from yellow to white. You’ll also notice that you can express more. At this time most mums become aware of their let-down reflex.

When your milk ‘lets down’, the milk-making cells in your breast contract and squeeze out the milk, forcing it down the ducts and out the nipple openings. You may notice: 

• a tingling sensation in your breasts 

• a sudden feeling of fullness 

• milk leaking out without you squeezing your breast  

• contracting in your uterus (after-pains) 

Some mums don’t notice these signs but you will see that expressing is suddenly easier. Milk seems to be coming out faster so look for this sign. If it doesn’t happen and it’s still difficult to get anything out, you may need some help to trigger your let-down.

This will depend on why you are expressing.

• Your baby may be in special care or NICU.
• You might be with them or have left hospital and be coming to and from with your expressed breastmilk.
• You may be at home with your baby but still establishing feeds at the breast. 

Your baby may only be taking very small amounts of milk at first. You will still need to build up the amount you express to 500 to 700 mL per day by the end of the second week. This may sound like a lot to start with, but once your milk comes in, nearly all mums can produce this much if they express frequently. If you express often, the amounts you express will soon increase. 

• Most hospitals will recommend that you express every 2 to 3 hours during the day and at least every 4 hours at night. This is tiring, but night sessions are important as they help build a healthy milk supply.  

• The time taken to express will vary but will usually be no more than 20 minutes for each breast, or in total if double pumping, from the time of the first let-down, when your milk starts flowing. 

• If your milk is still flowing (not just dripping) at 20 minutes, it is fine to continue until that flow has stopped. 

• Many mums express different amounts from each breast. It’s normal to have one breast that makes more milk than the other. It’s also normal to produce different amounts of milk each time you express. 

• You may find you can express more in the early hours of the morning than at other times. 

• Leaving long gaps between sessions won’t help your milk supply. You'll make more milk if you express until your breasts feel empty and do this more often. Stretching out the time between expressing means that, over time, you will produce less milk.  

• Expressing to a regular timetable will help you remember to express your breastmilk as often as is needed and build a good milk supply