Baby, Breastfeeding, Parenting, Postnatal, Work

Pumping & Storing Breast Milk

By Melissa Bugeja

While it is not necessary to introduce a bottle to breastfed infants, many mothers choose to do so, mostly, to be able to leave their babies with a care giver for when they need to go back to work. Another reason is so that their partner can take over some feeding duties. Whatever the reason a mother decides to express breast milk and give it to her infant, these are things worth knowing!

A very good time to express milk is first thing in the morning. The reason being we are still fresh and energetic and likely full of milk, especially if baby is sleeping 4-5 hours. It is preferable to express milk 10 minutes after you have fed your baby. First, because the baby will need to work hard to get the milk out if you expressed before they have had their fill. Also waiting 10 minutes after you fed the baby, will help milk come out quicker as you give time for your breasts to fill up again!

Many are surprised by the small amount of milk they express especially in the beginning.  It is taken for granted that if you have a good milk supply, you will express loads of milk.  This is normally not the case and even more so if you need to express milk from the very first day of life of your little one; because colostrum is very thick.  The most important thing to remember when starting to express milk is that the amount of milk you pump is not an indication of how much milk your baby receives directly.  Babies are more efficient than pumps and can transfer more milk than a pump.

While many buy a pump, you might want to try your hand at hand expressing.  Hand expression can be quicker than the pump and yields more milk as well! Once you decide on the best way to express milk for you, all you need is to find that quiet time and start.  Many women complain that not a drop of milk came out when they started pumping.  The reasons can vary but generally speaking unless you are relaxed, no milk will come out and at first your breasts need to get used to the different sucking pressure of the pump/hand.

For effective milk removal, make sure you are comfortable and relaxed. Being anxious, tired or thinking of what needs doing etc will yield less milk. Also if you are expressing for the first time, little or no milk might come out because we are anxious or feeling stressed among other things.

WHEN EXPRESSING BY HAND:

  1. Wash your hands well with warm soapy water.
  2. Have your clean container nearby.
  3. Massage your breast gently, starting from the top and going down toward your nipple. Make sure you massage the whole breast as it helps the let down reflex to activate.
  4. Position your thumb and finger in a C shape just away from the aerola (brown circle around your nipple).
  5. Gentle press inward – pressing your thumb and finger into your chest than move your finger and thumb toward each other, compressing the milk ducts and making the milk flow out of your nipple.
  6. Keep the rhythm going till the milk flow slows down and move fingers in a different position around the nipple till you feel your breast emptied.
  7. Do the same with the other breast!

WHEN EXPRESSING WITH A PUMP:

  1. Wash hands thoroughly with warm soapy water before handling pump and containers.
  2. Make sure you are not in a hurry and are relaxed and comfortable.
  3. Massage your breast gently, starting from the top and going down toward your nipple. Make sure you massage the whole breast as it helps the let down reflex to activate.
  4. Once you put your pump to your breast, start with a low suction and increase it slowly till it reaches your most comfortable level and yield of milk.
  5. After you are done pumping, store the milk in a fridge if you intend to give it later or add more milk to it OR in the freezer if you are not needing it for now. Make sure to date the bag/container and write the amount of milk on it as well.

Storing expressed breast milk:

NOTE: The hereunder guidelines apply for mothers who have healthy full-term babies (check with an International Board Certified Lactation Consultant for guidelines pertaining to storage and handling of breast milk for pre-term or ill babies).

Milk can be stored in clean glass, silicone, plastic containers or breast milk storage bags.

When storing milk, label with the full date to use the oldest milk first.  Stored milk will separate; this is normal and swirling it gently will mix it up again. You can combine milk expressed at different times within a single day or multiple days (always put the oldest date on the bag so if you first expressed 2 days ago and added milk, put the date of 2 day ago on it).

Breast milk in Malta can be left out at room temperature (18-24 degrees celsius) for 2-4 hours.  In a good cooler with ice packs in, it can be stored for up to 15 hours.  Milk can be left at the back of the fridge, where it is coldest, for up to 3 days and frozen in a fridge freezer (i.e. the fridge & freezer having separate doors) for up to 3 months. Chest Freezer for up to 6 months.  It is important to note that when reading articles on storage of milk from other countries the storage time is longer.  However the shorter storage time ensures that milk is fresher and has not lost much of its immunological properties.

It is best to store milk in small portions (2-4 oz/ 60-125 ml) to avoid waste.  It also thaws and warms quicker.

Breast milk Storage Guidelines

Room temperature (18-24 degrees Celsius) ~ 2-4 hours

Cooler with frozen ice-packs ~ 15 hours

Fresh milk in fridge ~ 3 days

Thawed milk in fridge ~ up to 24 hours

Freezer ~ up to 3 months

Chest freezer ~ up to 6 months

Handling and Thawing Milk

Frozen milk is best left to be thawed overnight in a refrigerator – this usually takes approximately 12 hours.  If you need a quicker method, it is best to put it in a small basin that is gradually warmed up.  Once thawed, breast milk can not be refrozen and must be used within 24 hours.  

Breast milk should be heated up to room temperature so as not to kill important immunological properties.  This could be done by putting it in a basin of warm water.  Heated milk can not be reheated.  It is important to remember never to heat milk directly on the stove or in the microwave.

Extensive research has not yet been done to determine if it is safe to give a baby milk that was left over from a previous feeding or milk that was previously warmed, but not used. However, most lactation experts agree that milk that is not finished at one feeding may be offered at one more feeding before needing to be discarded. Human milk has antibacterial and antimicrobial properties that result in slower spoilage as compared to other foods. (Becky Flora IBCLC)

CLEANING YOUR EQUIPMENT

You do not need to sterilise pump, teats, bottles etc every time you use them.

If you are using a breast pump more than once daily, simply wash with warm soapy water and leave in the fridge (taking out of course the electrical part of it) and sterilise at the end of the day. Same can happen with teats and bottles. Breast milk is antibacterial in itself and need not to be sterilised with every feed.

Once baby starts eating solid foods you need not sterilise at all; just wash thoroughly with warm soapy water.

Melissa Bugeja is a Certified Breastfeeding Counselor & Positive Discipline Parent Educator. She is the creatrix of Parental Thriving, where her passion to support women in their parenting journey has fused and ignited. Melissa is also a mother to 3 children who she breastfed into early childhood. You can reach out to her on 99895845 or visit her website www.parentalthrivingmalta.com

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