How to express breast milk. How to properly express breast milk by hand

The importance of natural feeding is enormous. But what to do if the mother cannot be with the child around the clock? Of course, it is easiest to switch to formula, however, simple pumping helps maintain lactation and continue feeding. Often, women who are faced with this problem for the first time have a question about how to properly express breast milk with their hands. It should be noted that WHO does not recommend resorting to such procedures unless absolutely necessary. Therefore, before you immediately understand this issue, you need to understand when you need to express breast milk and when it is not necessary.

According to outdated recommendations, artificial stimulation of the mammary gland was carried out in a number of cases. Currently, it is believed that these are false norms and there is no need to resort to them. The table shows evidence that expressing breast milk in some cases is not worth it.

Outdated recommendations in favor of pumping	Modern contestation
The so-called development of the mammary glands by hand is necessary.	A healthy child who has not been separated from his mother for a long period is able to independently stimulate lactation and receive as much milk as he needs.
Excess milk	Is it necessary to express the breasts in this case, because the milk bursts and causes pain? Artificial breast stimulation will lead to even greater lactation. You will always have to follow the procedure.
Lack of milk	It is recommended first of all to put the baby to the breast more often and to monitor the correct coverage of the nipple areola. Only if these methods do not help, then you need to resort to pumping.
After each feeding	Previously, there were recommendations for feeding regimens, and pumping was necessary to maintain lactation. Currently, when feeding on demand, such measures are not necessary. Expressing your breasts after feeding means giving your baby full fat milk.

These examples do not mean that you should completely ignore expressing milk from the breast.

When is it necessary to pump?

Still, there are some cases when you need to resort to this process. Let's figure out why some mothers express breast milk on the recommendations of specialists?

1. Premature babies have not yet developed a sucking reflex, so the question of whether they need to express their breasts or not should not arise. This must be done and fed to the child from a spoon or cup. You should not use a bottle, as the baby will get used to not having to put in much effort to get milk.
2. Infants with a congenital weak sucking reflex. Most often this is a lesion of the central nervous system. In order not to switch to artificial feeding, it is better to express the mother’s milk and feed from a pipette or spoon.
3. Stagnation of milk in the glands. This condition is dangerous due to the appearance of mastitis. However, such a problem can arise when the rules for expressing breast milk have been ignored.
4. A short period of treatment during which the mother is prescribed tablets and injections that are incompatible with breastfeeding. In this case, the expressed milk is not used and is poured out until therapy is stopped.
5. The need to store milk, for example, if the mother is at work.
6. After birth, the baby does not drink all the milk from the breast. If the glands become stone-like, then they need to be released. How do you know how much milk to express in this case? You need to try to make sure that there is still some milk left. Otherwise, the same number will arrive in a couple of hours.

Often, a nursing woman begins to express breast milk manually, citing the fact that the shape of the nipple is flat and the baby has difficulty getting food for himself. However, the baby sucks the areola, and milk only flows out of the nipple. The rules of breastfeeding are of decisive importance; if they are followed, then regardless of the shape of the nipples, the baby is able to eat.

In some cases, breastfeeding will be saved by pumping, performed according to all the rules and recommendations given below.

How to prepare for pumping

Before any technique of expressing breast milk by hand begins to be intensively practiced, it is necessary to take care of preparatory measures.

It's all about the hormone oxytocin. It regulates milk production and opens the ducts in the mammary glands. Another hormone, prolactin, is responsible for milk production. How to ensure the normal functioning of these two hormones? There are several preparatory techniques before an important procedure.

They can be combined and combined.

• applying a towel soaked in warm water to the chest;
• taking a shower with water temperature 37–38;
• drinking tea or drinking herbal decoction, the main condition is that the drink must be warm;
• breast massage with smooth movements without pressure or sudden jerks. If there are lumps, you should not crush them, as this can be harmful to your health. During the procedure, you should try to avoid pain;
• bending down and stroking the mammary glands;
• psychological mood with the help of music and sounds of nature, it is better to imagine a baby suckling at the breast.

While performing all these procedures, it is important that the mother thinks about her child, remembers his smell and voice. It is ideal if the child is nearby during these measures.

Lactation occurs more readily if the baby sucks on one breast and the mother expresses the other herself. As shown in the photo. Thus, a rush occurs in both mammary glands at once.

Preparation using the areola softening technique

This technique is practiced among young mothers who are still in the maternity hospital. This procedure is useful because it helps shape the nipple and softens the breasts. After such procedures, it is much easier for the baby to suck out milk, and the mother, if necessary, can easily pump.

Step-by-step instruction:

1. Place the middle and ring fingers of both hands near the nipple. The palms are to the right and left of the nipple, the middle fingers rest on the nipple.
2. Make a pressing movement and hold it for 10 seconds.
3. Place the same fingers on top and bottom of the areola and also press for 10 seconds.
4. Manipulations must be repeated 4–6 times.

The pressure when performing is not strong. It is enough to carry out such manipulations for 1 minute, and excellent preparation will be provided for pumping or feeding the baby.

Expressing breast milk by hand

How to express milk correctly after all the preparatory procedures? Hands must be washed well with soap. It is enough to wash the breasts with boiled water at room temperature.

Step-by-step instruction:

• Place your thumb on top of the areola and your index finger on the bottom.
• Make a squeezing movement with your fingers.
• Gently extend your fingers with the areola forward.
• Move your fingers onto the chest, while the areola is compressed between the fingers.
• Increase the pressure on the areola.

It is important to latch onto the nipple correctly, otherwise the milk may go deeper into the ducts, which will complicate the process. To better understand how to express your breasts correctly, you can watch the video.

How to express milk without harming your nipples, ducts and glands? You should use the following recommendations:

• carry out movements smoothly and leisurely;
• do not allow your hands to slide over your chest or change the position of your fingers;
• There is no need to pull the nipple too hard, as there is a risk of damaging the ducts.

You should not be immediately upset if, after the above operations, the milk does not come out or is released in drops. You must patiently perform all the procedures again. This is a long process that requires patience, time and perseverance from the mother.

Each woman decides for herself how often she needs to express her breasts, but we must remember that it is recommended to do this only when truly necessary.

When breastfeeding, the main thing is to remain calm and have a positive mindset. Not many women understand this and begin to worry at the slightest setbacks related to caring for their baby.

Warm bottle method

How to express properly if there is congestion in the glands or inflammation. In these cases, the nipple is hard, and unbearable pain is felt when touched. What is the best way to proceed in this case? It is in this case that you need to use the warm bottle method. Additionally, you need to purchase a glass bottle with a 4 cm neck. How to express milk using this method?

• heat the bottle with hot water;
• cool the neck with ice;
• lubricate the nipple and areola with oil or Vaseline and place it in the neck;
• the nipple is pulled into the bottle;
• When the upper steps are performed correctly, the milk flows out in a steady stream.

After relief, the stream stops flowing, but this does not mean that the breast is expressed enough. It may have bumps and compactions. Next, you can express it manually.

How much milk should be expressed

Milk after feeding contains a lot of fat, but it is very small. Sometimes you can't get a single drop at a time. If you express by hand before feeding, then one pumping will give 50–100 ml.

You can express much less breast milk during the day than at night. The main reason why this happens is hidden in the hormone prolactin, which is produced from 2 to 6 in the morning.

Some mothers are unable to express a normal portion of milk during the day, night, and all day before and after feeding. The main reason may be the wrong approach to technology. Sometimes women ignore preparatory procedures or are tense.

An important fact to remember: if you express your breasts before feeding and get little milk, this does not mean that there is no milk there. A child is better than any hands or breast pumps at sucking his own food. You need to give the baby a breast so that he can work on it.

Manual expression or breast pump?

Is it necessary to express breasts by hand? Of course, you can also purchase breast pumps - electric, piston, with a lever and a bulb. But is it worth expecting great efficiency from them? A comparison of the two methods is presented in the table.

Criteria	Manually expressing breast milk	Using breast pumps
Traumaticity	Minimum probability	Risk of bruising and bleeding
Convenience	Just wash your hands with soap and start the procedure.	It is necessary to sterilize parts, assemble, connect to the network and other preparatory operations provided for in the instructions
Speed	In any form, the process should not and cannot be quick and take less than 20 minutes
Expenditure of effort	You'll have to work hard with your hands	If it is not an electric breast pump, then obtaining milk is just as labor-intensive as with manual expression.

From the table you can understand that there is no point in spending money on breast pumps in the hope of significantly facilitating and speeding up the process. The amount of expressed milk will be the same regardless of the method chosen. Moreover, skin contact triggers milk production. Not all hand tools may be suitable for a particular case. It all depends on the size of the breast, the structure of the ducts and the shape of the nipple.

You can try many devices without getting results, whereas proper hand expression of breast milk is much more productive.

Now that we know how to express breast milk by hand, women don't have to worry about maintaining natural feeding. The first procedure may require a lot of patience from the young mother. A woman needs to approach the process with full responsibility, and it is important to remain calm and persistent in order to obtain a positive result.

“If you want to breastfeed, don’t be lazy and express milk after every feeding!” - For many decades, doctors professed this doctrine, believing that it is a prerequisite for good lactation and healthy mammary glands in the future. The confidence in the need to express breast milk was so great that mothers spent all their time doing it from one feeding to the next, complicating their lives.

Do I need to express milk?

The myth about the total benefits of diligently expressing breast milk is based on the observation that if you “take away” every last drop of milk from your breast, more of it will come. But this rule has other characteristics. Firstly, it only works with one-time use: if after morning feeding the mother expresses her breasts to the last drop, then the next day more milk will actually accumulate. If the woman does not repeat the procedure, the volume will gradually return to normal. The second circumstance: when the baby suckles on his own, the amount of milk produced and consumed is approximately the same. By expressing valuable fluid, a woman upsets the natural balance between the baby’s needs and the amount of milk produced. They always express more than the baby would eat, so by the next feeding too much milk will come, the breasts will become full, but the baby will still not eat more than he needs. If you do not express the remains, there is a risk of lactostasis. Mom gets to work, and in response to her efforts, more milk will come again than needed.

A vicious circle of expressing breast milk will form, which cannot be broken painlessly. Milk that is not demanded by the baby is a signal for the pituitary gland to reduce the production of hormones responsible for breastfeeding. The answer will be to reduce the amount of “baby food”. Noticing that there is less milk, the mother takes action: she spends even more time pumping, stretches out the breaks between feedings to “accumulate milk”, introduces supplementary feeding...

As a result, the baby suckles even less, and the mammary gland is deprived of the natural stimulation it needs. The normal feeding scenario is disrupted, and the baby gradually becomes artificial... The conclusion is obvious: continuous pumping is fraught with complications, and it is better not to start it. It leads to stagnation of unclaimed milk, which threatens the health of the mammary glands and interferes with normal lactation.

When should you express breast milk?

But you shouldn’t completely exclude expressing breast milk from the life of a young mother. A normal breastfeeding cycle for a baby lasts at least 1 year. During this period, a nursing mother will more than once find herself in circumstances where pumping is indispensable. Three situations are repeated more often than others, and each involves its own pumping tactics.

Story one. First arrival of milk.

Usually milk appears in the breast on the third day after birth. And it’s not always possible to guess how many will come. Sometimes the proceeds are so large that most of them remain unclaimed by the newborn and complicate the life of his mother, who has not yet recovered from childbirth. A woman’s breasts increase in size, become heavy, and if pressure is applied to the glands, pain is felt, they lose their usual softness and become rough. If measures are not taken in time, inflammation develops: the temperature rises, and health worsens.

What to do? For engorged breasts, a compress of cabbage leaves helps a lot. It gives a cooling effect by absorbing evaporation from the surface of the skin. Wash several large fresh cabbage leaves with warm water and cover the entire gland with them for about an hour. The next point of assistance should be gentle massage and pumping. One or two sessions will soften the breasts, helping to normalize milk production.

Since at the moment of rapid milk flow the breasts become very painful at the slightest touch, you need to prepare for pumping. Start by massaging the least affected areas, gradually expanding the affected area. Try to relax, take long exhalations - this will help bring the mammary gland out of the state of “shock”, then the elastic muscular tubes - the milk ducts - will begin to contract more actively, and the milk will flow on its own.

After 7-10 minutes of massage, try placing a pinch of your fingers on the areola and rhythmically squeeze and unclench them several times. If a drop of milk comes out, start expressing - manually or with a breast pump; if not, continue the massage.

When expressing milk with your hands, place your palm with four fingers under your breast so that your index finger is on the areola from below, and your thumb is on top. When you squeeze all your fingers, the nipple should move forward. Now lift your breasts, press them against your chest and squeeze and unclench your fingers around the areola several times. If milk starts to flow, continue pumping until the flow ends. To ensure that the lobules of the gland are emptied evenly, move your fingers around the circumference of the areola.

Important details. Expressing with a breast pump has an important advantage: the resulting product is easier to preserve, because the milk goes directly into a sterile bottle or bag for freezing milk. When working with your hands, some valuable liquid splashes out. When trying to express milk for future use, do not get carried away. Pumping too excitedly will lead to even more milk tomorrow, and you will wake up with sore breasts again.

The second story. Stagnation of milk leads to lactostasis.

First, the mother discovers a small lump in the breast, which, when pressed, hurts, as many women say, like a bruise. With lactostasis, the milk ducts, which are supposed to push milk out, lose their elasticity and stop contracting. No more fluid is produced than usual, but it cannot escape. If you do not take action, redness will appear. If you continue to do nothing, mastitis will begin - inflammation of the mammary gland.

What to do? An excellent remedy for treating lactostasis is pumping. It should begin with a similar chest massage - it will soften the lump, restore blood flow in the stagnation zone and activate sluggish ducts. Painful sensations should be avoided: the response to pain will be an even greater spasm of the ducts and worsened lactostasis. The entire gland should be massaged - not too much, but quite deeply. First, make several stroking movements along the gland from the periphery to the nipple, lift it, tap your fingers from below, from the side, approaching a particularly sore spot. To make your fingers glide better and not injure the delicate skin, apply nipple cream to them.

Important details. You should start pumping when you feel a rush of milk (usually heaviness, itching, or tingling appear in the chest) or you see that it has begun to drip. You can express by hand into a wide bowl, leaning over a low table: this puts the breasts in a position that stimulates outflow.

Story three. The child is not gaining weight

The baby is already a month old, he sucks normally, and nothing bothers his mother. But on the first visit to the doctor, it turns out that the baby has hardly gained any weight in a month. It turns out that he doesn’t have enough food and urgently needs additional feeding? The reason for the misunderstanding is that an inexperienced mother cannot always determine when her child is simply sucking on the breast like a pacifier, and when he is eating. She doesn’t notice that the baby just lies with the nipple in her mouth, smacking her lips, and doesn’t swallow anything. This behavior creates a sluggish milk order. If you put up with this tactic, then pretty soon the breast will empty, the baby will turn away from it, and lactation will stop almost immediately.

What to do? Milk is released in waves in response to the baby suckling at the breast. It is advisable not to allow long breaks between tides. If the baby falls asleep at the breast, shake him, lift him to a vertical position for a few seconds, offer one breast or the other. To activate the flow of milk, you will have to spend your free time on stimulating massage and pumping. At first, you need to spend several hours a day on these procedures: 3-4 sessions of 30-45 minutes each will be required. After a few days you will notice an improvement and the duration can be shortened. During massage and pumping, you should be comfortable: sit comfortably, turn on calm music, tune in to pleasant thoughts about the baby. Breast massage - stroking, shaking, tapping - should be alternated with squeezing and unclenching the nipple for 1 minute. As soon as the gland becomes softer, express some milk and start feeding.

Important details. Your task is not to express a large amount of milk; save the main portion for the baby. After all the effort, he would probably finally be able to eat lunch on his own.

If mom manages to collect milk by expressing it as needed, then sooner or later she will be able to create her own “milk bank” in the freezer. The product will definitely come in handy when you need to go away for a long time or take medication that is incompatible with breastfeeding.

It is worth preparing for the rapid arrival of milk. A day after the birth of the baby, you should limit your fluid intake - drink little by little and only still water. Soups, tea, compotes aggravate thirst. When milk production returns to normal, the restrictions can be lifted.

Breastfeeding often involves a procedure such as pumping. Many mothers do not know enough about this process, and extracting breast milk from the mammary gland becomes torture for them or does not work out at all. How to express breast milk correctly? Why is this necessary and is it necessary at all? How long can this product be stored and how to do it correctly?

Why express breast milk?

There can be many reasons for breast pumping:

• Congestion in the mammary gland, which can lead to mastitis. In this case, pumping is a necessary procedure.
• The baby weaned himself from the breast during the breastfeeding break and does not want to take the breast. Then the mother pumps and feeds the baby breast milk from a bottle.
• The breast is too full, the nipple is tense, the baby cannot latch on. Expressing a little breast milk will help ease the tension and your baby will feed on his own.
• Mom often has to leave for work or school. In this case, expressed milk will be an excellent alternative to adapted formulas.
• Taking medications by the mother leads to a forced break in breastfeeding, and pumping helps maintain lactation.
• Often you have to pump to increase insufficient lactation.
• If your breasts are too full and painful, and you cannot feed your baby, then pumping will help relieve the condition.

All these reasons are quite common, and the pumping procedure really makes life easier for a young mother. The main thing is to know how much and when to express breast milk so that the procedure brings relief and does not aggravate the situation.

When and how often should you pump?

The frequency of pumping procedures and the amount of milk received directly depends on the reason:

• For congestion - once every 1-2 hours. You need to express the amount of milk that will be possible until the compaction decreases. The procedure should last at least half an hour, but no longer, since pumping for too long can injure the mammary gland.
• To increase lactation - after feeding and once or twice in between the child’s meals. The procedure lasts about 10 minutes after feeding and 15 minutes in between.
• To relieve breast fullness, it is enough to express only when discomfort is felt. In this case, you need to express very little milk only until you feel relief, since the more you express, the more milk will arrive next time. In this case, you need to express for no longer than 5 minutes.
• To maintain lactation during a break in breastfeeding, you need to express once every three hours, simulating the baby’s feeding schedule. The amount of expressed milk should be sufficient so that when breastfeeding resumes, the baby is full. The length of each procedure is from 20 to 30 minutes.
• In order to make reserves, it is enough to express several times a day in between the baby’s meals. The time and amount of expressed milk should be chosen so that by the next feeding the breasts have time to fill and the baby does not remain hungry. In this case, everything is individual and depends on the individual woman, the volume of her lactation and the rate of breast filling.

How much milk can you express in one procedure?

It all depends on when mommy pumps. If immediately after feeding, you may not get a drop of valuable liquid. The exception is hyperlactation, when there is too much milk.

Immediately before feeding the baby, you can get 50-100 ml. This portion is enough to fully feed your baby with expressed breast milk. Sometimes even before feeding, mothers cannot strain anything - this indicates an incorrect technique.

Milk is expressed especially well at night, since it is at night that prolactin is produced and is responsible for milk production. Therefore, to replenish supplies, it is better to pump between 2 a.m. and 6 a.m.

The reasons for low pumping may be:

• The baby eats all the milk produced.
• Incorrect hand expression technique or poorly selected breast pump.
• Mom is too tense and can't relax.
• The woman neglects to prepare for pumping and does not wait for the tide.

Basic rules for expressing breast milk

If you follow these rules, pumping procedures will be completely safe and will only bring benefits:

• Pumping your breasts shouldn't hurt! If any painful sensations appear, this indicates an incorrect technique, and pumping must be stopped.
• Before the procedure, be sure to wash your hands with soap and prepare a clean, boiled container for the resulting dairy product.
• In order for pumping to go as quickly and painlessly as possible, you need to induce a flow of milk before it (wash your breasts with warm water, contact the baby, drink a warm drink, lightly massage the mammary glands, give one breast to the baby and express the other at the same time).
• After the milk has arrived, you need to express it by hand or use a special machine. When hand expressing, all that matters is proper technique (learn more about how to express breast milk by hand). During the hardware procedure, you should choose the right breast pump and accessories ().

Massage the mammary glands carefully and gently, in a circular motion, without squeezing them.

It is necessary to alternately change the grip of the areola to horizontal and vertical. This type of pumping will be more effective.

The correct position of the fingers when grasping the nipple is indicated by green arrows. Red arrows indicate incorrect grip

Selecting a breast pump funnel according to nipple size

• The pumping process should not be too fast. Do not pull, press or tug on your chest too much. You need to work for 4-5 minutes with each mammary gland alternately.
• If you don’t manage to express the first time, then don’t despair. You need to try again, and soon everything will definitely work out. The main thing is not to be too zealous so as not to damage your breasts.

How to pump your breasts for the first time

The first pumping will have to be done in the maternity hospital. Most likely, lactation will be abundant, and a newborn baby will not be able to eat so much milk. Pumping will help avoid congestion. Decantation is also necessary to relieve tension that prevents the baby from latching on to the nipple.

Basic principles:

• Don't panic or worry.
• Perform the very first procedure under the supervision of a nurse to ensure correct technique.
• Listen carefully to your feelings. There shouldn't be any pain.
• Express milk only until relief occurs, so as not to increase lactation even more.

How to express breasts during mastitis or congestion

Should I express my breasts during congestion and mastitis? Of course, pump! This is the main prevention and treatment of such conditions. Sometimes a mother can only get by with breastfeeding, but often even the child cannot resolve lactostasis. There are several features of the pumping procedure for mastitis and congestion:

• It is necessary to determine where exactly the seals have formed. This is usually felt immediately, but you can gently palpate the mammary glands to be sure.
• Before pumping, you need to lightly massage your breasts or take a warm shower. Water pressure and massage with light pats should be directed exactly where stagnation has occurred.
• Do not try to crush or knead the cones: this is extremely dangerous! Everything needs to be done as carefully as possible.
• If you have purulent mastitis, you should not heat your breasts!
• During the pumping process, direct your efforts to those lobes of the mammary glands where congestion has formed.
• Under no circumstances should you press on the place of stagnation!

If you follow these rules, pumping will be as painless as possible, and the unpleasant phenomenon of mastitis or congestion will gradually disappear.

Is it necessary to express “stone” breasts?

Often in the first days after childbirth, you can observe the phenomenon of “stone” breasts. The mammary gland is hard and tense, there is swelling, the nipple is retracted or flat. Many experts believe that this is normal, the baby will suck at the breast, and the phenomenon will go away on its own. But in practice, a newborn cannot even latch onto the nipple to start eating. As a result, the baby is hungry, and the mother suffers from heaviness and discomfort.

Signs of a “stone” breast. She is shown on the right in the picture

Pumping will help you get rid of “stone” breasts. There are several rules:

• A breast pump will not help in this case. First you need to work on the nipple to give it the desired shape.
• Then you can start pumping. The milk will drip out in drops, this is a sign that the ducts have not yet developed.
• If you don't succeed right away, you need to try again. You can’t leave things halfway, as stagnation may form.
• You can try this method: grab the breast at the base with both hands and slightly pull forward towards the nipple. This will make milk flow easier.
• After expressing some milk, you can offer the breast to your baby. If the nipple is formed and the main tension is gone, then the baby will cope on its own.

How to feed your baby expressed milk

In order to feed your baby expressed breast milk, it must be heated to a temperature of 36 degrees. If the milk has been in the refrigerator, then it is heated in hot water, in a water bath or in special electric heaters.

Frozen milk must be taken out and placed in the refrigerator so that it takes on a liquid form. After this, it is heated as described above.

Experts do not recommend using microwave ovens to heat milk, as microwaves destroy its structure and destroy many beneficial substances.

During storage, milk may separate into fractions, then before drinking you need to shake the bottle several times, and it will return to its original form.

When milk is taken out of the freezer or refrigerator, it must be used all at once. Remains must be thrown away

Can I give my baby food made with breast milk?

Experts do not recommend preparing hot dishes based on breast milk, such as porridge, omelettes, and casseroles. The fact is that the main benefit will be destroyed by heat treatment. Protein will coagulate under the influence of high temperatures, and it will be difficult for the child to digest it.

It is good to give breast milk mixed with baby biscuits, for example. You can also use the slightly warmed, strained product as a base for instant porridges that do not require cooking.

How long is breast milk good for?

The shelf life of milk depends on the storage method:

• At room temperature, milk can be stored for no more than 6-8 hours. If the house is very hot, then it is good to eat within 4 hours.
• In the refrigerator - 2 days.
• In the freezer – 1 year.

Tip: When pumping, you need to label the container, indicating the time and date of the procedure. This way, the likelihood that your baby will eat an expired product is significantly reduced.

Is it possible to mix milk expressed at different times?

The ideal option is to express each time into a separate container, but if this is not possible, then you can mix the expressed milk, following a few rules:

• Collect and mix expressed milk for one day only.
• Each portion should be expressed into a separate container and then cooled in the refrigerator to the same temperature.
• Do not mix breast milk of different temperatures!

Many experts generally do not advise mixing milk expressed at different times, since the composition and taste of the liquid is different each time. When mixed, the taste may change unpredictably, the child will simply refuse to drink it, and all the work will be lost. Therefore, mixing is a necessary measure that should be avoided if possible.

Pumping is not difficult at all. If you follow simple rules, this procedure will be an excellent assistant during breastfeeding.

The question of whether it is necessary to express milk after each feeding worries many parents who want to surround their newborn with care. Every mother wants her child to grow up healthy and happy, but what else does breastfeeding contribute to the formation of immunity at such a tender age? This gives rise to an understandable desire to save precious milk and extend the lactation period until the baby reaches a certain age. Breast milk is a source of a wide range of minerals and vitamins, amino acids and fats for a growing body. Sucking the mother's breast leads to periodic contractions of the uterus, which speeds up the process of the woman returning to her prenatal form.

Obstetricians and doctors of the “old school” often advise, but doctors of the new generation did not like this opinion; they consider the procedure useless. However, the opinion that developed in the 20th century is still considered by many to be dogma. There is no clear answer to this question; it all depends on the feeding regimen, the amount of milk during lactation in a woman, the baby’s appetite, and individual characteristics.

A woman who feeds her baby with colostrum thus strengthens his immunity. Milk is a valuable resource that is important to protect. Many eminent doctors give recommendations for expressing colostrum immediately before feeding. In some cases, the mother may actually need to express milk before feeding. If the mammary glands are working too actively, a lot of milk is produced, a feeling of fullness appears, and it is difficult for the child to eat - in this case, the procedure will only be beneficial. Still, you shouldn’t get carried away with this; lactation may intensify and the situation may worsen. You can often hear that expressing the “front” milk is necessary so that the baby can get to the “back” fatty colostrum. You can hear from a nurse visiting a baby that the child is underfed precisely because he eats only primary milk.

Modern research proves that there is no difference in the use of these two types, and the problem is simply exaggerated. Fat content depends on a group of factors: nutrition, body characteristics and even time of day. If the baby is healthy, is gaining weight regularly and has good digestion, there is no need to search for hind milk. It is a two-phase dairy product that helps meet the baby’s need for water, food, proteins and carbohydrates from the initial portion and fats from remote areas; Provides proper balance of nutrition at a tender age.

What to do with milk after feeding?

If the situation with pumping before feeding is more or less clear, then the debate about whether this procedure should be carried out after feeding has long taken over forums for parents and has even become the cause of more than one discord in the family. There are messages in books and on forums that a dairy product can spoil and become dangerous to the health of children. The real reason for the appearance of such a myth was the feeding system according to the regime.

To preserve milk during breastfeeding according to the regimen (6-7 times a day), it is necessary to express it. This advice is especially relevant at first, when the child is not yet accustomed to the regime. When the newborn gets used to this routine, he will suck the breast completely. If the baby leaves milk without finishing a certain part, then its quantity may decrease due to insufficient stimulation of the breast during sucking. The female body will receive a signal about excess, the amount of milk will begin to rapidly decrease.

Expressing can save the situation for a while, but this process is quite tedious and lengthy for a young mother, so sometimes at this stage she decides to give up breastfeeding. Why to express milk before feeding in this case is determined by the nursing woman herself, but if she plans to continue to maintain milk nutrition for the baby, then this procedure remains mandatory.

If the baby follows the regime strictly at certain hours, eating time is limited. Such a process is completely at odds with the laws of nature, within the framework of which the baby mammal had access to mother’s milk at almost any time. Over the centuries, the endocrine glands have been tuned to produce a sufficiently large amount of nutrition for newborns; they are not able to adapt to the routine in a short time. The optimal solution would be to switch to feeding on demand, when the baby is not limited in the amount of food.

In this case, the child receives breastfeeding every 1.5-3 hours, which favorably stimulates the glands, in contrast to the temporary gap of up to 8 hours when feeding according to the regimen. It is long-term stagnation of milk that provokes its decrease and disappearance. Feeding on demand will soon accustom the female body to producing a certain amount of milk; there will be no residue left for pumping. If, even with this outcome, you continue to use a breast pump, this will provoke the process of hyperlactation, which is certainly harmful. In addition, this type of feeding allows you to maintain the level of glucose in the baby’s blood at a stable level; without food for a long time, the level drops to critical after 3 hours.

When is it necessary to express milk?

Let's consider situations when the question does not arise whether it is necessary to express breast milk:

• If mother and child are separated for some time. Why is it important? Sometimes circumstances do not allow a woman to be with her baby for a certain period of time. Such downtime can be perceived by the endocrine system as a signal that milk is no longer needed and result in the cessation of lactation in the mother. To avoid this, it is advisable to resort to daily pumping up to 10 times a day, the duration of the procedure is at least 15 minutes.
• A short-term absence of the mother is the basis for leaving the child with dairy food. This should not be repeated too often, since no breast pump, much less a manual one, can replace sucking movements.
• Expressing has to be done when the ducts are blocked by clots or milk fat (lactostasis). The child is not able to dissolve such a buildup; it must be filtered out independently. You should proceed carefully but persistently until the breasts become soft. Before the procedure, it is better to massage your breasts to help loosen the lumps. Be careful, don't overdo it.
• If the maternity hospital advises you to express every last drop, you should not follow this recommendation. This will lead to hyperlactation. You just need to squeeze out a couple of drops.
• For cracked nipples, soreness and swelling before healing, it is possible to resort to a similar method, giving the baby the expressed product as an alternative.
• During the mother's illness, when taking medications that are not recommended for nursing mothers, it is necessary to express milk (if the nursing mother has a desire to preserve it).
• In a situation with a weak or premature baby, the first few drops must be squeezed out manually. The baby simply does not have enough strength for sucking movements. The situation is similar with tight breasts - the baby may not receive enough food due to difficulties with sucking.

What to do if there is too much milk?

Often, a woman begins to fight the excess by pumping, but this worsens the situation. Indeed, almost every mother produces more milk than necessary, but it is not worth removing the excess earlier than after 24 hours, otherwise the body will produce milk with redoubled force. The best solution would be to put the baby to the breast on demand, when the woman realizes that the breast is overfilled. Only if contact with the child is impossible for objective reasons, he refuses to eat, or the need arose while the newborn was resting, can you express a little milk to make him feel better. You should not repeat the manipulation more than once every few days; if possible, you should eliminate it altogether. Another way to avoid troubles associated with breastfeeding is to latch your baby on as early as possible, preferably a few hours after birth.

The rule of the "golden mean"

Excessive pumping can serve as a starting point for the development of breast diseases: mastitis and lactostasis. The body will calculate the need based on the product expressed and eaten. In this case, the more that goes away, the more that will come. The breasts literally work for wear and tear when stimulated by squeezing. Hence the unfortunate diseases of the endocrine system and breasts, from which pumping, in the firm belief of our grandmothers, should protect the young mother. Be patient; after some time after giving birth, the process will stabilize and the body’s milk production will return to normal.

With proper organization of feeding, problems with lactation and sucking will not arise, and the breasts will become softer and more pliable. If the problem does not disappear, then you should contact a specialist and ask whether you need to express milk after feeding; excessive pumping can cause milk stagnation. Remember that deficiency is not always associated with the activity of the endocrine system and mammary glands or even feeding regimen. Among the obvious reasons is the newborn’s incorrect grasp of the nipple halo when eating. Precious colostrum will give protection to the child from the first minutes, give him strength and health, and relieve the new mother from the difficulties of feeding the child. The breast will be able to adapt to the needs of the newborn earlier and faster, without causing any inconvenience to its owner.

What to do?

Modern medicine rejects the need to express milk before feeding and express milk after feeding. This is an extreme measure, but not a daily ritual. Such remnants of the past can negatively affect the health of the mother. The decision about whether it is necessary to express milk before or after feeding should be based on an assessment of a combination of factors: the amount of colostrum during lactation, the appetite of the newborn, feeding regimen, the presence of contraindications and illnesses of the mother or child. There is no universal way of breastfeeding that would suit everyone, but if the baby is gaining weight regularly and the mother is feeling well, then there is no need to change the feeding pattern.

The conclusion from all of the above is simple: pumping should be thoughtful. It is quite justified in the first days of stay in the maternity hospital, justified to increase the amount of milk, but it is good only in moderation. There are cases when this particular process made it possible to save colostrum and increase its quantity. In contrast, there are stories about provoked mastitis, painful hyperlactation and disappearance of milk. In any case, manipulations with the mammary glands should only take place under the supervision of a competent specialist and wisely. Why should you express breast milk? Whether you should express it or not, your local pediatrician can tell you after weighing your baby.

Don't despair if your milk supply gradually decreases. After a while, the baby will be introduced to complementary foods, which can also be prepared for him by the nursing father. But try to preserve for as long as possible at least a little of the milk that your baby so needs. Now you know whether you need to express this precious product, why you should express milk and how to do it.

How much breast milk does a baby need?

Many moms wonder how much expressed breast milk they should have on hand if they need to go away.

In infants who are exclusively breastfed, milk intake increases rapidly during the first few weeks of life, then remains the same from the first to the sixth month (although intake is likely to increase briefly during growth spurts).

Current research shows that, on average, breast milk consumption does not change as the baby ages between the first and sixth months. After six months, breast milk consumption remains at the same level until the baby begins to eat other foods. Then the amount of milk in his diet will begin to gradually decrease.

Research suggests that exclusively breastfed babies consume an average of 750 ml per day between the first and sixth months of life. This indicator may vary depending on the child himself. The typical range is 570 to 900 ml per day. We can use this information to calculate how much milk an average baby needs per day:

1. Count how many times a day (24 hours) your child eats.

2. Then divide 750 ml by the number of feedings.

3. This will give you the approximate amount of milk you will need per feeding.

For example, your baby eats 8 times a day, then for one feeding he will need 94 ml of milk (750/8 = 93.75). (This is an average value, and you need to focus primarily on the child and his appetite, and not on exact numbers - editor's note)

When you are with your baby, allow him to breastfeed as often as he needs.

Although there are several ways to estimate the amount of milk a baby needs based on the baby's weight and age, research shows that from a few weeks of age onward, these methods overestimate the amount of milk breastfeeding babies actually need. breastfeeding Current research suggests that breast milk consumption remains approximately the same in infants over one month of age, and increases slightly as their height and weight increase. Researchers have finally confirmed what moms and lactation consultants have already observed in their own experience.

Summary table of the amount of breast milk consumed by a child at a given age based on scientific research:

Child's age	Breast milk consumption per day		Source
	grams	milliliters
	498 +/- 129 g
	708 +/- 54.7 g
	453.6+/-201g from each breast	440 ml x2 = 880 ml
	742 +/- 79.4 g
		875 ml (93% of total energy obtained from food per day)
		550 ml (50% of total energy obtained from food per day)
		487 ml (32% of total energy obtained from food per day)
	208.0+/-56.7 g from each breast	202 ml x2 = 404 ml

Specific gravity of breast milk = 1.031, density of mature breast milk ~ 1.031 g/ml. Some indicators were calculated based on these data.