Most new mothers don’t anticipate the reality of not being able to breastfeed but it is a situation faced by many mothers.
Not being able to feed directly from the breast does not necessarily limit your choices to just formula.
And expressing breastmilk is not just for mothers who cannot breastfeed. Knowing how to express properly is an invaluable skill for all new mothers.
We spoke to Lisa about the many challenges and lessons she has learnt from expressing breastmilk over the last ten months.
I couldn’t breastfeed
There are plenty of reasons why new mothers may need to express milk. You might need to express if your baby is premature and has trouble sucking or to help your milk come in while you are only producing colostrum after birth. You may be heading back to back to work and want to continue breastfeeding but will be away from your baby for many hours at a time or you may have a similar experience to Lisa.
“I had terrible pain from breastfeeding – I had a completely drug free birth and loved my experience but I found breastfeeding excruciating! My nipples were one big scab and even wearing clothes was painful, and worst of all it was affecting my bonding with my baby because she could sense my discomfort.
“I saw 6 lactation consultants – I was doing it all with proper technique – they couldn’t explain it, which just made me feel so inadequate. Sometimes having a label to say what is wrong can help you feel better.”
But I could still make milk!
“I had to stop feeling sorry for myself and jealous of women who could breastfeed. I couldn’t put my baby on the breast but I could still feed her my milk with the help of breastpump.
“There is certainly a knack to it and over the months I have had to overcome pretty much every obstacle that comes with expressing milk.
“I have been doing it for ten months so I am a bit of a pro now.”
“If you’re only going to be expressing occasionally, for example going out for an evening, then a manual pump will be ok,” Lisa says.
“If you’re going to be expressing all the time like I do then I would recommend a double automatic pump.
“These are much faster and you can get ones that clip to your bra while they pump leaving your hands free look after baby, talk on the phone or read a book while it’s pumping away,” Lisa continued.
“They are quite pricey but you can hire them from chemists. There are second hands pumps available but you must still buy all the parts as new which touch your milk. Also be wary that you don’t get any warranty with second hand and my pump broke a couple of times, so that warranty was very important.
“If you are going to be expressing over quite a long time period it is probably more cost effective to buy one.”
Once you have chosen your pump it’s time to take it home and take it for a test run.
“You need to learn the nuances of your particular brand of pump,” said Lisa.
“If you find it is regularly taking more than half an hour, then it’s probably not sucking properly. It is more likely to work correctly and the valve is less likely to stick if all the parts are dry when you put them together. You should also only be able to hear the motor, not any whistling noises.
How many ml to express and when to do it
How long and how often? It seems the most fundamental aspect of expressing milk is shrouded in the greatest mystery. Of course every woman is different and it’s important you find a routine that you’re comfortable with but Lisa has some tips based on her experiences.
“To begin with, you have to pump regularly to make sure you don’t get painful lumps or blocked ducts which may lead to mastitis,” she says.
“This can mean five times a day including getting up and pumping through the night.
“As your breasts get used to producing milk, the number of pumps can be reduced to around three times a day.”
As Lisa explains, it is important not to become too complacent when it comes to the amount of pumps you perform.
“I have seen women who have been busy with work and could only pump twice a day and their supply has dried up,” she says.
“I think three pumps per day is the minimum you should go.”
As far as how long to pump for, Lisa says…
“A lot of women only pump for 15 minutes while their milk is spurting out and miss out on the hind milk.
“I pump for half an hour at a time to extract that good hind milk.
Once you get your expressing routine sorted you may notice your baby growing bigger and faster than you expected, Lisa explains why this might be happening.
“You will probably find that your baby grows faster and bigger if they eat expressed milk rather than directly from the breast because it is much easier and faster to eat from the bottle. The doctor confirmed that bottle-fed babies are bigger,” she says.
“Although a baby is more efficient at extracting the milk than a pump, they tend to get tired doing so and it is so comforting they often fall asleep, so will have shorter feeds more often.
“With the expressed milk they are getting more of the fatty hind milk with every feed so there are some benefits to expressing.”
How to make more breastmilk naturally
As in life, when it comes to expressing milk no two women are exactly the same. Lisa says she produces about one litre of milk a day. Some women may make much more and some much less, but as Lisa found there are a few things you can do to help maximise the amount of milk you’re able to produce.
“You need to balance the amount of exercise you have and make sure you eat good food regularly and drink plenty of water,” she says.
“Nibbling on healthy snacks and sipping on a litre of water with you while you pump will help.
“It’s good to think of your baby or look at photos of baby while you’re pumping. This helps to get a mental let down of the milk.
“It’s important while you’re pumping to remain relaxed. If you are using the hands free, try not to run around doing housework or chasing baby – sit in one spot and distract little one with their favourite toys to help you achieve your maximum yield,” Lisa continued.
“Unless it’s really painful don’t use the low setting on the pump. Use the highest setting you can while still remaining tolerable, this will save you a lot of time.”
Cleaning the pump, storing and transporting your milk
When you’re expressing breastmilk for your child it is important to follow some basic advice on hygiene, storage and transportation.
“The pump needs to be cleaned after every single use,” Lisa says.
“Dismantle the pump into its various parts as per the instruction manual and wash them in hot soapy water, rinse them thoroughly and leave them to air dry. Air drying is more hygienic than using a tea towel.
“You can store the milk in the fridge for up to five days or in the freezer in hygienic containers for up to three months,” she says.
“You need to make sure that baby finishes the bottle within an hour (and much faster in summer) as bacteria from baby’s mouth can make the milk go off.
“If you find you do not have enough milk you can dilute it with 50% formula for baby under six months or 20% sterile water for babies over six months.”
It’s not easy, but you can make it more pleasant
Even with all of Lisa’s experience and knowledge of expressing, she makes no hesitation when saying it isn’t easy, it’s a skill you learn and practice over time and the pros will eventually outweigh the cons.
“Pumping for a couple hours a day in total for months on end can have you starting to feel like you’re always hooked up to a machine,” says Lisa.
“But at the same time you are rewarded with watching your baby grow up big and strong with all the nutritional benefits of breastmilk.
“Try to time your pumps while baby sleeps and keep up your motivation by doing something you enjoy while you are pumping like reading, watching your favourite shows or chatting with friends on the phone. This will help to pass the time and make it seem like less of a chore which will ultimately lead to a more enjoyable experience… and more milk.”