Ways to express breast milk

  1. Manual hand-expression
    Before expressing breast milk by hand, wash hands with soap and water. Place the forefinger and thumb at the edge of the areola (the dark area of the breast) and press back firmly against the breast. Then bring fingers together and compress the areola using the finger pads. It is encouraged to compress the breast in a rhythmic manner when expressing milk.
  2. Manual pumping
    Mothers are advised to use the piston-type pump, which allows for control over the suction. Ensure that the flange of a pump is placed over the areola to form a complete seal, just as baby’s mouth would when she is being breastfed. Pump continuously for five minutes, alternating each breast and massaging the breast in between pumps. Each session should not last more than 30 minutes in order not to tire out the mother.
  3. Battery or electric pump
    If choosing to use the battery-operated or electric pump, remember to begin with minimum power before increasing the intensity to which one is comfortable with. Fully automatic electric pumps and those that allow for double pumping work to reduce pumping time and promote milk production.

General tips on expressing breast milk

  1. Frequency of expression: This should be between 8 and 12 times in a 24-hour period during the initiation of milk supply – it includes one or two night-time expressions. The frequency is strongly recommended especially in the first two weeks of breast milk expression.
  2. Length of expressing episodes: Each episode should last approximately 20 to 30 minutes, or until the milk flow stops or slows down. Swap breasts frequently – two to three times during each expressing episode is recommended. Initial volume is small but it will increase dramatically within 72 hours.

How to feed stored milk

To feed baby with the expressed milk, simply thaw – either by transferring it earlier to the refrigerator or by warming the milk in warm water or a warmer for 10 minutes.

Some important points to note:

  1. Do not boil the milk or warm in a microwave oven.
  2. Do not refreeze the milk once it has been thawed as it may be contaminated.
  3. Discard any excess milk left in the bottle after a feed.
  4. Newly expressed milk should not be added to earlier stored milk and then re-stored.

In general, freezing of milk is not encouraged for premature babies who are still hospitalised. “Direct nursing is always encouraged once the baby is able to latch on and suck, and the mother is well,” says Dr Varsha Atul Shah, Department of Neonatal and Developmental Medicine, Singapore General Hospital (SGH), a member of the SingHealth group.

Ref: Q15