Expression & Storage of Breastmilk

All breastfeeding mothers should be encouraged to learn how to express breastmilk, although letting the baby suckle the breast directly is the most efficient way of extracting and stimulating the mother's milk supply.

Preparation for Expression (Manual/Pump)

•	Be relaxed in a warm quiet room/area with a drink prepared, & your baby's photo nearby.
•	Use a clean plastic container for each expression.
•	Wash your hands with soap & water. (This is a very important step in preventing infection.)
•	Apply warm compress to the breasts (e.g. with a warm towel) for a few minutes.
•	Massage your breasts by gently stroking with the fingertips, or gently rolling your closed fist over the breast towards the nipple for a couple of minutes, to enhance the milk flow. There are no right or wrong ways to massage, provided that you do it gently.

How To Express Breastmilk By Hand
Place your thumb & forefinger on opposite sides of the areola, while the other fingers gently support the breast. Gently feel for the small thickenings of milk sinuses beneath or around the margins of the areola. First, press the fingers slightly inwards towards the chest wall. Then gently bring your forefinger & thumb together pressing behind the nipple & areola, and release. Repeat the press-release movements until the milk flow slows down. Rotate the position of the thumb & forefinger around the areola to drain milk from all segments of the breast.

Methods of Maintaining Lactation

•	To maintain your milk supply, express milk every 2-3 hours during daytime, and once at night, with a total of ~ 6-8 times /24 hours.
•	More prolactin (milk producing hormone) is produced at night, so breastfeeding/ expression at night is especially helpful for keeping up the milk supply.

Storage of Breastmilk
Containers for Storing Breastmilk:

•	Use plastic containers with a tight lid.
•	Special breastmilk freezer bags can also be used.
•	Milk keeps in room temperature for about 6-8 hours.
•	Refrigerated milk in a 2-door fridge can be kept for 72 hours, or in a single door fridge for 24 hours.

Frozen milk can be kept: -
Freezer compartment of a fridge : for 2 weeks
Self-contained freezer unit of a fridge : for 2 months
Deep freezer : for 6 months

Useful Guidelines

•	All containers must be labelled with date & time before storage.
•	Freeze milk in single feeding quantities (i.e. 60-120 mls) to prevent wastage.
•	Do not add freshly expressed breastmilk to frozen milk. (Chill freshly expressed milk in the fridge for about half an hour before adding into frozen milk. The amount of frozen milk should be more than the chilled milk.)
•	Never store breastmilk at refrigerator or freezer doors where the temperature is unstable.
•	It is best to thaw frozen milk by placing it in the refrigerator, where the expressed breastmilk can be kept for 24 hours.
•	If a quicker method is preferred, hold the container under running water. Thawed breastmilk stored in the refrigerator should be used within 12 hours.
•	Never use microwave or a stove to warm the breastmilk. (Hot spots in the milk can scald your baby!)
•	Never re-freeze thawed breastmilk.
•	Use warm water to warm breastmilk before feeding (optional).
•	Always use the earliest expressed breastmilk first, & leftover breastmilk must be discarded.
•	Breastmilk normally separates into milk & cream on standing. Gently swirl the container to mix the milk before offering it to your baby.

Transportation of Expressed Breastmilk
Expressed breastmilk can be transported in an insulated container, with cold packs or crushed ice in hot weather.