Expressing breast milk. How to remove a blockage in the outlet of a duct

Try the following tips to stimulate the withdrawal reflex breast milk:.

1. Follow the established pumping order.

One of the most effective tips is to create a routine. Express in the same place, on the same chair, drink the same drink. Prepare everything you need in the same order each time, use psychological techniques for relaxation. All of this stimulates your breastmilk ejection reflex.

2. Before pumping, take a few minutes to massage your breasts.

Start from the armpit and massage this one point on your chest in a circular motion with your opposite hand. Then move your hand slightly and massage again. Continue the massage, gradually moving around the breast and down in a spiral towards the areola (This is similar to how you or your doctor checks the breast for lumps). Finish the breast massage with a series of strokes from the chest down to the nipple, also repeating your movements around the entire breast. Then massage the other breast. If your milk flow slows down while pumping, a few minutes of breast massage will help restart the process.

3. “Fill the pump”

Drink a couple glasses of water right before pumping.

4. “Pump yourself up”

During the process, imagine mountain streams or rivers rushing to the ocean. Or pretend that you are a breast milk fountain or any other image that will help your milk separate and flow into the breast pump.

Take a baby blanket or some item of your baby's clothing. Enjoy its smell. (Or ask for a photo of your milk baby with the host family and look at him - approx.)

6. Find out what your child is doing.

Before expressing breast milk, call your babysitter and ask what your baby is doing. (The same technique can be used for infants - approx.)

7. Listen to music.

To avoid distractions during the process, try listening to music. Enjoy your favorite music while pumping or listen to the soothing sounds of nature: the ocean, rain in the forest - whatever you like best.

If your nipples are already a little sore, try the following:

8. Try setting your breast pump to a lower suction level.

If your nipples become sore, try reducing the suction on your breast pump or changing its mode if the device has several options. Make sure the nipple does not rub against the flange while pumping.

9. Apply a small amount of emollient

Apply an emollient containing lanolin, which will help soothe and heal sore nipples.

Tips for Expressing More Breast Milk

If you are faced with the task of collecting as much breast milk as you want, then try the following:

10. Pump as often as your baby eats.

Usually this is once every 3 hours (or more often - approx.). If you're worried about whether you have enough breast milk, do this more often . Frequency stimulates the milk ejection reflex more effectively than increasing the time of each pumping.

11. Add another pumping session early in the morning.

Early morning is the time when you produce the most breast milk. If you are trying to create a "strategic stock" in your freezer, then this good time days to achieve the goal.

12. Check your breast pump.

Sometimes the most effective advice is the most obvious. Have you assembled the device correctly? Is the bolt or any other parts worn out? Check with the manufacturer (the phone number can be found in the instructions). If you purchased or rented a breast pump from a breast pump consultant breastfeeding or a La Leche League leader, she may be able to advise you on replacing worn out parts.

13. Try pumping one breast while your baby is nursing the other.

The baby will trigger the milk release reflex and it will be easier for you to collect milk from the other breast. (This is easiest to do with an electric breast pump rather than a manual one)

14. Double pumping.

For most women, double pumping (from both breasts at the same time) is the most useful recommendation, because this usually results in more pumping. Prolactin levels in the blood are also higher if you stimulate both breasts at the same time. The best and easiest way to do this is to use good quality electric breast pumps, but some manual ones can be operated with one hand. Get 2 of these breast pumps and you can double pump manually.

15. If pumping is not going well, try a different breast pump.

It is best if you try a breast pump by an order of magnitude, or even two orders of magnitude best quality than the one you are using. Rent a clinical unit for a week or two. You might be surprised by the difference! (Some women express more effectively by hand. We do not recommend that everyone use exclusively clinical breast pumps, as it may seem from the text - approx.)

How to Make Expressing Breast Milk More Comfortable

Try these few tips to make the process easier and more convenient.

16. Wear two-piece clothing for easier access to your breasts.

One of the tricks that makes life easier for mothers is to wear comfortable clothes. It's easiest to pump (just like breastfeeding) if you wear a loose top that can be removed separately from the bottom. There are cute and comfortable nursing clothes on sale with special hidden holes for the breasts.

17. Lean forward while pumping.

This will prevent milk drops from getting on your clothes.

18. Double pumping with one hand.

Try leaning over the table to hold the breast pump using the edge of the furniture, and use one hand to hold the flanges of the breast pump on your chest. Your second hand will be freed up for flipping through the pages of a magazine or eating. Or try using a footrest or thick book to elevate your knees so that you can rest the collecting bottles on your knee as you lean forward.

But the issue of expressing milk still remains controversial for many, since the remnants of the Soviet past are still alive, when our mothers and grandmothers were taught that after each pumping it is necessary to “dry” the breasts until last straw. Today doctors no longer have such a principled position. Still, some questions remain open. Why do you need a breast pump? Does pumping help increase lactation? How to express milk correctly? How to store breast milk? Etc. We will try to answer all these questions.

Why express milk?

You can express milk for several reasons, depending on each specific case. Mainly the reasons are as follows:

In the first stages. At first, the breasts are not yet adapted for feeding, the ducts are narrow, and the nipples are flat. To help the baby suck on the breast and eat, it is necessary to prepare the breast for the process.
Increased lactation. Expressing milk really has a positive effect on lactation. If the baby sucks ineffectively or little, if it occurs, then the mother needs to pump in order to somehow stimulate production. The more and more often you express milk, the more milk is produced.
Supply exceeds demand. This is the other side of the coin. Much more milk is produced than the baby is able to consume.
Prevention of mastitis and lactostasis. This is a continuation of the last point. Due to excess accumulation of milk, there is a risk of developing mastitis or lactostasis, so it is recommended to express it. But this must be done only when discomfort appears and without fanaticism, since one must not forget the rule - as much as you express, so much will come back.
Food product. If the mother works, for some reason leaves the baby for a while, and also if the mother is sick, then it is necessary to express milk in order to leave food for the baby, and also so that lactation does not stop due to lack of demand. In this case, doctors recommend expressing each breast every 3-4 hours for 8-10 minutes.

These are some of the most common reasons, here you can also add premature babies or children with birth injuries who cannot eat on their own and need to be pumped for them, as well as problems with lactation (lack or excess) in the first month after birth, the baby’s diet in the maternity hospital etc.

We answered the questions - why you need to express milk, and whether expressing helps increase lactation. Let's move on.

Why do you need a breast pump?

A breast pump is a convenient, functional thing that facilitates the process of expressing. Many mothers say that in the first month after giving birth they are simply tormented by “terrible” lactation, which tires not only their breasts, but also their arms, which are forced to constantly work. In this situation, a breast pump is simply a salvation. It all depends on what schedule the baby is brought to you at the maternity hospital. If he is constantly with you, and you have the opportunity to apply him to your breast on demand, then lactation will improve and adapt to this regime. If the baby is delivered on schedule, then most likely you will have to express, and a breast pump will come in very handy.

A breast pump not only makes the process easier, but also helps mothers who have not yet experienced pumping and do not know how to do it correctly, especially considering that the first hot flashes can be very painful. Most of these devices allow you to express painlessly and comfortably. But there is a small “but” - many maternity hospitals do not allow the use of a breast pump due to the fact that there is no necessary conditions, because this device must be sterilized and stored correctly after each use.

How to express milk correctly?

Before you start pumping directly, you need to prepare your breasts, namely, induce a tide. To do this, you can take a warm shower, do soft massage breasts, tune in psychologically (think about the baby, imagine that he is nearby). This must be done if there is no tide and the chest is not bursting with milk, otherwise there is no point in such preparation, milk already oozes from one touch.

It is best to pump during feeding, while the baby is suckling on one breast, you pump on the other. Having a baby next to you is the surest way to cause a hot flash.

Now directly about:

Grab the nipple's halo so that thumb located on top, and the rest below.
Without lifting your thumb from the skin, begin to perform a sliding movement from top to bottom, towards the areola and back. Use your lower fingers to help, pressing lightly.
If everything goes well, and this can be seen by the stream of milk, then begin to move your fingers in a circle, giving the rest of the mammary glands the opportunity to release.

You can see a more accessible process of expressing milk in the following video story.

If after the first few minutes you don't get the milk to flow, don't worry. At first, the milk always flows in droplets, and only then flows. It is necessary to express one breast until the milk stops flowing, then you can move on to the second. The complete pumping process usually takes about 20-30 minutes, so don't try to do it faster.

Important to remember! There is no need to press hard on the breast or push and pull on the nipple, this will lead to cracked nipples and chafing of the skin.

How to store expressed breast milk?

Expressed breast milk is sterile! It should not be confused with cow's milk, which must be boiled after milking. In no case! All you need for this is to take sterile containers - bottles or special bags, and place the milk in the refrigerator or freezer. Be sure to indicate the due date so you don’t forget later.

The shelf life of breast milk depends on the storage conditions:

Milk can be stored in the refrigerator at 8-12 degrees for up to 5 days, in a cooler bag for up to 24 hours.
IN freezer can be stored for 5-6 months, depending on the power of the freezer.
At room temperature, breast milk is stored for 5-6 hours at temperatures up to 25 degrees.

Because breast milk can be frozen, you will be able to feed your baby for several months even after lactation has stopped.

In order to determine whether it is necessary to express, you need understand the physiology of milk production. Provided that the mother breastfeeds the baby when he needs it, the body produces exactly the amount that the baby needs at the moment. The whole process is controlled by the mother's hormonal system.

Under what conditions does the formation of breast milk occur: physiology of the process

The hormone prolactin is responsible for the lactation process. When a baby begins to suckle, a signal is transmitted through the nerve endings of the areola to the pituitary gland, which produces prolactin. The more often and more actively the baby sucks, the more hormone is formed and the greater the volume of milk will arrive at the next feeding. If the child is rarely brought to the breast and given a nipple, it starts to accumulate, which reduces the amount of hormone in the future. You can increase the flow by putting your baby to the breast more often.

Oxytocin is responsible for its release directly during feeding. It affects the muscles surrounding the mammary gland, which contract and push the accumulated fluid towards the nipple. If there is less oxytocin, both feeding and pumping will be very difficult even when the breasts are full. This physiological aspect can completely debunk the myth about the need for complete pumping. After all, next time not only the amount needed by the child will be formed, but also the volume that was expressed last time. An increase in the production of this product is called hyperlactation, which entails the development of lactostasis and subsequently mastitis.

Breastfeeding advice: should I pump after feeding?

The first and most basic recommendation is not to wash your breasts before or after feeding, while using any hygiene products. It would be better to use clean water. Strong odors from gels or soaps can scare a child away. It's best if the breasts have a milky smell.

Mother's milk is conventionally divided into two types: anterior and posterior. The foremilk is bluish in color. It provides the baby's body with fluid needs and is rich in protein and milk sugar (lactose). There is no need to constantly express after feeding; sometimes this can even lead to unpleasant consequences for the child. If a woman expresses after each feeding, the baby receives primarily only foremilk, which can lead to excess lactose in the intestines. The child’s digestive system cannot cope with such volumes of sugar, causing fermentation and abdominal pain. The stool becomes greenish and liquid.

Such consequences can be avoided if the baby also receives hind milk. It is thicker and greasy. It contains a large amount of the enzyme lactase, which breaks down milk sugar and helps it be better absorbed. In addition, the back contains a lot of nutrients, necessary for the child. Therefore, it is not worth weaning the baby from the breast before hind milk begins to be released. After feeding, be sure to squeeze out another drop and lubricate the nipple. This simple technique will help prevent cracks from occurring.

Do I need to express milk after feeding?

Nature does not provide for such frequent production of large volumes of milk in women, which is provoked by frequent pumping. There are two options for feeding babies:

In the case of an established lactation process, when the mother is healthy, the baby is full-term, he grasps the nipple well and attaches correctly to the breast, both methods of feeding will be acceptable, and pumping may be practically not required.

When is it necessary to pump?

First of all, before expressing, you should prepare the dishes. It must be washed clean and sterilized. Then the woman herself must prepare for pumping. Makes the pumping process much easier relaxing environment, close contact with the child and positive emotions. Stress and bad mood make it difficult for milk to flow. It is recommended to take a hot shower and rub your body with a towel before pumping. Warm drinks will also help make pumping easier.

If the mother does not yet have experience pumping, it is advisable to consult a breastfeeding specialist or doctor. Midwives can also help with the first pumping maternity hospital. If you follow the correct process technique, pumping will be successful and painless.

Massaging the mammary glands towards the nipple also has a beneficial effect on pumping. It will stimulate the production of the hormone oxytocin, which will help increase flow. When pumping, you should squeeze your breasts in the area of the areola, since milk accumulates there.

You can express like using a breast pump, and manually. If a woman chooses to use a breast pump, she will need to ensure that it is clean and sterile before each pumping session and that there are no cracks in the nipples. The device will work best when your breasts are full. While expressing, you should press the breast shield tightly, change the position of the nipple relative to the breast pump, and take short breaks. When using the device correctly, the pumping process is greatly facilitated, however, if the breasts become limp, you will have to pump out the milk with your hands. The movements should be performed smoothly and slowly, without applying unnecessary effort. Otherwise, it may have a bad effect on the milk alveoli.

The milk is expressed until the breasts become completely soft; this can take from twenty minutes to half an hour. No lumps should be felt in the mammary glands. If compacted area detected, it needs to be precisely kneaded. At the initial stages of pumping, it may turn out that the milk stops flowing, although the breasts feel full. In this case, you need to take a break and either start expressing the other breast, or take a little break and rest.

How much breast milk should I express?

The amount of milk you need to express will depend on your goals. If you need to stimulate lactation as much as possible, you will need to express your breasts completely. If pumping is carried out to ensure a supply of milk for future use, the volume required is that required for one feeding. During congestion, it is recommended to express very little to relieve tension in the chest.

Methods for storing milk depend on the period of time for which it is planned to be stored:

Each woman must decide for herself whether she needs to express after each feeding or not. However, no expert will recommend pumping after every feeding. After all, the more milk comes - how more woman expresses him, which is not always necessary and takes a lot of time and effort.

Many expectant mothers, preparing for the birth of their baby, draw up plans in advance, trying to take into account all the important little things that will help them in caring for their baby in the future. This list most often includes a breast pump - a special device for expressing breast milk.

Why a breast pump and not your hands, since you can express your breasts with your hands? Modern breast pumps will help you save a lot of time and save your energy.

The choice of these devices today is so wide (functionality differs from each other in the mechanism of their operation, price, properties, convenience, etc.) that a woman’s eyes simply run wild. In order not to be tormented by the question of which breast pump is the best, and which one to choose for comfortable expression of milk, you should know what types of these devices exist.

Types of breast pumps: which one to choose

(Photos are clickable)

Absolutely all breast pumps are divided into two types according to the principle of their operation: manual, that is, mechanical, and electric.

Manual breast pumps are not as expensive as their electric counterparts. They can be divided into:

Pump-action

The simplest of existing devices. Consists of a breast attachment and a rubber pump (or bulb). When expressing milk with such a device, a woman needs to squeeze the pump frequently to create a certain vacuum around the nipple and cause a flow of milk. Milk flows with every pressure on the breast.

Plus models- low price. The price of pump breast pumps starts from 90 rubles for the simplest models.
Minuses– due to the constant mechanical squeezing of the pump, the hand quickly gets tired, with frequent use there is a possibility of. The milk doesn't flow well.

Pump breast pumps are available without a bottle and with an attached bottle.

Breast pump in the form of a syringe

The device consists of two cylinders, where the inner one is applied directly to the nipple itself, and the outer one moves forward or backward. This option is the most common and popular: it is easy to clean, simple to use, and small in size.

Piston (cylindrical)

This type of breast pump consists of a silicone nipple nipple with a special lever attached to it and a bottle included. To pump, just press the lever, pressing the nozzle tightly against your chest.

Pros:

thanks to silicone nozzles, expressing with a piston breast pump resembles natural breastfeeding, which helps improve lactation;
quick pumping. In 10 minutes it is expressed to 150-200 ml. (When expressing manually, this takes up to 40 minutes);
silent operation;
the ability to sterilize all parts of the breast pump;
relatively low price and a huge selection of different models.

Minuses:

fragility of parts. If used very frequently, the breast pump lever may break.
When pumping, a woman’s hand quickly gets tired.

Electric breast pumps

In addition to mechanical models, there are also electric models to facilitate the pumping process. Using any model of electric breast pump will not be difficult for a nursing mother.

The principle of operation of the device is not to manually create a vacuum around the nipple, but using a special motor. A woman just needs to press a button and the device will start working on its own!

Pros:

Note to moms!

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the ability to remember the pumping mode;
There are models with two-phase mode. At first, the device operates in a fast and gentle mode, gradually moving to slow and deep expression. This mode allows you to express the accumulated breast milk as much as possible;
There are models that allow you to pump from both breasts at the same time;
easy to disassemble, parts can be washed and sterilized;
An electric breast pump is suitable for constant use, as it does not injure the nipple and does not contribute to fatigue.

Despite the undoubted advantages of electric models, they also have certain disadvantages. These include very high cost and noise during use. This type of breast pump can hardly be used next to a sleeping baby.

Electronic

This is a microprocessor-controlled breast pump that fully controls milk flow and pumping rhythm. Operates from a power outlet or battery. They are correspondingly expensive.

An example of expressing two breasts with an electronic breast pump

Video: choosing a breast pump

Having decided on the choice of a breast pump, a woman is faced with questions about how to properly prepare for pumping and how to express breast milk as efficiently as possible.

Rules for expressing with a breast pump

During the feeding period, most mothers have to deal with a situation such as pumping. To protect yourself from unnecessary risks, every mother must know how to properly express her breasts using a breast pump so as not to harm herself.

Expressing your breasts with a breast pump is absolutely not a shameful process, you don’t need to be afraid or embarrassed!

The main reasons that force you to express:

You have a lot of milk, so in order to avoid it hardening in your breasts, you must get rid of the excess;
Your breast milk is not quite enough to feed your baby, so you need to pump to stimulate lactation;
You need to attend an important event where it will be impossible to provide the child with access to the breast, or the baby remains at home without you with grandma and dad and they need to feed the baby;
The child refuses to take the breast, but drinks milk from a baby bottle.

There can be a lot of options...

Preparing to pump

Before expressing milk with a breast pump, read the following recommendations:

Wash your hands with soap and wash your breasts warm water.
If possible, drink a glass of warm water or tea to improve milk flow.
Please read all instructions included with your breast pump carefully.
If you are using a breast pump for the first time, be sure to boil it and let it dry. Then collect all the parts and prepare a sterilized container to collect the milk.
Before starting the process, select a funnel of the right size; the nipple itself should not be adjacent to the wall of the suction device, otherwise expressing will be slow and painful. The nipple should move back and forth without obstruction, so you need to leave room for it to move.
For large breasts or large nipples, it is recommended to choose a breast shield with the largest diameter.
To help your breasts adhere better to the breast shield, moisten the skin with a damp towel.
Find a place that is most convenient and suitable for such a procedure.
Start pumping at the speed that is most comfortable for you, even if it is the strongest. The main thing is not to forget to constantly stimulate the flow of milk.
The breasts can be stimulated with light circular movements before and during the procedure.

Preparation is complete, you can start pumping

If you feel the slightest difficulty while pumping, do not forget that pumping is an artificial process, an imitation of feeding. Reach positive result possible through the production of a pumping hormone called oxytocin. To do this, it will be enough to take a warm bath, drink (preferably with milk), put a warm towel on your chest, or just look at a photo of your baby. Already during pumping, the hormone prolactin will begin to work, and it determines how much milk you can express.

Video: expressing milk

Desktop instructions for nursing mothers

Expressing with a breast pump takes 10-15 minutes for each breast. If you express faster, don't stop - continue for a few more minutes.

To make the process easier, it is better to bend forward a little, but not too much. This position will allow the lobules to pass milk more easily and it will be much easier for the mother to collect it.
While supporting and slightly lifting your breast with one hand, apply and press the breast pump nozzle firmly against the nipple with the other. The nipple should be in the middle of the nozzle. In turn, the funnel must fit tightly to the nipple, otherwise the necessary vacuum will not be created and the pumping process will be difficult.

(Photo clickable)

The nipple should be in the center, the funnel should fit tightly and tightly to the breast

Press the plunger (if the breast pump is manual)

When using a mechanical device, start pressing the lever or pump; to express with an electric breast pump, just press the button. There is no need to squeeze the breast so as not to injure the nipple. If pain still occurs, check whether the breast pump funnel is positioned correctly and whether the nipple is located exactly in the middle. If you experience severe discomfort, you should stop pumping and start the process again after a while.
You should pump until the breasts soften and the lumps can no longer be felt. Before completing the process, massage your breasts again from the armpit to the center, driving out the remaining milk from the side lobes. At this point, pumping is completed; you can use the milk immediately or freeze it.

How to use a breast pump (video no. 2)

Why is it impossible to express with a breast pump?

So, how to choose a breast pump and how best to express a woman already knows, and What should you do when you can’t express a single drop of milk with a breast pump? Expressing, although an imitation, is still a natural process and if there is no milk in your breast, then no breast pump will be able to express it. Having studied the pumping technique and the rules for handling such a device, we can conclude that you will not be able to express milk if:

The seal between the nipple and the funnel is broken. If air gets in, the breast pump will not work properly.
Milk stagnation ( I also call it lactostasis -). If your breasts feel very firm to the touch and there are painful areas, then it will be difficult to express milk quickly. In this case, a long breast massage will help ( See article

You can still sometimes hear advice to a young mother to express her breasts “dry” after each feeding. The most varied arguments are given: so that the milk does not disappear, so that there is no stagnation, “I did this, and only thanks to this I fed it!” Indeed, in the middle of the last century there were such recommendations. There was a good reason for them: after all, another recommendation was widespread at that time - scheduled feeding. The baby was put to the breast 6-7 times a day with a long night break. As a rule, one feeding is one breast, so the baby was attached to each breast 3-4 times a day. Feeding at such a rhythm is critically insufficient stimulation of the breast for milk production. Regular pumping in this case made it possible to at least somehow support lactation.

If the mother feeds the baby on demand day and night, does not limit the duration of feedings, latches to the breast for 12 days or more, the baby gains weight and develops according to age standards, then there is no need for additional pumping!

Milk production is a law of supply and demand: the more milk is removed from the breast, the more milk is produced, and vice versa. If a mother regularly pumps her breasts, the body perceives this as a signal that the baby needs more milk than he actually sucks. This can easily lead to hyperlactation, and too much milk is no more pleasant than its lack, and can lead to stagnation, inflammation in the mother, and digestive problems in the child.

WHEN PRESSURE CAN HELP

However, there are situations in which pumping can be very helpful. Here are the most typical ones.

1. Pumping in order to establish lactation and feed a child who, for some reason, cannot yet suckle at the breast (low birth weight, premature newborn, a child with anatomical structural features that make sucking difficult, other special situations when it is difficult for a child to suck effectively).

2. Pumping to alleviate the condition of severe fullness or engorgement of the breast, when it is difficult for the child to take a full breast.

3. Pumping to maintain lactation and feed the baby if the child for some reason refuses or cannot temporarily attach to the breast (breast refusal, illness of the child).

4. Pumping to increase milk supply when really needed.

5. Mom goes to work or needs to leave home (regularly or from time to time).

6. Expressing in case of stagnation of milk.

7. To maintain lactation if the mother is forced to be separated from the child for some time.

HOW OFTEN SHOULD YOU PRESSURE?

Each situation is individual and the best solution would be to seek help from a lactation consultant. The specialist will develop an individual pumping scheme and teach pumping techniques.

1. To establish lactation, if the baby after birth for some reason cannot suckle, it is necessary to start pumping as soon as possible. Preferably within the first 6 hours after birth. At first it will be just a few drops of colostrum - the first milk that is in a woman’s breast immediately after childbirth.

Then you need to express approximately in the rhythm of the baby's latches to the breast. At least once every 2-3 hours, including at night. Try to get at least 8 pumpings per day.

If night pumping is difficult to accomplish, one break of 4-5 hours is possible.

Nighttime pumping is very important for adequate milk production! Try to have at least 1-2 pumping sessions between 2 and 8 am.

Rare pumping or its absence in the first days, if the baby is not latched to the breast, can interfere with the normal development of lactation processes and provoke insufficient milk production in the future.

2. To maintain the amount of milk in the mother, if the baby is temporarily not attached to the breast, it is advisable to express at approximately the same rhythm in which the baby suckled or a little more often, since no breast pump can stimulate the breast as effectively as the baby.

But no less than once every 3 hours for a child under 6 months.

3. Regardless of how much time has passed since the last pumping, it is necessary to express a little, until a feeling of relief, if the mother feels too full. Even if, according to the developed scheme, the time to express has not yet come.

4. When working to increase milk supply or create a milk bank, everything is very individual and depends on the specific situation. Consult a specialist!

5. If you can’t pump as often and for as long as planned, it is important to remember that any breast stimulation is a “request” to the mother’s body to produce milk. Even 5 minutes of pumping is better than nothing. A child in the first months of life can be attached to the breast up to 20 or more times a day and suck from a few minutes to 1 hour or even longer. If it is not possible to express at a certain rhythm, simply express at any convenient opportunity.

WHEN TO EXPRESS. EFFECTIVE SCHEMES.

1. If the baby is attached to the breast, then you need to express immediately AFTER feeding or 30-40 minutes after it (that is, between feedings), and not before. There are situations when it is acceptable and even necessary to express before feeding, but these are special cases and should be recommended by a specialist. In the vast majority of cases, it is advisable to express after the baby has fed well from the breast.

2. It is very effective to express one breast while feeding the other breast, since the baby stimulates the flow of milk in both breasts by sucking.

3. The most effective pumping mode is “5+5…1+1”: first 5 minutes on one breast, then 5 minutes on the other, then 4 minutes on each breast, then 3, 2 and finally 1.

4. Simultaneous expression of both breasts also stimulates milk secretion and milk production very well (this can be done either with a breast pump designed for simultaneous expression, or manually, after some training).

5. Usually one pumping session takes 15-20 minutes for each breast. If you are working to increase your milk supply, continue pumping for another 2-3 minutes after your milk has stopped coming out.

6. Sometimes mothers combine two types of pumping - first they express with a breast pump, and then a little more with their hands. This often allows you to express more milk.

7. Don't think too much about expressing a lot of milk. Practice shows that if a mother expresses without looking into the container or counting milliliters, she manages to express more milk.

IMPORTANT! The baby creates a stable vacuum and performs a whole range of movements (almost all facial muscles are involved in the sucking process) to extract milk. When expressing by hand or with a breast pump (even the best), it is impossible to completely imitate the baby’s actions. Pumping is a skill! The volume of expressed milk cannot judge whether the mother has enough milk.

Pumping technique

What to express?

What is the best way to express - with a breast pump or by hand? Each option has its supporters. If you are expressing milk for the first time in your life, try doing it manually. It is easier to control the process with your hands and stop immediately if the sensations become painful. By expressing with your hands, you can study the characteristics of your breast, choose effective pumping movements, speed and compression strength.

A breast pump is usually easier to use when your breasts are full. It may be less effective if your breasts are soft.

Some mothers note that immediately after giving birth, expressing with your hands is much more effective than using a breast pump.

There are women who, due to the characteristics of their breasts, cannot express a single drop with a breast pump, but they can do it just fine with their hands. Try and find your own option.

If you have to express regularly, you should consider using an electric breast pump. The best electric breast pumps are clinical devices and those that express both breasts at once.

Avoid using the simplest “bulbs” - breast pumps: they can easily injure your breasts, and the efficiency of pumping is low.

Never use a breast pump if your nipples are cracked or swollen! This may make the situation worse.

Preparing to pump.

When expressing milk, the same processes are launched in the body as when feeding a child, but weaker - after all, expressing is only an imitation of the feeding process. However, both during feeding and during pumping, the level of the hormone oxytocin, which helps milk flow from the breast, and prolactin, which is responsible for milk production during lactation, rise.

To make milk flow more easily from the breast, you can help the “oxytocin reflex” start working before you start pumping. Here are actions that can help you relax, calm down, and thereby promote easier milk release and effective pumping.

1. Before you start pumping, wash your hands and prepare everything you may need during the process (container for pumping, warm drink and snack, napkins, phone, book, etc.)

2. Sit comfortably, relax, you can turn on quiet, calm music.

3. To stimulate milk secretion, you can use a light breast massage: “tapping” with your fingertips, stroking, fingering “like lotto barrels in a bag”, you can “shake” your breasts a little, leaning forward, and lightly move your fingers from the periphery to the nipples. It's a good idea to stimulate your nipples for a while by lightly pulling or rolling them with your fingers (just be very gentle!).

IMPORTANT! Any action should not hurt you!

4. It’s very good to drink some warm drink before you start pumping. What exactly is not important, it should be tasty for you :-).

5. If there is no fever or inflammation, you can immediately warm your breasts for a few minutes before pumping - for example, put a towel soaked in warm water on it, or take a warm shower. You can warm your hands and feet in the water.

6. If possible, have someone close to you massage your neck and back - this will help you relax.

7. If the child is nearby, skin-to-skin contact helps, look at the child, touch him, hold him in your arms.

8. If the child is not nearby, you can look at his photo or keep some of his clothes nearby. Give free rein to pleasant thoughts about your child.

9. During the process of pumping, some mothers imagine a running stream of water, waterfalls.

You may feel the milk ejection reflex kick in or notice milk flowing from your breasts, but you may not feel anything. You don't need to know or feel this reflex to produce milk.

Expressing by hand.

1. Place your thumb above the areola (or about 2.5-3 cm from the nipple) and your index finger opposite your thumb under the areola. The remaining three fingers of the hand support the chest.

2. “Roll” your fingers a little, place them a little higher or lower, feel the “peas” under your fingers (they are located approximately on the outer border of the areola). These are the ones that will need to be influenced (they can’t always be felt. If you don’t feel anything, don’t worry, just keep your fingers approximately on the outer border of the areola). There is no milk in the nipple! :-)

3. Lightly squeeze your chest with your thumb and forefinger, towards the chest, as if pressing your fingers a little inward.

4. Roll your fingers forward and when the milk is squeezed out, relax your fingers. Do it all again. Important: fingers should not move over the skin, they should remain in one place. They don’t move, but rather “roll” across the chest!

5. For the first minute or two, until the milk release reflex starts, it may be released very weakly (or not at all), it is important not to stop rhythmic pumping movements.

6. When the milk has stopped actively flowing out, move your fingers a little along the border of the areola and continue expressing. From time to time, move your fingers in a circle so that all segments of the breast are emptied evenly (with the exception of targeted pumping of a certain lobe during stagnation of milk).

7. It is good to alternate direct pumping movements with additional stimulation. If you see that the flow of milk has slowed down after the end of the flow, you can:

Attach the baby to the breast (if possible),

Drink something warm

Give a light breast massage and then continue pumping.

If you feel the “hot flashes” well, then you can be guided by the fact that during the 1st “flush” about 45% of the milk comes out of the breast, the 2nd flush – more than 75%, the 3rd flush – more than 94%.

If not, then just use the pumping time as a guide (about 15-20 minutes for each breast).

Expressing with a breast pump.

1. Read the instructions carefully: is the breast pump assembled correctly, are the parts in contact with the breast and milk clean?

2. It is important to choose the nozzles that exactly match the diameter, otherwise milk may be expressed painfully or ineffectively, and cracks or swelling of the nipples may occur.

3. If the breast pump has several power levels, start with the minimum to avoid nipple injury, and then gradually increase the power until it is comfortable, but not painful.

4. Stop pumping immediately if it hurts! Further:

Make sure that the nipple is exactly in the center of the nozzle and that it is the right size for you.

Reduce power

Don't pump for too long, take breaks.

WHAT TO DO WHEN “THE MILK HAS COME”?

Separately, you need to talk about the correct actions at the moment the milk comes in (usually on the 3-5th day after birth). Many mothers, even before giving birth, hear stories that “on the third day my milk came in, my breasts became just stone, everything hurt, the baby couldn’t suck it out, they could barely pump it out!” And what a pain!” And this very arrival of milk and straining “until the stars in her eyes”, the mother begins to expect with fear. Meanwhile, with the right actions after childbirth, you may not feel anything at all when the milk comes in, or the sensations will be quite comfortable and the breasts will simply become fuller. What should these actions be?

1. The most important thing to do is to ensure that milk is removed from the breast from the first hours after birth. This is done by putting the baby to the breast at least once every 2-2.5 hours or by pumping, as described above.

If before arrival large quantity If the first milk, colostrum, is not removed from the breast, then it literally becomes a plug that interferes with the outflow of milk from the breast (as it has a thicker consistency).

2. The key to removing milk from the breast is effective sucking. Make sure your baby has a good latch and is sucking milk, rather than just holding the breast in his mouth.

Here are signs that everything is fine:

The baby's mouth is wide open (obtuse angle 120 degrees or more),

Both lips are turned outward

The tongue covers the lower gum,

When expressing, milk does not flow out; expressing is painful.

Seek qualified help!

Rada Melnikova, lactation consultant,