KBBF: Expressing Breastmilk
When I made the decision to breastfeed, I had never heard of expressing milk or pumping. However, with an extended stay in hospital post-birth, I was there when my milk first came in. And did it come in!! I felt like someone was inflating my boobs in front of my eyes and seriously believed they were going to burst! The pain was unbelievable and I was in tears, desperate for some help. Eventually, a nurse gave me the electric double breast pump and I sat and watched the gold liquid gradually fade to a normal creamy colour, completely unaware of the magic I was literally throwing away. I sat there for hours, draining that first milk away, just glad of some relief from the pain. I hadn’t slept for 4 days by this point and was probably a little bit gaga to be honest, but I really didn’t have a clue and no-one told me otherwise. Unsurprisingly, within hours, I was back to square one, my boobs full to bursting, reacting to the demand the pump had inadvertently placed on them.
With hindsight, I cannot believe my naivety and stupidity. My tiny little baby, that was barely more than a yellow, medical pin cushion wasn’t getting the very thing that she needed as I had been too uninformed to know what I was throwing away. So while I was fortunate not to have anyone force formula on me due to lack of time and staff, the very reason they didn’t also meant my baby missed out on the crucial colostrum milk.
I’m not too sure when I learnt about these things, but am pretty certain that once I got home and finally had some sleep, I may have been sane and lucid enough to do some research. I believe we began with Mumsnet and some breastfeeding gurus there will have pointed us towards the oh so wonderful Jack Newman and Kellymom websites. Gradually, as I read and researched, I began to understand more about breastfeeding, about how it worked, what I needed to do, and most of all what I shouldn’t do.
I hated expressing milk. I bought an expensive electric pump (I have wrist problems that meant a hand pump would be too painful), but still hated it. I avoided it as much as possible, to the point that I never built up a stash of breastmilk supplies and my wife even had to rush out to the local shop to buy some formula when I was out longer than planned on one occasion!
When I returned to work in London, I was determined not to give up breastfeeding, so tried again with my pump. It was ok but never enjoyable. I was usually stuck in a store cupboard with dodgy lights, no chair and my laptop. For an hour at a time. And I’d manage just a few oz. I continued like this for 3 months and then stopped. Bunny barely noticed!
If you need to express, especially if you are returning to work, here are some tips to make it less of a chore and more enjoyable and productive. There are many reasons to express milk: general breast comfort to avoid engorgement; helping a baby to breastfeed or one that is unable to breastfeed; stimulation and/or maintenance of the milk supply; and finally, possibly the most common reason, allowing someone else to feed your baby.
First of all, it is important to point out that if you are returning to work and continuing to breastfeed, that you are protected by similar laws to those of pregnant women, as long as you have confirmed in writing that you are breastfeeding. This means that your employer must undertake a risk assessment to ensure that you are not exposed to any hazardous substances that may enter your milk supply and that your workplace is safe for you as a breastfeeding mother; they should allow you to take extra breaks or alter your working hours to enable you to express milk or continue breastfeeding your baby without loss of pay. In fact, if the circumstances are serious enough, you can be suspended from your job on full pay! They should also provide suitable facilities for rest (for breastfeeding or expressing milk). This should not be a toilet though!
Deciding how to express is down to personal preference and practicality. Hand expression can be preferable for a more gentle experience and appears to produce a better hormonal response which allows for better drainage of the breast. Using an electric pump is easier, almost hands free and can result in larger volumes of milk. If at all possible, express from both breasts at once as it has been shown to increase prolactin levels and shorten the time needed to express. This is especially useful when supply needs to be rapidly increased or larger volumes of milk are required.
It is recommended that you breastfeed as soon as you can after getting home each day to establish a routine and try to express early in the day when milk production is at its best. As much as is possible, try to express at the same time as your baby would normally feed and increase the frequency if your milk supply appears to decrease (not the length of time spent pumping at each session). If you are returning to work, begin expressing around one month in advance to build a stash of milk. Remember, that from 6 month’s old, unless there is an allergy, babies can drink cow’s milk and this can be sourced through a variety of sources (as long as it is not baby’s only food) and four breastfeeds a day is enough to nourish a 1 year old.
Drink a couple of glasses of water right beforehand, then begin by using a warm compress or gentle massage before starting to express to help stimulate let down, imagine you are nursing your baby, or look at a photo of your baby while doing so to help you relax. Use quick, short pumps at the start if using a hand pump to emulate the initial sucking of your baby, moving to longer, slower pumps once the flow has started. Try not to watch the collection bottle, especially when you are new to expressing as this is likely to cause you unnecessary stress and is not conducive to relaxing. Store the flange in a sealed bag in the fridge between sessions to avoid frequent washing and use hot water before the next pump to warm them up.
If you find that you are getting sore from pumping, check that your nipple is not hitting the flange of the funnel and if possible, try a different pump.
Finally, it is rare that you will love expressing milk, so try to make it a special time for something – whether reading, eating something you shouldn’t or watching some trashy TV! This will help you look forward to it and allow you to take the focus off the task itself.
This post is part of the Keep Britain Breastfeeding Scavenger Hunt.
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