Hand Expressing & Storing EBM.

Hand Expressing

Hand expressing is one of the more gentle ways of expressing Breastmilk for you baby. There is a nack to getting it right so practice makes perfect :).
Remember to RELAX!

1. Place your thumb and forefinger on either side of your areola, well back from the nipple, with an imaginary line between them running through
your nipple. A mirror might be of assistance if you cannot easily see the
lower part of your breast.

2. Gently press your thumb and forefinger back into your breast tissue, until you feel the bulk of the breast. If your breasts are full, your breast tissue might feel hard, lumpy or even a little sore. Treat your breasts gently; expressing should not hurt. When the let-down reflex occurs and the milk flows, the breast tissue softens and expressing becomes easier.

3. Press your thumb and forefinger towards each other, using a slight rolling action. This will compress the large ducts in the breast just behind the nipple and cause the milk to flow out of the nipple. Until the let-down reflex occurs, the milk may drip from the nipple and you might need to hold your bowl close to catch it.

4. Continue this compressing motion, in a rhythmical way, until the let-down reflex is triggered. The milk can seem to spray from the nipple. Several jets of milk can occur with each compression. The let-down reflex may take several minutes — don’t worry, the let-down is a conditioned response and will soon occur quickly each time you express.

5. When the flow eases, move to another section of breast, working your way around the areola. Remember to place your finger and thumb on either side of the nipple, as before. If your hand tires, you might like to use your other hand.

6. If the flow seems to decrease, try expressing the other breast in the same way. Change hands and breasts frequently if your fingers tire. You will find they become stronger with practice. You can swap between breasts until the milk no longer flows well.

7. If your supply is low you may find that you get only a few dribbles at each expressing session. Do not be discouraged. Frequent short sessions will gradually build up your supply. See the Australian Breastfeeding Association booklet, Increasing Your Supply.

8. When you are expressing all your baby’s needs, you should aim to have some longer and some shorter expressing sessions. During the longer sessions you might find you will get two or more let-downs and thus produce more milk.

9. Some mothers use their right hand for their left breast and vice versa, others use the left hand for the left breast and their right hand for their right breast, still others use a combination. With practice you will find what is easiest for you. To avoid strain in your forearms and shoulders, relax and change your expressing positions frequently.

Storing, thawing & using EBM

Storage:
Breastmilk freshly expressed into a closed container can be kept at room teperature for 6–8 hrs (26ºC or lower).

If refrigeration is available store milk there 3–5 days (4ºC or lower) Store in back of refrigerator where it is coldest 2 weeks in freezer compartment inside refrigerator.

Breastmilk can be kept for 3 months in freezer section of refrigerator with separate door. Or 6–12 months in deep freeze (-18ºC or lower).

Previously frozen & thawed in refrigerator (leaving it in the fridge to thaw over night) but not warmed can be kept at room temperature 4 hours or less (ie the next feeding). Can be kept in the fridge for up to 24 hours. Do not refreeze.

Thawed outside refrigerator in warm water can be kept for completion of feeding. If thawed in warm water but NOT given to baby straight way can be kept in the fridge for up to 4 hours or until next feeding. Do not refreeze.

Once your baby has begun feed, breastmilk should then only be kept for completion of feeding, then discarded.

Glad Snap lock type bags are NOT recommended for storing EBM. Chemicals in the plastic may leech into the EBM.

FJ - just a question -once frozen can you transfer to a plastic bag or what about the ice cube trays with EBM in them can you remove from trays and then store in bags or tupperware or ? .

Not that I do atm.

I have some milk stored in sterilised baby plastic food containers and Avent - can I now remove and store in another bag ?

I will suss it out, by other bags do you mean the snap lock ones?

any really like freezer bags/double bagged or if inside tupperware type conatiners?

I think it would be safe to put into tupperware. I would probably avoid any plastic bags that aren't EBM bags.

If I express a couple of times during the day, can I combine them in one bottle? Or would it be bad to add room temp milk to chilled milk? (With the intention of feeding the same day, not freezing.)

FJ -how can tell if EBM has gone off ? I had some 2.5 days old in fridge since expressed it and it smells funny ?

Should be ok, BM does seem to have an odd smell once its been cooled or frozen. Your ok for up to 5 days in the coolest part of the fridge.

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If I express a couple of times during the day, can I combine them in one bottle? Or would it be bad to add room temp milk to chilled milk? (With the intention of feeding the same day, not freezing.)

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ETA - You need to chill it before mixing it.

thank you FJ

Oh god I just combined milk i expressed late lastnight with freshly expressed this morning and i didnt chill it before mixing them.. Will this be an issue??

Sorry I didn't reply to this earlier. But for next time, I never use to chill before adding to already cold milk. It was never a issue for me. But ABA does reccomend chilling before mixing.

If I am keeping it at room tempurature can I mix them together??

Yes thats ok, its just adding new milk to cold or frozen milk that you need to chill the new milk before adding it. But if you are just adding room temp milk to room temp milk from the same day thats fine.

with the EBM bags, can you add to them, or do i have to seal it up with what you have put in them. I want to buy some but If i cant do that then its a waste of moeny for me.

Umm you should be able to add to them, I don't see why not. As long as you chill the new EBM before adding to whats already in the bag. Can't see why it would be any different to adding to a bottle KWIM?
However you can't reuse the bags so if your looking for something that you can reuse look out for cheap baby bottles to use. You can usually find the little ones pretty cheap in the junk shops.

The bags are single use, well at least the last time I looked at them they were but I haven't used them in aggggeeesssss so its possible something reusable has come onthe market.

Just a quick question:
For those of you that express BM, and use bags,
which bags will hold the most milk- the ones i have, Kanesno only hold 200mls, but DD has about 220ml. Do you think that i would fit it 250ml as an extra, or would that be pushing it?

Sorry, can't help you with that one.

Quick question here. I have just started expressing and I am using the Avent sterilised bags, but I am having a hard time working out how much I have expressed. Do I leave them in the holder for the reading or flatten the bag out of a little? There isn't a huge difference in the readings, but I am a little confused.

hmmm I dunno! lol I would think when its in the holder would be more accurate.

This is a fairly basic question but I just wanted to make sure it was OK to store EBM in the freezer in the bottle that I expressed into. It has a screw lid with one of those little plastic covers on it. I have also put the bottle into a zip lock bag.

This is my first time freezing EBM so when I go to use it how far in advance should I take it out of the freezer - basically I have no idea how to thaw it!

TIA
Jem

Yes its fine to use the bottle you expressed into. Just remember where it is incase you need it later on though LOL.
when you thaw it, it will depend on how fast you want to use it. Its best to put it in the fridge overnight & let it thaw that way but you can also use warm (not hot) tap water & run that over the bottle while rotating it to thaw it out to be used straight away.

eta - Previously frozen & thawed in refrigerator (leaving it in the fridge to thaw over night) but not warmed can be kept at room temperature 4 hours or less (ie the next feeding). Can be kept in the fridge for up to 24 hours. Do not refreeze.

Thawed outside refrigerator in warm water can be kept for completion of feeding. If thawed in warm water but NOT given to baby straight way can be kept in the fridge for up to 4 hours or until next feeding. Do not refreeze.

Once your baby has begun feed, breastmilk should then only be kept for completion of feeding, then discarded.

Thanks heaps FJ. You are a wealth of knowledge :D!!

Why do you have to discard BM that has been started by bubs?

Is it because it's been heated? Or because it's been at bub's lips?

I'm struggling at the moment to get enough to feed him and I don't want to waste a drop!!

Hi,

Because when the bottle is in your baby's mouth, it will get the bacteria from your baby's mouth - which may grow better in a warm environment.
But, breastmilk is pretty tough stuff, and contains factors which inhibit the growth of bacteria. Unfortuantely some of the info we get is extrpolated from formula feeding. - so use your own judgement a little.
Many mothers find it helpful to store milk in smaller quantities - say 50mls, so that if baby suddenly doesn't want it we haven't wasted too much.
How old is your baby now?

Barb

Thanks for the clarification.

My little prince will be a week old tomorrow!

Unfortunately I don't have many bottles as he has a cleft palate and we need to use special teats so I tend to fill the bottles which means more wastage. I may look at storing the milk in 'normal' bottles and then we can just put the milk in the special bottles as he needs it to minimise wastage.

Even 50 mls takes me about 5 mins to express so it's all a little devestating to discard any... :(

Barb maybe you can corect me if I am wrong but I though the reason you need to discard milk once its the feed has comenced is because the saliva from the babies mouth may also enter the bottle & start to breakdown the milk, the same thing happens when you start a feed of solids, its generally much more watery by the end of the feed because teh saliva on the spoon has started the process KWIM?

Nettie, you need a big round of appluse for giving your bub BM when things are stacked against you with the your DS having a cleft palate. I can only imagine how difficult it must be to establish a good supply with just the breastpump & hand expressing.
Get yourself some cheap normal bottles so you can store more milk. The junk shops like the reject shop or go low (not sure what you have in SA, the names seems to differ state to state) often have the smaller 100ml bottles pretty cheap. Also sometimes chemist with have them.
Check out the MothersDirect online shop via the ABA website also, they have a few nifty things for storing BM. There is a fairly new product that is like a ice cube tray that you can store BM in.
Anything you can label, has an airtight seal & can be disenfected will be suitable for storing BM.

Good Luck!
I think another BB member who is BFing a cleft Bubba is PurpleMumma, her DS is older & has had his repaired but I am sure she would be happy to help with any questions you may have.

FionaJill - thanks for the info.

We've started a system of storing the BM in a bigger container once expressed, then putting moderate amounts in a bottle at feeding time. This way we're not wasting as much. Only about 10 - 20 mls gets wasted if any.

Seeing as he's only 1 week & 1 day old, we're probably doing ok with figuring things out! This is also only his fourth day at home... we'll get it figured!

I expressed more than 150 mls this morning, so the supply is certainly getting there! Especially as he's only taking between 50 - 80 mls a feed (3 hourly approx).

Thanks for your support.

I can't find EBM bags, where do you all get them from?

Most chemists should stock them. Or you can order them online from mothersdirect via the Australian breastfeeding Association website.

Danni, I found they were getting harder to find not long before I stopped expressing. As FJ said you can get them from Mothers' Direct, and some pharmacies still have them - try the bigger ones. But one of the companies stopped making them so there are fewer around. I switched to the Avent reusable cups near the end as they ended up cheaper.

Hi ladies, just wanted to say that I was going to use the bags but then at the chemist I found Avent "VIA" products. Basically they are containers that you can express straight into using your Avent breast pump and attaching an adaptor onto it. Then when it's done you can label them and pop them straight in the freezer. I've been using them for the last couple of days and for me it's a lot easier to store in the freezer because the containers are stackable. I also prefer it because it means that at day care they just need to attach the teat onto it and it's ready to go (in my head that means less handling and less contamination).

The containers double up for when bub starts eating solids too, so I know I'll get a lot more use out of them. They come sterilised and ready to go!

if i store the ebm in the fridge and then want to use it the next day, do i heat it up when i want to use it, or get it out in the morning and leave at room temp? What temp should ebm be served at?

With how warm it has still bean I personally wouldn't leave it out to come to room temp on its own.
I think its if the room is 26 degree or less its ok to do that.
I would warm it to body temp just before you use it. Best way to do that is to simply rotate the bottle under running hot tap water.

Thanks hun. you are wonderful to have provided all this great advice.

Ali, from a safety point of view there is no right temperature. It can be served straight from the fridge if your little one will drink it chilled. Some babies are quite fussy about temperature though, so it might be trial and error. Room temperature is probably not a bad place to start. EBM can be left un-refridgerated for a few hours but it's best not to unless you have to. So if you can warm it to room temp quickly by leaving it out that would be ok, otherwise putting it in a jug of warm (not hot) water is a great way to do it.

Can I mix EBM expressed on different days so I have enough for a feed while out? Eg if the milks were expressed 3 days apart?