8.3.3  Expressing breast milk

Expressing breast milk can take 20-30 minutes or longer to start with, but it gets quicker with practice. First tell the mother to wash her hands and her breasts with soap and water, and dry them with a very clean towel. Then prepare a cleaned and boiled cup or jar with a wide opening. If she is unable to boil the whole container, pour some boiling water into it and leave it there until just before she is ready to put milk into it; then pour the water away. This will keep the milk safe from bacteria.

The mother should sit comfortably and lean slightly towards the container. Show her how to hold the breast in a ‘C-hold’ (her hand is shaped like a big letter C; Figure 8.2a). Press the thumb and fingers back toward the chest wall (Figure 8.1b), then role the thumb forward as if taking a thumb print, so that milk is expressed from all areas of the breast. Express the milk from one breast for at least three to four minutes until the flow slows and then shift to the other breast. Thinking about feeding her baby while she expresses her milk may help the milk to flow out more easily.

Breastmilk being expressed by hand from the breast.
Figure 8.2  Expressing breast milk (a) Hold the breast in a C-shaped grip; (b) roll the fingers and thumb backwards and then forwards so milk spurts from the nipple into a sterilised container.

Important! Expressed breast milk that cannot be kept cool, or that is stored for more than six hours, should be thrown away

Breast milk can be saved at room temperature for up to six hours if the room is not very hot and the milk is stored in a sterilised container. Or it can be stored for longer in a refrigerator, if the mother has one. Wherever it is stored the milk must be warmed to body temperature before it is fed to the baby. To warm up the stored breast milk, put the container to stand for a while in a bowl of warm water. Never boil breast milk! Boiling destroys nutrients and antibodies.

8.3.2  Tips to help a mother breastfeed a preterm or low birth weight baby

8.3.4  Show mothers how to cup feed the baby