Tips for expressing and storing breast milk

Breast milk requires special care that all mothers should know

Tips for expressing and storing breast milk

With information extracted from the monograph Breastfeeding: Guide for Professionals, of the Breastfeeding Committee of the Spanish Association of Pediatrics.

Knowing the possibility of expressing the milk to give it to the baby later is essential to maintain breastfeeding in certain cases and is of great help to the mother in specific circumstances.

The effective expression of breast milk is not difficult but it should be taught to mothers because it requires their technique


Breastfeeding and return to work

Many mothers do not know that they can express their own milk and keep it so that someone can give it to the baby when they are away. The mother should start expressing her milk two weeks before going to work to practice and store some milk. Then, if you express it at work, the milk can be stored at room temperature until you get home or in a small cooler.

The effective expression of breast milk is not difficult but it should be taught to mothers because it requires their technique . The ability to express milk is learned, and with time and practice it is perfected. In principle, all breastfeeding mothers should be instructed because it can be useful at various times throughout the breastfeeding period.


In what cases can it be useful?

This technique may not only be necessary to feed the baby with our milk when we have to be absent for work, but also in other circumstances in which the mother must separate from the baby such as trips, surgical interventions, etc.

In addition to obtaining food from our child , it serves to prevent or reduce breast engorgement in circumstances in which the baby cannot express milk for a few hours. It is also useful to maintain or increase milk production when we have to travel often or when we take medication that can pass to the baby through milk and we have to go a few days without offering milk.

It is essential to feed premature infants , to increase the amount of milk in low-weight babies, or to stimulate milk production when the baby does not breastfeed efficiently.

The expression of milk should never be used as an indicator of the amount of milk because, especially at the beginning and while the mother is trained in the technique, the amount of milk expressed by her will be much less than the amount that the baby would express. This could make the mother think that she does not have enough milk and lead her to give up breastfeeding. The mother needs to know that in the first extractions the amounts of milk will always be low . Experience and peace of mind when expressing will produce more adequate emptying and larger amounts of milk.


How can you express your milk?

The milk can be expressed manually or with breast pumps , which in turn can work mechanically or electrically. The manual removal is the most widely used method because it does not require any device and any mother can do it anywhere in the world. However, learning is necessary to be effective and it is somewhat laborious. The mechanical breast pump can be of several types: lever, piston or knob (not advised) and actuates the hand of the mother. Electric breast pumps do the pumping themselves and are faster , but they are also more expensive.

Before the extraction, the mother should be relaxed, and that the environment is suitable, that she looks for a quiet and comfortable place. It helps the extraction to gently massage the chest, breathe deeply and relax and listen to calm music. It also helps to look at a picture of the baby or smell his clothes.

The extraction techniques have their steps, which are very easy to learn and apply, but you have to know . Here it would be very extensive to explain why it is advisable that mothers and future mothers who do not know them contact their Health Center where they can advise them.


The best time to express milk

It is best to do it after the baby suckles or 20 minutes later , or at peak production times that vary for each woman. But most of the time you get the most milk in the morning when you wake up. Ideally, do it afterwards every 3 hours so that the breasts do not become engorged, so you should be able to express your milk at work, but if you cannot, you should take advantage of the time you are at home to do it.

How long should the extraction take?

It may take a minute or two for the milk to start coming out . If pumps are used, they should be held for 15-20 minutes on each breast . If the extraction is manual, it usually takes about 30 minutes. We must be guided more by time than by quantity, especially at the beginning when the quantity of milk will be less, since it will increase as we increase the frequency of extraction.

In what containers can we keep the milk?

The milk should be expressed in clean and hermetically sealed containers and, if possible, sterilized. And if storage is desired, the containers must be labeled with the date and time of extraction.

It appears that materials affect milk differently . The polypropylene can decrease the content of lysozyme and lactoferrin , but does not affect micronutrients or leukocytes and packaging glass reduce the level of leukocytes which are adhered walls. In any case, these two materials are recommended for being the most innocuous. PVC should not be used because it can exchange toxic molecules with milk fat . And polyethylene is discouraged (plastic bags) especially for premature babies, because it reduces secretory IgA levels by up to 60%, in addition, its handling is difficult, can easily break and must be stored in hard containers to protect them from breakage and refrigerator odors or freezer.

Thus, the most advisable are hard glass or polypropylene containers . They should be covered with hard caps and not with nipples that isolate less from bacterial contamination and protect less against oxidation of the milk.


How long can the milk be stored after it is expressed?

The milk can be stored at room temperature if it is to be used in a few hours, or it can be refrigerated or frozen. Ideally, store it in small amounts of 50 to 100 cc in each container to handle each time only the one that is going to be consumed.

Milk can be kept

– At room temperature:

At 15 ° C: 24 hours.

At 19-22 ° C: 10 hours.

At 25 ºC: 4 to 6 hours.

Between 30 and 38ºC: 4 hours

– Refrigerated in fridge:

Between 0 and 4 ºC: from 5 to 8 days.

– Frozen :

In a freezer within the same refrigerator: 2 weeks.

In a freezer that is part of the refrigerator but with separate doors (combi type): 3-4 months (because the temperature varies when the door is opened with a certain frequency).

In a separate commercial freezer at -19ºC: 6 months or more.


How should breast milk be thawed and warmed?

It is best to remove it from the freezer the night before and leave it in the fridge. It can be given within 24 hours after thawing. If it is needed at the moment, it is advisable to defrost it under running hot water from the tap or leaving it in another container with hot water.

It should never be thawed or heated with the microwave because it would cause the denaturation of some proteins and the inactivation of some vitamins. Nor should it be boiled because it would have the same consequences.

To heat it, once defrosted, you have to shake the milk gently to homogenize its texture again and then heat it in a water bath or under hot tap water. Once heated, it should be given to the baby and discarded the excess.

Some mothers may notice that their milk has a musty odor when thawed . This is due to the action of lipase. To prevent this, you can heat the milk until you see that foam begins to form around the edges of the container and then allow it to cool and freeze. Once it has a musty odor, nothing can be done to remove it. There is no evidence that this stale milk is harmful to the baby, but most reject it.

Know more

Mothers may appreciate that chilled or frozen milk can settle in layers of different colors, this being completely normal. Milk that has been in the refrigerator for up to two days can be frozen; if it has been for more than 2 days and less than 5 days it can be given to the baby but it should not be frozen.

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