Expressing or squeezing milk from the breasts is a common practice for many breastfeeding mothers. In the first few days after giving birth, squeezing milk can help stimulate milk production and relieve engorgement. Later on, mothers may squeeze milk to obtain milk for storage or bottle feeding. There are safe and effective techniques for squeezing breast milk, as well as some precautions to take.
When to squeeze breast milk
There are several situations when squeezing or expressing breast milk may be recommended or desired:
- In the first few days after delivery when the breasts are engorged and painful. Squeezing some milk can provide relief.
- To stimulate milk production and establish breastfeeding in the early days with a newborn.
- To remove a small amount of milk before breastfeeding to soften the areola and help the baby latch on.
- To get milk flowing if the let-down reflex is slow.
- To empty the breasts if needed for comfort or to increase milk supply.
- To obtain milk for storage and later bottle feeding.
- If separated from the baby, to maintain milk supply by expressing regularly.
- If the baby is unable to effectively empty the breasts.
- To donate or sell breast milk.
Squeezing milk can be done occasionally or frequently depending on the reasons for expressing milk. A pump may or may not be required along with hand expression.
Technique for squeezing breast milk
Hand expression requires no equipment and can be done anytime, anywhere. With the proper technique, many mothers can effectively express milk from their breasts. Here are some tips for effective hand expression of breast milk:
- Have a clean container ready to collect the milk.
- Wash hands thoroughly before expressing milk.
- Massage the breast gently to stimulate milk flow. Stroke from the chest wall toward the nipple using the flats of your fingers.
- Position the thumb and first finger about 1-2 inches behind the nipple. The fingers should be opposite each other, like the shape of a “C”.
- Press back toward the chest wall. Then compress the thumb and finger together to squeeze the milk ducts beneath the areola between them.
- Avoid sliding the fingers along the skin, which can cause friction.
- Squeeze and release in a rhythmic pattern, avoiding excessive force.
- Rotate around the areola to ensure all ducts are compressed.
- Express one breast for 3-5 minutes until flow slows, then switch to the other side. Alternate breasts until empty.
- Express milk from the bottom, sides then top of breast to ensure thorough emptying.
It may take some practice to get the hand position and squeezing pressure right. At first, only drops may be produced, but the milk should start flowing with repeated compression. Contact a lactation consultant if having difficulty with hand expression technique.
Tips for effective milk expression
Besides good technique, there are some other tips that can help ensure adequate milk extraction when squeezing the breasts:
- Have a photograph of the baby nearby to aid with let-down.
- Apply warm compresses to the breasts before expression.
- Massage and gently shake the breasts while expressing.
- Try leaning forward to utilize gravity.
- Express milk in a quiet, relaxing environment.
- Gently roll the nipple between expressions to keep milk flowing.
- Pump after finishing hand expression to ensure complete emptying.
Mothers should notice an increase in the amount of milk obtained over several sessions as the technique improves. Always contact a lactation consultant with any concerns when expressing breast milk by hand.
Precautions when squeezing breast milk
While expressing breast milk can be beneficial, there are some precautions mothers should take as well:
- Avoid excessive force, which can cause breast trauma.
- Do not squeeze the nipple itself, only the breast.
- Watch for any cracks, bleeding or severe pain.
- Alternate between breasts to avoid overemptying one side.
- Limit expressing sessions to 10-15 minutes per breast.
- Only express 1-2 times per day until milk supply is well established.
- Clean equipment and wash hands thoroughly before and after expression to avoid infection.
Squeezing milk too forcefully, for too long, or too frequently can lead to problems like sore nipples, blocked ducts, mastitis and oversupply. Always follow medical recommendations for when and how often to express breast milk.
Storing expressed breast milk
Breast milk that is squeezed or pumped should be collected and stored properly to preserve its nutritional and immunological properties. Here are some guidelines for storing expressed breast milk:
- Collect milk in a clean, BPA-free container made for breast milk storage.
- Date the milk container and use the oldest milk first.
- Fresh milk can be stored at room temperature (up to 77°F) for 4 hours.
- Store refrigerated milk at back, not door, of refrigerator for up to 4 days.
- Milk can be frozen for up to 6 months in a deep freezer at 0°F.
- Avoid storing milk in the door of refrigerator or freezer.
- Leave space at top of container for milk to expand when freezing.
- Cool freshly expressed milk before adding to already cooled/frozen milk.
Properly stored milk maintains most nutrients and antibodies to help feed the baby even when separated. Always use clean technique when expressing and storing breast milk.
Using a breast pump
A breast pump is a device that uses suction to express milk from the breasts. Pumps can range from manual hand pumps to electric pumps. Reasons mothers may choose to use a pump include:
- Increase milk supply
- Build a stash of milk for later use
- Relieve engorgement
- Allow someone else to bottle feed breast milk
- Maintain supply when away from baby
- Express when hand expression is difficult
Electric pumps are more efficient at removing milk from the breast than manual pumps. They allow the mother to express milk from both breasts simultaneously. Options include single and double electric pumps, battery operated or plug-in models.
Tips for using a breast pump
- Ensure flange size fits nipple and areola without rubbing.
- Use massage and warm compresses before pumping.
- Pump after or between breastfeeding sessions.
- Start on low suction setting and gradually increase as milk flows.
- Double pumping yields more milk in less time.
- Pump until flow slows then switch breasts and repeat.
- Aim for 10-15 minutes per breast when pumping.
Using a properly fitted pump after priming the breasts can result in complete emptying. Always follow manufacturer’s directions for pump assembly, cleaning and use.
Reasons for difficulty expressing milk
Some mothers encounter challenges with squeezing or expressing breast milk. Common reasons include:
- Poor flange/breast fit with pump
- Infrequent pumping
- Insufficient breast massage and compression
- Breast anatomy making expression difficult
- Stress inhibiting let-down reflex
- Hormonal problems like thyroid dysfunction
- Breast surgery such as reduction or implants
- Pumping too early before milk supply is established
- Overuse of artificial nipples causing nipple confusion
Trouble expressing can be frustrating for breastfeeding mothers. Seeking help from a lactation consultant and trying different techniques may improve results. Sometimes medical treatment is needed if hormonal or breast issues are involved.
Alternatives to squeezing breast milk
If squeezing or pumping breast milk is not working well, there are some alternative options to consider:
- Supplemental nursing system (SNS): Allows supplementing at the breast using formula or donated milk.
- Cup feeding: Use small cups to feed expressed milk or supplement.
- Finger feeding: Use a small tube and syringe to supplement at breast.
- Donor milk: Milk bank provides pasteurized donor human milk.
- Wet nursing: Another woman directly breastfeeds the baby.
- Relactation: Regaining milk supply after weaning.
Before supplementing, consulting an IBCLC can help determine if restoring a mother’s own milk supply is possible. Support is available when expression fails and alternatives are needed.
Conclusion
Expressing breast milk by hand or pump can provide many benefits to breastfeeding mothers. Proper technique, massaging the breast, using warm compresses, and relaxing the body can help facilitate let-down and milk removal. Milk obtained can be fed to baby by bottle or used to maintain supply when apart. While usually simple and safe, expressing breast milk does require some precautions to avoid complications. Reach out for help from lactation professionals if any difficulties arise with expressing the quantity of milk desired.