Expressing breastmilk & storing breastmilk

Expressing breastmilk: the basics

Expressing breastmilk is when you take milk out of your breast.

Expressing and feeding from a bottle or cup can be handy. You might want to express your breastmilk because you:

are separated from your baby – for example, if your baby is in hospital or you’re at work
have swollen or engorged breasts and need to relieve discomfort
have a blocked milk duct or breast inflammation
are sick and don’t feel well enough to breastfeed
want to store breastmilk in the fridge or freezer.

Some women find it easy to express, and other women find it more difficult. It can sometimes take a while to learn how to express.

Women express varying amounts of breastmilk. It depends on many things, including your body, your baby’s last feed and your baby’s age. It can also depend on how often you express.

If you can’t express much (or any) milk, check with your midwife, child and family health nurse or lactation consultant to make sure you’re expressing correctly.

An Australian Breastfeeding Association (ABA) counsellor can also help – phone the National Breastfeeding Helpline on 1800 686 268 or use ABA LiveChat.

It’s recommended that you breastfeed if you can, and express only when you really need to.

Getting ready to express breastmilk

Here’s how to get ready to express breastmilk.

Give yourself plenty of time, especially when you’re still learning how to express.
Wash your hands with soap and warm water. Dry your hands with a clean towel.
Have a glass of water handy to drink. You might get thirsty.
Have a clean towel handy to catch spills or wipe slippery, wet fingers.
Get relaxed and comfortable in a private, quiet place.
Encourage your let-down reflex. You can do this by gently massaging the top and underside of your breast several times. Or put a warm washcloth or heat pack on your breast.

There are 3 ways to express breastmilk – by hand, with a manual pump, or with an electric pump.

Expressing breastmilk by hand

Here are the basic steps for expressing breastmilk by hand.

Place a clean plastic dish or a wide bowl under your breast, either between your legs or on a low table. You can express into the dish or bowl and leave both your hands free. If your back gets tired, move into a more comfortable position.
Support your breast with one hand. This can be good if you have large and heavy breasts.
With the same hand, place your thumb and finger directly opposite each other, either side of and well back from your nipple, near the outside of the areola.
Gently press back and inward towards the centre of the breast, until you feel the bulk of the breast. Expressing shouldn’t hurt.
Gently press finger and thumb towards each other using a rhythmic rolling movement. This will compress the ducts, and milk will flow out of your nipple. There might be only drops until your let-down reflex happens. After this, you should get sprays from the nipple with each squeeze.
Once the milk flow slows, move your thumb and finger to a different position around the areola and press again. This expresses more milk from all sections of the breast. Change hands if your fingers get tired.
Repeat the process on the other breast. Expressing milk can be tiring, so stopping for a drink of water might help you relax before you start again.
If you need more milk, change from breast to breast, or wait and try again later.

Expressing breastmilk with a manual pump

Manual breast pumps usually consist of a breast shield attached to a pump handle and collection bottle or container.

Here are the steps for expressing with a manual pump:

Check that the breast shield is the right size. You’ll know it’s right if your nipple and a small amount of your areola fit comfortably in the shield.
Place the breast shield directly over your breast with your nipple centred.
Squeeze the pump handle gently and rhythmically. You might see only drops of milk until your let-down happens, and then it’ll spray.
Gently massage your breast with your free hand to increase your milk flow when it starts to slow.
Pump until your milk flow stops. This helps you collect the fattier milk that’s released towards the end.
Switch to the other breast. You can go back and forth several times.

Manual pumps are good if you express only now and then, but electric pumps are better for long-term use. That’s because electric pumps are more efficient than manual pumps at removing milk.

Expressing breastmilk with an electric pump

Here are the steps for expressing with an electric pump:

Check that the breast shield is the right size. You’ll know it’s right if your nipple and a small amount of your areola fit comfortably in the shield.
Place the breast shield of the pump directly over your breast with your nipple centred.
Start with low suction and increase it to a level that’s comfortable for you.
Pump until your milk flow stops.
If you’re using a single pump, switch to the other breast. You can go back and forth several times.
Try hand-expressing after the flow with the pump has stopped. You can often get more milk.

You can buy or hire electric breast pumps. The ABA hires them out, as do some pharmacies. You’ll need to buy your own pump kit to attach to a hired electric breast pump machine. Pump kits include breast shields, collection containers, connectors and tubes.

You might come across wearable electric pumps. These pumps are small, lightweight and portable. Wearable pumps might not always remove milk well enough to maintain your supply. It’s best to use a wearable pump only occasionally and once you have a good milk supply.

There are many manual and electric pumps on the market. If you’re interested in using a pump to express, it might be a good idea to speak with your child and family health nurse or an ABA counsellor. They can help you choose the right pump for your needs.

Storing expressed breastmilk

After you’ve expressed, put your breastmilk into a clean, closed container or a special breastmilk storage bag. You can buy storage bags from your pharmacy or other shops that sell baby equipment.

It’s best to refrigerate or freeze breastmilk after expressing. Don’t forget to write the date of expressing on the storage container or bag before you refrigerate or freeze the breastmilk.

If you’re adding fresh breastmilk into the same container or bag as other chilled or frozen breastmilk, cool the fresh breastmilk in the fridge first. The date on the whole container or bag should be the date when the oldest breastmilk was expressed.

The guidelines below explain how long you can store breastmilk at different temperatures and when you should use stored or frozen breastmilk.

Freshly expressed breastmilk
Store:

at room temperature (26ºc or lower) for 6-8 hours
in the fridge (5ºc or lower) for up to 72 hours – at the back of the fridge where it’s coldest
in the freezer compartment (-15ºc or lower) inside a fridge for 2 weeks
in the freezer section (-18ºc or lower) of a fridge with a separate door for 3 months
in a chest or upright deep freezer (-20ºc or lower) for 6-12 months.

Previously frozen breastmilk – thawed in the fridge but not warmed
Store:

at room temperature (26ºc or lower) for 4 hours or less – that is, until the next feed
in the fridge for up to 24 hours – at the back of the fridge where it’s coldest.

Don’t refreeze previously frozen breastmilk.

Previously frozen breastmilk – thawed outside the fridge in warm water
Store:

at room temperature (26ºc or lower) until the end of the feed
in the fridge for 4 hours or until the next feed.

Don’t refreeze previously frozen breastmilk.

If your baby doesn’t finish their feed of expressed breastmilk, you can’t use it for another feed. You should throw it away. Offering small amounts of expressed breastmilk at a time might help to reduce wastage.

Transporting expressed breastmilk

You can transport expressed breastmilk between home and other places. Expressed breastmilk can travel:

in an insulated container like an esky or cooler bag with one or more freezer bricks
either frozen or fresh – if the milk has thawed, use it within 4 hours and don’t refreeze it.

Place the labelled breastmilk in the fridge as soon as you arrive or in the freezer if it’s still frozen.

Preparing expressed breastmilk for use

You can give your baby expressed breastmilk with a cup, spoon or bottle. Warm your container of breastmilk by placing it in warm water. Use fresh breastmilk first if you have some, but if you’re using frozen breastmilk, you can thaw it by placing it in either cool or warm water.

Test the temperature of the milk before feeding your baby. The temperature should be lukewarm or around body temperature. Some babies don’t mind milk that has been thawed but not warmed.

Don’t use a microwave oven to thaw or warm the milk, because this destroys some of the components of breastmilk. It can also result in hot spots, which can burn a baby.

You might notice that expressed and stored breastmilk has a surface layer of fat, with lighter milk underneath. This is normal. You can gently swirl the bottle or container after warming to mix the fat through.

Cleaning expressing equipment

Before use, clean all breast pump parts and storage containers used to collect and store breastmilk. You don’t need to clean sterile expressed breastmilk bags or new plastic bags before use.

Here’s how to clean your expressing equipment:

If your water supply is different for drinking and washing, use drinking water to clean your expressing equipment.
Check the manufacturer’s instructions to find out how to pull apart your breast pump.
Wash your hands well, and dry them with a clean cloth or paper towel.
Take apart your breast pump and rinse with cold water to remove any milk.
Wash all equipment well in hot water and detergent. Scrub with a brush that you use only for cleaning this equipment.
Rinse equipment at least twice in hot water.
Place equipment upside down on a clean cloth or paper towel, and cover it with another clean towel while it dries.
If there’s any water left on the equipment, dry the equipment with a clean cloth.
Store the dry equipment in a clean, closed container or plastic bag until next use.

If you and your baby are well, you don’t need to sterilise expressing equipment after cleaning.

If your baby is aged under 12 months and you’re using bottle-feeding equipment or a cup to give them expressed breastmilk, you do need to sterilise this equipment after cleaning. You can read more about cleaning and sterilising feeding equipment.

This information applies to healthy babies being fed their own mother’s breastmilk. If your baby is premature or sick, the health professionals caring for your baby will tell you what to do.