Expressing breastmilk & storing breastmilk

Expressing breastmilk and storing breastmilk: the basics

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

You might want to express your breastmilk because your breasts feel swollen or engorged or because you want to have some breastmilk stored in the fridge or freezer for using later.

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.

Different women can express different amounts of breastmilk. It depends on many things, including your body, your baby’s last feed, your baby’s age and 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.

There are three ways to express:

by hand
with a manual pump
with an electric pump.

Most mums find expressing breastmilk easier if they’re in a comfortable, private place. Get yourself relaxed and comfortable, and have a glass of water handy to drink. Give yourself plenty of time too – especially when you’re first learning to express.

Expressing breastmilk by hand

Here are the basic steps for expressing breastmilk by hand.

Getting ready to express breastmilk by hand

Wash your hands with soap and warm water.
Gently massage your breast. Start from the top of your breast and stroke towards your nipple. Massage the underside of your breast too. Do this several times to ensure the whole breast is massaged. This improves your let-down reflex.
Place a clean plastic dish or a wide bowl under your breast, either between your legs or on a low table, leaving both your hands free. You might need a clean towel on your lap to catch any spills or to wipe slippery, wet fingers.

Expressing by hand

You can support your breast with one hand if you have large and heavy breasts.
Place your thumb and finger directly opposite each other, either side of and well back from your nipple.
Gently press 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 fingers to a different position around the nipple and press again. This expresses more milk and empties all sectors 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.

Just as with hand-expressing, the first step in expressing breastmilk with a manual pump is getting yourself relaxed and comfortable. This helps get your let-down happening in whatever way works for you. Gentle massage as described above is a good idea too.

Here are the next steps, when you’re ready:

Place the breast shield of the pump 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.
Pump until your milk flow stops.
Switch to the other breast. You can go back and forth several times.

Expressing breastmilk with an electric pump

Electric breast pumps are much like manual pumps, except that you don’t have to do the pumping yourself. Attach the breast shield to your breast (or breasts, in the case of double pumps).

As with expressing breastmilk by hand or by manual pump, get comfortable and relaxed to start. This helps with your let-down.

Here are the next steps, when you’re ready:

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.

You can often get more milk by hand-expressing after the flow with the pump has stopped.

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 the electric pump.

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 give you information to 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 stuff.

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
You can store breastmilk:

at room temperature (26ºC or lower) for 6-8 hours
in the fridge (4ºC or lower) for up to 72 hours – the best spot is the back of the fridge where it’s coldest
in the freezer compartment (-15ºC or lower) inside a fridge for two weeks
in the freezer section (-18ºC or lower) of a fridge with separate door for three 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)
You can store breastmilk:

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

Do not refreeze previously frozen breastmilk.

Breastmilk thawed outside the fridge in warm water
You can store breastmilk:

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

Do not 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.

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 four 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.

Gently swirl the bottle or container, and test the temperature of the milk before feeding your baby. The temperature should be lukewarm or around body temperature. Some babies don’t mind it if you feed them milk that’s 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.

Cleaning expressing equipment

All manual breast pump parts and detachable parts of electric breast pumps that come into contact with breastmilk need to be thoroughly washed and stored in a clean, closed container after each use. Check the manufacturer’s instructions for information on how to pull apart your breast pump.

Wash the breast pump parts in a clean wash basin using warm soapy water and rinse well. Do not place the pump parts directly in the sink. Air-dry parts or dry parts with clean paper towel. Store covered until next use. Clean the wash basin and bottle brush well.

Baby bottles, teats and storage containers for breastmilk should be thoroughly washed, rinsed and then sterilised before use until your baby is 12 months old. You can read more about cleaning and sterilising bottle-feeding equipment.

This information applies to normal 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.