How to hand express (pump) milk to feed infants who are unable to breastfeed

By: - 22nd August 2019
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All babies from their first cry are dependent on breast milk from their mum, but there can be several instances where a newborn infant is unable to drink milk directly from their mum’s breast. Some reasons for this are:

  • The nature of the breast / nipple (op 2 - deformities in the breast/nipple)
  • The infant hasn’t matured sufficiently or is sick
  • Colostrum (first form of milk) that is expressed in the first few days is too thick
  • Mum or infant is admitted to intensive care
  • Milk-clotting due to increased milk production in the breasts
  • The infant is not gaining enough weight
  • Where milk production is less (in this situation you should express milk only after the baby has finished feeding)
  • When mum needs to stop breastfeeding because of a wound in a nipple or due to any lumps in the breasts that have been caused by blocked milk ducts (in order to allow time to heal or to prevent further aggravation).
  • Where mum starts to work
Expressing milk: All you need to know!

If you are facing any of the above situations, you will need to learn how to express (pump) breast milk and feed your infant. It is important to note that even if your infant is unable to suck milk, you still need to ensure continuous milk production in your breast. To do this, pumping milk is essential. Upon your doctor’s advice, public health midwife will help you to express milk by showing you how it needs to be done. Initially, this might seem like a tough task, however with the proper training, it will become a simple and easy task you do for your little one' You will need to allocate roughly 20-25 minutes for this. Freshly expressed or pumped milk can be kept in normal room temperature for 6 hours, or in the fridge for 24 hours. It can be frozen and stored safely in the freezer for 3 months.

If you are pumping milk by hand, you should make ready a stainless-steel cup which has a wide opening. Ensure it has been kept in boiling water for 10 to 15 minutes. However, after boiling the cup you need to ensure that it has cooled down before expressing milk into it, since heat can damage the nutrients in the milk.

The amount of milk your baby will require will vary based on their needs. If possible, try to maintain separate cups to store milk in advance for feeding sessions as it could be more convenient for you. In the first few days, you will only be able to extract a few drops of colostrum for a feeding session, therefore you will only need a small cup or even a tablespoon to collect the breast milk.

Milk pumping: A step by step guide
  • First, wash your hands and make sure they are clean.
  • Sit down in a comfortable position where you will be able to express milk from your breast to a cup easily.
  • Bring the cup close to the nipple.
Now you are ready to start pumping milk.
  • The mum’s palm should be kept under the breast.
  • The thumb should be kept slightly on top of the areola while the other fingers should be kept under the breast.
  • Now start messaging your breast (ensure that you are not pulling your breast up and down). After the first drops come out the rest will start flowing.
  • Once the milk flow reduces in the breast you should now switch breasts. By doing so you will be able to extract enough milk for your little one.
  • Don’t forget to drink 2 to 3 glasses of water once you have pumped milk.
  • If you have limited time or facing difficulties to express milk with your hands, you could use a milk pump to do the same.

As you can see, none of the points mentioned at the start of the article should be a reason to deny your little infant breast milk. Through proper planning, patience and focus you will be able to manage whatever situation so that your baby will still reap the benefits of consuming breast milk. It will be helpful if you can get help from your husband or another family member to help make you comfortable during this time.

An article compiled by Dr Mahesh Kumbukage, Practitioner of Public Health at the Ministry of Health.

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