By Dr Ananya Mandal, MD
Some mothers are unable to breastfeed their babies directly. These mothers can also feed their babies on breast milk using milk that is pumped out of the breasts.
Regular and frequent pumping and emptying of the breast ensures a continuous supply of breast milk for the baby and ensures a continuous flow and manufacture of milk within the mother’s breasts.
Some precautions and pointers for mothers who pump breast milk include:-
Maintenance of good hygiene
Normal breastfeeding allows the baby to take milk directly from the breast and there is no need for sterilization. For mothers who pump breast milk there is a risk of contamination.
Mothers need to wash their hands before pumping. The area where they are expressing should be clean. Toilets are not good places to express breast milk especially for working mothers.
After pumping the pumping equipment needs to be washed and sterilized.
Breastfeeding and the milk ejection reflex sometimes need emotional cues. For beginning of milk to flow sometimes closeness to the baby or even a picture of the baby helps.
An item of the baby’s clothing with his or her scent in it or the baby’s blanket may help the milk to start to flow when expressing breast milk away from the baby (for example at work).
Sometimes gentle, warm, moist compress over the breast or a little massage may get the milk to flow. The main prerogative for expressing breast milk is to remain relaxed in a calm setting.
Manual or mechanized breast pumps
Milk may be expressed using manual or mechanized breast pumps. Electric breast pumps can provide most efficient pumping. They require minimal effort, can relieve both breasts at once and provide rapid emptying.
Hospital-grade electric pumps may be rented from a lactation consultant at a local hospital or from a breastfeeding organization.
Storage of breast milk
Pumped breast milk is stored in clean glass or hard BPA-free plastic bottles with tight-fitting lids. Milk storage bags may also be used to stored expressed breast milk. Disposable bottle liners or other plastic bags should not be used to store breast milk.
After each pumping the date and time should be labelled on the container. The child’s name needs to be mentioned if the milk is given to the childcare provider.
Refrigeration of breast milk
After expressing the milk the container should be refrigerated or chilled immediately. Milk can be stored in small 2 to 4 ounce packs for later use.
After the milk is completely frozen the lid should be tightened on the container. At least an inch or so must be left on top of the level of the milk to allow it to expand while freezing. In the fridge the milk should be stored at the back of the freezer and not at the door.
For thawing the milk before use there are several ways and some precautions. The oldest expressed milk needs to be given first.
Breast milk does not need to be warmed. It can be served at room temperature or be given cold. If the milk is frozen, it can be thawed by leaving the tightly lidded container in warm running water.
Breast milk should never be warmed in a microwave. Microwave can over heat the milk causing burns and more importantly may damage some of the beneficial nutrients, antibodies and cellular components of the breast milk.
Swirling the milk
Before feeding from a container the container needs to be swirled gently to mix the cream of the milk that may have risen to the top. Shaking the milk is not recommended as it may break or damage some of the cellular components of the milk.
Temperature may be tested by dropping a few drops of the milk into the inner skin over the wrist. It should be comfortably warm. Thawed breast milk should be used within 24 hours. Thawed milk should not be refrozen.
Reviewed by April Cashin-Garbutt, BA Hons (Cantab)