Expressing breast milk

You can express (remove) milk from your breasts by hand or using a breast pump. If you need to be away from your pēpi, you can express and store milk to feed to them later.

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When to express breast milk

You might want to express milk:

  • if your pēpi is in the neonatal unit and unwell, premature or small
  • after breastfeeding to give extra breast milk to pēpi later
  • if you have to be away from your baby — for example you are going back to work or your baby is in hospital
  • if your baby is not able to latch or suck well yet, but you still want to give them breast milk
  • if someone else is going to help with feeding your baby
  • to help your milk production increase — removing milk often will help more milk to come
  • to soften the area around the nipples (areola) to help with deep latching.

If you are separated from your pēpi, or your pēpi is not feeding for some reason, it is important to express milk to keep up a good milk supply. This includes when they are first born.

  • Express within the first hour of them not feeding.
  • Continue to express 8 times in the first 24 hours, including one time over night.

Do not have a break longer than 6 hours in a 24-hr period.

Using a breast pump

If you use a breast pump:

  • it is best to use an electric pump
  • choose the correct sized breast shield — the recommended size is the smallest size that you find comfortable
  • pump after breastfeeding for 10 to 20 minutes maximum
  • do not suddenly stop using a breast pump — slowly cut down the volume and frequency over a few days.

Types of breast pump

If you will be using a breast pump long term and often, it is best to rent or buy a heavy-duty closed system pump. Rental pumps are cleaned and sterilised between users.

In some situations, Work and Income (WINZ) may help you buy a breast pump. Ask your midwife, healthcare provider or lactation consultant for more information.

If you are using a pump only occasionally, a smaller electric pump should be suitable. This might be if you need to express milk to try to increase your milk supply.

If you need the pump for a short time, such as if you have painful or damaged nipples, a hand pump is usually enough. Or you can hand express.

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There are many different types of breast pumps including single user and heavy duty pumps. Talk to your midwife or lactation consultant about what kind of pump will best suit you and what brands are effective and reliable. Many of the cheaper pumps do not work well.

Single user pumps are available to buy at many pharmacies and some baby stores.

Heavy-duty pumps are available to buy or hire from some baby stores, pharmacies and lactation consultants. If hiring, there will be a weekly or monthly hire charge. You will also need to buy a personal pumping kit with items such as:

  • breast shields
  • collection containers
  • tubing.

Ask your midwife or lactation consultant for advice about local suppliers of heavy duty pumps.

When you are expressing with a pump, you will also need a well-fitting breast shield. A shield that does not fit properly can create friction around your nipple. This can cause nipple damage and prevent you from getting milk out effectively.

To apply a breast shield:

  • centre your nipple carefully in the opening
  • switch the pump on and increase the suction to a level that is comfortable for you.

While you are pumping, your nipple should move freely in the shield tunnel. You should see rhythmic movements and milk flowing from your nipple.

Pumping should be comfortable and pain-free. If it is not comfortable, check these things.

  • If your nipple is not moving and looks squashed in the shield tunnel, you might need a larger breast shield.
  • If your nipple and a large amount of the area around it (areola) are being pulled into the shield tunnel during pumping, you might need a smaller shield.
  • Turning the suction up high does not necessarily mean that you will get more milk out. The suction should be set at a level that expresses milk while being comfortable for you.

How to hand express breastmilk

If you are expressing colostrum in the first 2 to 3 days after birth, it is usually better to do this by hand. Colostrum is too thick for breast pumps to remove effectively.

You may also find it works well to express by hand if you need to remove milk between feeding.

When you hand express, sometimes it takes a while for your milk to start flowing. Try to choose a time when you feel relaxed. Having your baby (or a photo of them) nearby may help your milk to flow. Keeping skin-to-skin contact while hand expressing or before can help release oxytocin and aid milk flow.

1

Wash your hands

First wash your hands. Get a clean container such as a breast milk bag or small bottle to hold your breastmilk.

1

Wash your hands

First wash your hands. Get a clean container such as a breast milk bag or small bottle to hold your breastmilk.

2

Get comfortable

Get comfortable – preferably in a warm, quiet room where you can relax undisturbed. Place the container within easy reach.

2

Get comfortable

Get comfortable – preferably in a warm, quiet room where you can relax undisturbed. Place the container within easy reach.

3

Massage your breasts

Start by making sure your hands are warm. Use long strokes from your armpit, working towards your nipple.

3

Massage your breasts

Start by making sure your hands are warm. Use long strokes from your armpit, working towards your nipple.

4

Start to express

Cup your breast in a C-shape using your finger and thumb (2cm to 3cm back from your nipple). Your finger and thumb should be opposite each other – if you imagine that your breast is a clock, your thumb would be at 12 o'clock and your finger at 6 o'clock. Then gently press your thumb and fingers together, release your fingers and repeat in a rhythmic movement. It may take a few minutes. Your breast milk (or colostrum) will start to slowly drip out. Keep going to build up a rhythm.

4

Start to express

Cup your breast in a C-shape using your finger and thumb (2cm to 3cm back from your nipple). Your finger and thumb should be opposite each other – if you imagine that your breast is a clock, your thumb would be at 12 o'clock and your finger at 6 o'clock. Then gently press your thumb and fingers together, release your fingers and repeat in a rhythmic movement. It may take a few minutes. Your breast milk (or colostrum) will start to slowly drip out. Keep going to build up a rhythm.

5

Repeat the process on the same breast

When you notice your milk flow slowing down, move your hands around your breast so you are expressing from a different area. Position your finger and thumb at 11 o'clock and 5 o'clock and repeat the process.

5

Repeat the process on the same breast

When you notice your milk flow slowing down, move your hands around your breast so you are expressing from a different area. Position your finger and thumb at 11 o'clock and 5 o'clock and repeat the process.

6

Repeat on the other breast

Once you have expressed as much as you can from one breast, repeat the process on the other. Then move back to the first breast.

6

Repeat on the other breast

Once you have expressed as much as you can from one breast, repeat the process on the other. Then move back to the first breast.

Storing breastmilk

You can store milk in either a:

  • breastmilk bag
  • glass or BPA-free plastic container with an airtight lid.

If you plan to take the milk away from your home, include the name of your pēpi on the label. 

Avoid any clear, hard, plastic bottles or containers that do not have a recycling number on the bottom. Avoid containers with the numbers 3, 6 and 7. You can buy BPA‑free bottles, or use glass bottles or breastmilk bags.

Store milk in amounts from around 60 ml to 200 ml.

If you are planning to express a few times a day and you are getting small amounts each time, you can mix milk that has been stored in the fridge. Make sure all milk is cooled before mixing. You can do this for any milk you express within 24 hours. 

Never add warm milk to cold milk or to frozen milk. This can cause part of the milk to thaw.

Store expressed breast milk at the back of the fridge. Fridge doors tend to get opened a lot so the back of the fridge is cooler.

If you cannot store expressed milk in the fridge or freezer straight away, put it in a chilly bin with ice packs in contact with the bottles. If you do this, keep it no longer than 24 hours.

How long you can store breastmilk

You can store breastmilk:

  • at room temperature for up to 4 hours
  • in a fridge for up to 3 days
  • in a freezer for up to 6 months
  • in an upright freezer for 4 months.

Using stored breast milk

Thaw frozen breast milk slowly in the fridge. If you need to thaw it quickly, put the container of milk in warm water.

Do not use a microwave to thaw or heat breast milk. This can cause uneven heating, which can scald a baby's mouth. It also damages some of proteins that pass immunity to your pēpi.

Warm the expressed breast milk in a jug of hot water. Test the temperature of the milk by shaking a few drops onto the inside of your wrist.

Do not re-warm breast milk that has been thawed and previously heated.

Breast milk can vary in colour and does not look like cow's milk or formula milk. It can be:

  • yellowish
  • bluish
  • quite pale and watery looking.

All these colours are normal. Sometimes the fat separates during storage and goes to the top of the milk. If this happens, shake the bottle gently before using the milk to mix the fat back in again.