Milk Expression

Question 1

When should hand expression be taught?

Answer 1

Within 24 hours of birth so that the mother is confident to deal with any issues
Pollard (2017)

Question 2

Why is hand expression recommended over pumping in the first few days?

Answer 2

Colostrum levels are low and may get lost in the pump. Hand expression provides tactile stimulation which encourages lactation hormones and enables the mother to target sites where there are blocked ducts

Question 3

If there is zero breastfeeding

Answer 3

The mother should be encouraged to feed at least 8 times a day, including night when prolactin levels are at their highest

Question 4

How to teach hand expression

Answer 4

Best done using a breast model according to the BFI and hands off approach should be taken unless asked otherwise

Question 5

Different hand expression techniques

Answer 5

- Stroke the breast with a 
  gentle geather like 
  movement or gently roll 
  knuckles from the top of the 
  breast towards the areola
- Roll the nipple between the 
  thumb and forefinger
- Stroke under the nipple and 
  areola with the palm of the 
  hand in an upward 
  movement.

Question 6

Hand expression method

Answer 6

 Cup your breast and feel 
    back approx. 2-3 cm from 
    the base of the nipple – 
    there will be a change in 
    the texture 
 Avoid sliding your fingers 
    over the skin 
 Using your thumb and the 
    rest of your fingers in a C 
    shape, squeeze gently in 
    this area – it shouldn’t hurt
 Release the pressure and 
    repeat several times 
    building up a rhythm 
 At first only drops will 
    appear but keep building 
    up your supply 
 When the flow slows move 
   your fingers around to try a 
   different section of your 
   breast and repeat
 When the flow stops or 
    slows, change to the other 
    breast

Question 7

Why use breast pumps?

Answer 7

Mothers of preterm infants use them to establish and maintain milk supply.
Other uses include expressing milk when they are separated from the infant

Question 8

Incorrect use of breast pump

Answer 8

Can cause pain, nipple and breast tissue damage, milk contamination and infection

Question 9

Electronic pumps

Answer 9

Designed to imitate the infant’s suckling, vacuum and sucking rhythm

Question 10

Hand pumps

Answer 10

Are cheaper than electric and the suction is created by pumping a handle but can be tiring

Question 11

Environment for pumping

Answer 11

Should be prepared to reduce anxiety and aid comfort to increase oxytocin levels. Wash hands and massage breast first

Question 12

Storing breastmilk at room temperature

Answer 12

19 to 26 degrees good for 4-8 hours

Question 13

Storing breastmilk in the fridge

Answer 13

5-10 degrees for 3 days

Question 14

Storing breastmilk in the freezer

Answer 14

-18 to 20 degrees for 6 months

Question 15

Double pumping

Answer 15

Good option for mothers who regularly express as it saves time and increases prolactin and thus milk production