Expressing breastmilk and storing expressed breast milk - Questions and Answers

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Expressing breastmilk and storing expressed breast milk

How do I express breastmilk?

Hand expressing

If a mother is only going to be separated from her baby for a short time and the baby will be able to restart breastfeeding very soon then hand expressing her breasts may be an option. Some women prefer hand expressing as a means to remove milk generally, regardless of the time the baby is not at the breast.

Expressing breastmilk by hand can become quite a fast and efficient way to remove breastmilk. It also has no financial cost attached apart from obtaining containers for the milk. If removing breastmilk by hand mothers may find the time it takes to achieve a let-down of milk is shorter by hand than with a breast pump.

Breast pumps

If hand expressing is not an option then a manual hand breast pump can be used. There are also mini-electric pumps available for purchase, which run both on a battery and through a mains electrical supply. The breast can be massaged gently, prior to using the breast pump, and a hand expressing technique used on the nipple and areola to stimulate the milk flow before applying the pump. This reduces the amount of time pumping before the milk flow starts which can be an uncomfortable few minutes for some women.

If a mother needs to express breastmilk for all a baby’s feeds for a long period of time then a hospital grade electric pump may need to be hired. Breast pumps are available to purchase from pharmacies and many baby shops. Under certain circumstances, a mother may qualify for financial assistance for purchasing a breast pump. Hospital grade electric breast pumps may be hired from pharmacies and some lactation consultants in private practice also provide a loan service for these pumps. See also: Information on Work and Income assistance available for buying or hiring breast pumps in the Breastfeeding information resources section.

The type of breast pump required is dependent on the reason for needing to express. Sometimes it is because of a sick preterm baby or it may be due to a temporary breastfeeding challenge. It may also be because a mother is returning to the paid work force or needing to spend some time away from the baby.

Information about breast pumps is available from a Lead Maternity Carer (LMC) midwife, the La Leche League, a lactation consultant and a Well Child Health worker. It is important to seek advice because there are a number of breast pumps on the market which may not work very well for everyone. If a breast pump is not effective then breastmilk supply may be reduced and may also damage the nipples.

How often?

Breastmilk needs removing regularly and frequently from the breasts to maintain supply. In general terms if a baby is not at the breast for any feedings the breasts should be expressed at least eight times in a twenty-four hour period. Individual and ongoing advice however is necessary for women who need to express breastmilk as there are many variations in breasts, milk supply and circumstances. You can obtain information about breast pumps and expressing from an LMC midwife, La Leche League counsellor, lactation consultant or Well Child Health worker.

How do I store my breastmilk?

Ideally, milk fed directly from the breast is best. However, direct breast feeding is not always possible, so expressed breast milk that has been correctly stored is the next best option for infants.

Mothers should wash their hands before they express breast milk. Once expressed, breast milk can be stored in a plastic or glass container with an airtight sealed lid, for example, a food storage container or bottle. The container should be dated at the time of collection, and the caregiver should always ensure that the oldest milk is used first. Fresh or refrigerated milk retains beneficial properties and is preferable to breast milk that has been frozen. The milk should be stored in small portions of around 100–300 mL to prevent waste.

Expressed breast milk that is being refrigerated or frozen should be stored in a new container rather than added to previously refrigerated or frozen breast milk. Adding expressed breast milk to frozen milk can cause the milk to thaw and then refreeze, which increases the risk of bacterial growth in the milk.

Containers and feeding equipment should be washed in hot soapy water and then rinsed. If the infant is three months old or younger, the containers and equipment also need to be sterilised. Sterilising equipment and tablets to make sterilising solution are available from supermarkets and pharmacies. The manufacturer’s instructions must be followed carefully. Alternatively, the containers and feeding equipment can be boiled.

In the refrigerator, expressed breast milk needs to be kept towards the back of the main body of the refrigerator where it is thought the temperature is the coolest. The New Zealand Food Safety Authority recommends refrigerators are operated at 0–4^oC (NZFSA 2008).

Options for the short-term storage of expressed breast milk include using an insulated cooler bag containing ice packs where refrigeration or freezing is not immediately available (CDC 2007; Jones and Tully 2006). The maximum storage time using this method is 24 hours. Little research has looked specifically at this form of storage. The recommendations include advice that the ice packs should be in contact with the milk containers at all times and there is limited opening of the cooler bag.

How long can I store breastmilk?

Note that these guidelines are for expressed breast milk that is fed to healthy, full-term infants who live at home.

Guidelines for storing expressed breast milk

Storage conditions	Storage time	Comments
Room temperature (< 26ºC)	4 hours	Cover containers and keep them as cool as possible (e.g., surround the closed container with a cool towel to help to keep the milk cooler)
Refrigerated	48 hours	Store milk in the back of the main body of the refrigerator
Frozen Freezer box in refrigerator	2 weeks	Store milk toward the back of the freezer, where the temperature is most constant
Separate door fridge/freezer	3–6 months
Separate deep freeze	6–12 months

How do I use expressed breastmilk?

Frozen expressed breast milk can be thawed in the refrigerator or by placing the container of milk in warm water until the milk has thawed.

Expressed breast milk should not be thawed or heated using a microwave oven because microwaving destroys some of the milk’s immunological components. There is also a risk of uneven heating and scalding.

Expressed breast milk can be warmed by placing the cup or bottle containing the milk in hot water. Before feeding the infant, caregivers should swirl the container of milk to mix the fat portion back in and distribute the heat evenly. They should test the temperature of the milk by shaking a few drops on the inside of their wrist. It should feel comfortably warm to the touch before being given to the infant.

Who can support me with this?

Seek support from your family and friends. You may also need to have support from your workplace, see the section on the webpage on workplace.

Where do I go for help?

Your LMC, Well Child nurse or doctor should be able to help you or refer you to someone who can help.

Is expressing milk the same as breastfeeding?

Expressed breast milk (EBM) provides very similar nutrient and immunological composition to breast milk from the breast although as EBM is stored the composition does change.

The advantages of breastfeeding are that it provides milk that is always at the right temperature, readily available and microbiologically safe.

Breast milk varies in composition over the lactation period and during a single feed to meet the child’s individual and varying appetite and thirst, and hence nutrition and fluid requirements, so being breastfed allows the infant to self-regulate feeding.

Breastfeeding also encourages emotional attachment between the mother and infant.

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Where to get help

Midwives

Healthline - 0800 611 116

Well Child

La Leche League

More information on these and other breastfeeding help providers...

Page last reviewed: 31 July 2008