You may not be able to feed your baby at your breast if your baby is:
- very premature
- unwell
- separated from you
But you can express your milk for your baby. Expressing breast milk from the start helps to maintain your milk supply.
Express your milk as soon as possible after the birth. Try to do this within the first hour if possible. Your midwife will guide you depending on your baby’s needs and how you are doing.
You may be unwell after the birth and need specialist care. But your midwife will help you when you feel well enough.
Starting to express your breast milk
When you first express milk, you do it by hand. In the early days it's normal to express just drops of colostrum.
The nurse caring for your baby will give them the colostrum you express. If your baby has not started feeding by mouth, the nurse can use your colostrum for oral care. This is when the colostrum is absorbed through your baby's mouth. This can help improve your baby's immunity and fight infection.
It may take a few times before you produce milk. Your baby’s tummy is tiny and every drop of colostrum or breast milk matters.
Hand expressing breast milk
Massage your breasts before and during expressing. Massaging your breasts may feel a bit strange but it is important, even after your milk comes in.
It can be difficult to make milk at first and the amount can be very small. Do not worry if there is very little or no milk the first few times you express. Keep trying and you will soon see an increase.
How to hand express milk (video)
How often to hand express milk
Hand express at least 8 to 10 times every 24 hours. This is every 2 to 3 hours. It is how often a newborn baby feeds in 24 hours.
Try to express at least once between midnight and 6am. This is because prolactin (milk-making hormone) levels are higher at night. Expressing at night helps your breasts to make more milk, especially in the early weeks after your baby’s birth.
Storing breast milk
When you finish expressing, write the date and time on the container or syringe labelled with your baby’s details. Then send the milk to your baby’s unit or place the closed container in the fridge.
Storing and transporting your breast milk
Using a breast pump
You can start using a breast pump when your milk changes from yellow colostrum to white-coloured milk. The hospital staff will guide you on when to start using a breast pump.
Breast milk benefits
If your baby is born premature, the breast milk you produce is especially suited to your baby's needs. The milk is different to breast milk produced for a full-term baby.
Premature breast milk is higher in protein and minerals. It contains different types of fat that your baby can more easily digest and absorb. The fat in breast milk helps the development of your baby’s brain. This is especially important for a premature baby.
Breast milk is easier for your baby to digest than formula. It also means that you can avoid exposing your baby's immature gut lining to the cow’s milk proteins found in formula. Exposure to these proteins can lead to a higher chance of developing allergies.
Premature babies who are breastfed are less likely to develop infections of the digestive tract than babies who are formula fed. The milk you produce in the first few days contains high levels of antibodies to help your baby fight infection.
Every single drop of your milk is important for your baby. The tiny drops you make at this point are precious and will help your baby.
Concerns about your milk supply
Some things can delay your milk coming in, including:
- having a caesarean section
- some medical conditions
- your baby being born very early
If you have any questions or concerns, ask your midwife or your nurse so they can help you.
Getting help
Expressing breast milk may feel difficult when you are tired and worried about your baby. Remember to look after yourself and try to get rest.
Give yourself time. Expressing is a skill that gets easier with practice and support.
Talk to your baby's nurse or your midwife. They can help you find a routine to have as many expressing sessions as possible.
The hospital's lactation specialist will help if you have challenges breastfeeding.
