When babies are born early, often this can mean that the physical changes that happen in your breasts to enable you to breastfeed have not yet fully completed. Therefore in order to get a good milk supply started it is really important that you start to express your milk as soon as possible after the birth of your baby.
Even though you may be feeling exhausted, anxious and frightened if your baby was born prematurely, gently expressing milk by hand as soon as you are able (but preferably within the first couple of hours after birth) will help to switch on your milk supply. Ask a member of staff to show you how to hand express your milk. It is important to express your milk at least 8 times in 24 hours including once during the night to maximise the amount of milk you produce. If you have a large glass of water before you go to bed at night your bladder will be sure to wake you up and you can then fit in an expression.
You don’t have to express to a strict routine, but if you think about how a baby would feed (two or three times close together followed by a longer gap) this flexibility can help you fit in the eight or more expressions needed for an effective milk supply. Having something to remind you of your baby (photos, sound recording, item of clothing that will have his smell) will help your milk to ‘let down’. Practicing relaxation techniques and gentle breast massage will also help. Remember, providing your breastmilk for your baby is a valuable and unique contribution to helping him grow and develop during this crucial time.
FAQs
Why do I need to hand express rather than use a pump?
In the first few days your body produces a substance called colostrum. This is really important for your baby and comes in very small quantities to begin with. It is also very thick and concentrated so it is not easy to express with a pump. As the volumes you produce start to increase then it generally becomes easier for you to use an electric breastpump and the staff will show you how to use one then.
Do I have to use a breast pump?
As it is essential for you to express your breastmilk at least 8 times in 24 hours you may find that a breastpump will generally be more effective and less time consuming than hand expressing in the long term. Hand expressing can still be useful to help with your milk let down and to help soften your breast as your baby begins to breastfeed.
Do I need to buy my own breast pump?
Most neonatal units will be able to provide you with information on where you can hire a breast pump and some units may even have their own system for pump hire. When using a breast pump ask the staff to check that the funnel connection is the correct fit for you as using a funnel that is too small or too big could make you sore. Double pumping is the most effective way of making sure you make as much milk as possible for your baby and the more milk you make in the early weeks after the baby’s birth the better chance you have of having a good milk supply in the long term.
Why is it important that I express in the night?
Expressing frequently will give your body lots of the messages it needs to encourage you to make lots of milk. Its not important to express to a strict regime – most newborn babies feed in an irregular pattern with some feeds close together and others spread further apart, but it is important to avoid going for too long without expressing as your body will miss out on the frequent signals it needs to produce milk. Also, once you start to make bigger quantities of milk, leaving milk in your breasts for long periods will start to dampen down future production. We have also learned that the fat content of milk can be lower if long gaps are left. Most experts would agree that it is better not to leave a gap longer than six hours overnight.
How much milk will I make?
Every mother and every situation is different. At the start, even a few drops of colostrum are incredibly valuable for your baby. As the days go by you should notice that the volume starts to increase as long as you are expressing effectively and frequently enough. Ideally, by the time your baby is two weeks old you should be making around 750ml of milk in each 24-hour period. This may seem like a lot but if you divide this by 8 expressions it amounts to around 90ml per expression which may feel more achievable. Your midwife or neonatal nurse will be able to give you some tips about how to make sure you are doing the best you can to make enough milk.
Will I ever be able to breastfeed?
As your baby grows, develops and matures (with the help of your breastmilk) he will begin to show signs of wanting to feed at your breast. Holding him in skin-to-skin contact will really help him to move on to breastfeeding sooner. Signs that he is getting ready to breastfeed include
- Opening his mouth and poking his tongue out
- Turning his head if you stroke his cheek with your finger
- Trying to put his fingers towards his mouth
Even before your baby is ready to feed it is really helpful to practice holding him in the way that you would for breastfeeding. Letting him nuzzle at your breast and expressing a little milk for him to lick will help to familiarise him with your breast and make it easier when the time comes for him to actively breastfeed. The practice period can last for weeks but patience will pay off in the end and when he eventually does begin to breastfeed it will make all those weeks of expressing milk seem worth it.
