Why express?

* You may need to leave your baby with a carer.

* To feed a premature baby and to preserve your milk supply.

* Having a baby, toddler or yourself hospitalised.

* For relief if your breasts are engorged or you have sore nipples.

* To increase your milk supply.

How should I express?

You can express by hand, or use a pump (electric or hand). If you decide to use a pump, it is still a very good idea to learn to express by hand, as this allows you to express at any time and anywhere (you cannot forget your hands - nor do they need a plug socket or run out of batteries!).

Expressing, whether by hand or by pump is not the same as when your baby feeds from you. Your hands or the pump cannot imitate the suckling motions of your baby, and therefore it will take time for your breasts to produce milk in this way.

If you are expressing in order to preserve or increase your milk supply then you may need to express more frequently than if you were doing it to relieve symptoms of engorgement. To preserve your milk supply, you will need to express as often as your baby was feeding, and to increase it more often still. A breastfeeding counsellor will be able to discuss your particular situation with you.

Before you begin to express:

* You must relax (tension may inhibit your milk ejection reflex) - have a warm drink before you start;

* Warm your breasts, expressing after a bath or shower, or by wrapping a warm towel around to help the milk flow;

* Gently massage your breasts for a minute or two, towards the areola, this helps to stimulate your milk ejection reflex;

* It will also help to look at your baby while expressing, or if your baby is not near to look at a photo, and/or smell a piece of baby’s clothing.

Expressing by Hand

* Wash your hands thoroughly (there is no need to wash your breasts).

* Have a sterilised container ready, (a bowl will do) to express into.

* With your areola between your thumb and forefinger, try to feel for small ‘pea sized’ lumps underneath the perimeter of the areola.

* Gently cup your breast and press towards the chest, and squeeze, release the pressure, then do it again.

* Work around your areola so that your fingers ‘express’ all the ducts.

* It may take a minute or two before any drops appear, and the amount of milk that you can express by hand will increase with perseverance and practice.

Expressing with a pump

Most pumps - hand or electric - work on the principle of creating a vacuum when a funnel has been placed over the areola. Make sure that the funnel is not too small when the nipple is brought into the narrow part of the funnel as this could damage the nipple.

* It is very important to sterilise the pump – follow the manufacturer’s instructions for your pump. Milk is the ideal breeding ground for bacteria.

* Swap breasts frequently - for example; left breast for three minutes, right breast for three minutes, left breast for two minutes, right breast for two minutes, left breast for one minute, right breast for one minute then stop and rest, unless the milk is flowing free. This gives the milk time to come down from the back of your breasts.

* Double pumping is when you pump both breasts at the same time. It usually increases supply very quickly, and makes the pumping session shorter.

* If you are expressing to increase your supply, continue pumping for a minute or two after the last drip of milk.