Expressing breast milk is popular amongst breastfeeding moms in developed countries, especially the USA. For a lactating mother expressing breast milk can be beneficial for improving or sustaining lactation. However, expressing milk is not a necessity or a pre-requisite for breastfeeding. Also, using a breast pump, popularly associated with expressing breast milk, is optional and need-based.

What is expressing breast milk?

Expressing breast milk is just the act of removing milk from a mother’s breast without a baby sucking it out. Breastfeeding is the best way to provide breast milk to the baby (with least overheads of cleaning, storing etc.). But in some scenarios feeding directly at the breast may not be possible. Expressing breast milk may be the best alternative to provide precious breast milk to a baby in such scenarios. There are two ways to express breast milk:

  • With Hands
  • With a breast pump

Is it necessary to express breast milk?

Experts suggest that mother’s milk is the best source of nutrition for a newborn baby. WHO highly recommends to breastfeed a baby for the first 6 months exclusively and to continue feeding the baby until one year. A mother, who wishes to breastfeed her baby, can face various challenges. The act of breastfeeding itself doesn’t come naturally to all. Lactation or latching issues can hamper breastfeeding. Also, in our Indian urban structure of a predominantly nuclear family, we may have limited help available for childcare. Limited support for childcare, or a deadline to join back work, can affect the chances of sustaining breastfeeding.

Expressing breast milk is a great way to improve or sustain breastfeeding. Expressing milk is helpful even in case of oversupply to prevent lump/blocked duct/mastitis. However, expressing breast milk is optional and recommended only when needed.

There are various practical reasons why mothers may express breast milk. Notably to:

  • Reduce breast engorgement
  • Improve breast milk supply
  • Create a breast milk reserve for future use
  • Feed a baby who cannot latch at the breast

Expressing breast milk to reduce breast engorgement:

Breast engorgement is common in the initial 7-10 days when milk supply kicks in. It is common to have uncomfortably fuller or engorged breasts in the initial 6-12 weeks after baby’ birth. Or until the mother’s breast milk supply establishes. Engorgement can even happen if baby misses a feed (e.g. mother away from the baby, or baby unwell, or latching issue etc.).

A baby sucking on the breast is the most efficient way to reduce engorgement. However, when it is not possible, expressing milk can help to relieve breast engorgement. Also, a baby may find difficult to latch on an engorged breast. Express a bit, to make breasts softer, before feeding baby from an engorged breast. Click here to read more about breast engorgement.

It is imperative to relieve breast engorgement else it can lead to lumps, or blocked duct, or mastitis and may even require medical intervention.

Expressing milk to improve breast milk supply:

Breast milk production is based on demand. Which means more the demand for breast milk, more will be the supply. In the initial days after childbirth, a mother may face low supply due to various reasons like an improper latch, mother’s calorie deficient diet, a medical condition in the baby or the mother, stress etc.. Your baby, feeding at the breast, is the best demand creator. However, if the baby is unable to nurse well or the supply is low, expressing milk may become necessary to improve breast milk supply (along with galactagogues).

Please consult your GYN/paediatrician/lactation-consultant if you suspect low milk supply. A medical professional can guide with the right techniques to increase milk supply.

Expressing breast milk to create a reserve for future use:

If you are away from your baby for a long duration, a stockpile of expressed breast milk can help to provide milk to your baby in your absence. Build a stash especially if you intend to go back to work or foresee an extended/frequent separation from your baby.

If you intend to go back to work, you may not have time to express milk daily while working. Or your baby needs multiple feeds a day in your absence, while you cannot express numerous times a day.  In many Indian offices, women still struggle to find a suitable place for expressing milk. Not just expressing milk, but the daily associated cleaning routine may be overwhelming for a working mother. A stash of expressed breast milk, along with the daily expressed milk (if possible), can provide adequate supply to your baby.

Expressing breast milk when a baby cannot latch at the breast:

A baby may be unable to feed directly at the mother’s breast due to different reasons like pre-term baby, latching issues, medical condition, illness in mother etc..

If a baby cannot feed directly at the breast, expressing milk is a known alternative to provide breast milk to the baby.

Expressing milk – Manually vs Using a breast pump

Expressing with hands is preferred for reducing breast engorgement. A breast pump is also useful to relieve engorgement. However, using a breast pump on the engorged breast may damage the breast tissues. If you need to express on a few occasions, expressing by hand may be more convenient (minimum overhead of cleaning) and economical.

A breast pump is better suited to express milk for improving supply or if you need to express frequently. Expressing frequently by hand can be cumbersome and time-consuming.

Invest in a breast pump based on your need. If you not sure about investing in a pump, wait till the baby is born. If a need arises or a doctor recommends, buy a breast pump.

Summary

Evaluate from your GYN, if necessary, if you need to express milk. If your supply is sufficient (click here if you doubt your milk sufficiency) and baby can feed directly at the breast, you can happily skip expressing breast milk. Or if you do not face breast engorgement then you are saved from the efforts for expressing breast milk. If you do plan to express frequently, using a breast pump may be more useful. Otherwise, hand expression should suffice.