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Milk Expression Techniques

Techniques for expressing milk:

You will have to depend on milk expression to establish and then maintain milk production until your high-risk baby is ready and able to take over milk removal through effective breastfeeding. Most mothers find they get more milk in less time when using a hospital-grade, electric breast pump with a double collection kit when providing milk for high-risk newborns.

Developing a milk expression routine:

You will want to pump at least eight times in 24 hours. Even if using a good electric pump, it is helpful to learn manual expression in case you are ever without some of the equipment pieces for the electric pump when it is time to express milk.

Do not put off or stretch the time between pumping sessions during the first three to five days postpartum. You may not see any milk during the first several pumping sessions, and you may only get drops for several sessions after that. The milk produced before day three to five postpartum is called colostrum, and it is normally produced in low amounts. However, colostrum is especially rich in the anti-infective properties that help your high-risk baby. If you are able to pump or hand express even one drop, it may be beneficial. Drops can be drawn up, and stored, in syringes specially labeled as "colostrum."

Helpful equipment:

How often and how long?

A full-term, healthy newborn typically breastfeeds for the first time within an hour or two of birth and will want to eat about eight to 12 times, for a total of about 130 to 150 minutes, in 24 hours for the next several weeks or months. A milk expression routine should closely imitate this pattern, so you will want to begin pumping as soon after your baby's birth as possible:

How much milk?

After seven to 10 days of frequent pumping sessions - at least eight times a day and for a daily total of 100 minutes or more - expect to produce between 16 to 32 ounces (about 500 to 1,000 ml or cc) of breast milk a day. This may be more milk than your high-risk baby needs just now, but you will be glad to have extra milk in the freezer if milk production drops at some point, which is not unusual after several weeks. Occasionally a mother must take a medication or receive a treatment that affects her milk, so milk is "pumped and dumped" for a few days. Then any stored milk can be used.

Do not be surprised if you obtain more milk at some pumping sessions than others. Many mothers find they obtain more milk earlier in the day. Also, expect some variation in the total amount pumped from day to day, but talk to a certified lactation consultant (IBCLC), your baby's nurse or physician, or a breastfeeding support leader if you find the daily total keeps dropping for several days in a row.

Helpful hints:

Mothers of high-risk newborns have found some or all of the following suggestions helped them develop and stick to a routine when expressing their milk for days, weeks or months:

Click here to view the
Online Resources of High-Risk Newborn

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