Expressing shortcuts

How can I make expressing easier?

There are ways to make expressing less work. Mothers can use double pumping or double manual expression. Both are more effective than single expressing and take less time. Some mothers find hands-free pumping systems useful. For most breastfeeding mothers, the best advice is to stay in synch with the baby’s feeds by expressing right after each one. If mothers are expressing regularly or all the time, it’s OK to change the times a bit. They just need to make sure that at the end of the day they have expressed the expected amount and expressed the normal number of times. If a mother is expressing a consistent amount of milk every day and has a large storage capacity, she may be able to decrease the number of daily expressions.

A) General ways to decrease the work of expressing

There are shortcuts that can make expressing less work.

1) Double expressing

Double expressing saves a lot of time and is often more effective than single expressing.

2) Hands-free pumping systems 

Hands-free pumping systems allow mothers much greater freedom while pumping.

3) Ask for help

While expressing can only be done by the mother, different family members can help with milk supplements, giving you time for expressing. They can also care for the baby and do other household tasks.

B) Mothers who are breastfeeding and expressing

Mothers who are breastfeeding and expressing usually express soon after the baby is breastfed and if needed, supplemented with milk. This allows you to feed the baby and express and then have a break for a few hours. Being out of synch with the baby means never getting a break: You may have to feed the baby, express one hour later, feed an hour after that, and so on.

C) For mothers who are only or mostly expressing

1) Change the timing of expressing sessions

Because babies don’t feed exactly every three hours, expressing times can vary a little as well. You can move the expressing times around a little. For example, you may be away from the baby and it may be more convenient to express after two hours and then start the next session after another four hours.

Just make sure that at the end of the day, you have expressed or breastfed your normal number of times, you have expressed the expected amount of milk, and over time, your expressed amounts do not decrease.

2) Decrease the number of expressions per day

The number of times you need to express each day generally depends on the storage capacity of your breasts.

If you are expressing a consistent amount of milk every day and you have a large storage capacity, you may be able to decrease the number of daily expressions. Expressions should be spread out over regular intervals. This approach is safe for only a minority of women.

For example, if you are expressing seven times a day, you can try doing it six times a day. After a week, if you are still expressing the same amount of milk per day, you can try decreasing the number of expressions to five, and so on.

Increase the number of daily sessions if:

One study (Lai 2019) showed that the maximum interval between expressions should be seven hours and mothers should express at least five times each day. However, another study (Ru 2020) showed that mothers should express at least six times each day to maintain their milk supply.

Our clinic cared for one exceptional mother who had premature twins who could not latch. One year after their birth, she pumped twice each day. She was able to pump for 1000 millilitres (33 U.S. fluid ounces) in the morning and the same amount at night. However very few mothers can do this and many more who are only expressing struggle to maintain their milk supply, even when expressing after each of the baby’s feeds.

References

Lai CT, Rea A, Mitoulas LR, et al. Short-term rate of milk synthesis and expression interval of preterm mothers. Arch Dis Child Fetal Neonatal Ed. 2019 Jul 11. pii: fetalneonatal-2018-316551

Ru X, Huang X, Feng Q. Successful Full Lactation Achieved by Mothers of Preterm Infants Using Exclusive Pumping. Front Pediatr. 2020;8:191. Published 2020 Apr 24