When to express

When should I express?

Mothers can express right after breastfeeding, during or right after the baby is fed by another means, or on a three-hour schedule; it depends on the reason for expressing. If a mother is breastfeeding but also expressing to increase or maintain her milk supply or relieve breast fullness, she should do it right after the baby is breastfed or if needed, supplemented with extra milk. If it’s because a mother is not breastfeeding, she can express right after the baby has been fed or she can express every three hours. The breasts should be emptied at least 7 times in 24 hours with a maximum five-hour break at night. Morning is usually the best time to express milk for later use, since babies normally feed a little less at night, leaving more milk available after breastfeeding for expressing.

A) Describing when to express

Effective breastfeeding is generally preferred over expressing. However expressing can be helpful and even critical for breastfeeding success.

All mothers who wish to maintain their milk supply should ensure their breasts are emptied by breastfeeding or by expressing at least 7 times in 24 hours with a maximum five-hour break at night. If expressing, they need to ensure that it is effective.

Expression can be regular or occasional, depending on the reason for expressing. It can also be in addition to breastfeeding or when the baby is not breastfeeding.

B) Expressing and breastfeeding

Mothers who are expressing and the baby is being brought to the breast:

  • Should express right after breastfeeding if the baby does not need a milk supplement.
  • Should express right after the baby gets a milk supplement, if one is needed.
  • Can express while someone else supplements the baby.

If mothers are breastfeeding, they usually find it is easiest to express right after the baby has fed. This gives mothers a longer amount of time between feeding-related tasks in which to attend to other matters. Being out of synch with the baby means never getting a break; mothers may have to feed the baby, express one hour later, feed an hour after that, and so on.

If the mother is breastfeeding, expressing closer in time to the baby’s next breastfeed will decrease the amount of milk in the breast and available to the baby.

Mothers who have painful nipples or breasts may express on the more painful side but continue breastfeeding on the less painful one. They should follow the above directions. 

C) Expressing when the baby is not breastfeeding

Mothers who are expressing and the baby is not being brought to the breast:

  • Should express right after the baby is given a replacement feed.
  • Can express while someone else feeds the baby.
  • Can express every three hours if the baby is ill and unable to feed when hungry.

Mothers of premature or sick babies may find that their babies are on unusual feeding schedules. For example, some very small premature babies may receive their milk continuously by feeding tube. Sick babies may require surgery which will delay feeds. In these situations, mothers should express every three hours with a maximum five-hour break at night.

For periods of mother-baby separation, mothers should express around the same time that the baby is fed.

D) Expressing to store milk

Mothers may wish to express in order to store breast milk.

Some normal mothers can only express small amounts of milk (15 millilitres [1/2 U.S. fluid ounce]) after breastfeeding. They:

They may find it is best to express right after the baby’s first-morning feed. Because babies feed a little less often at night, there is more milk left in the breast after the baby’s first-morning breastfeed than at later feeds.

Some mothers may need to express several times to obtain enough milk for one replacement feed. 

 

E) Interrupted expressing sessions

Sometimes mothers have to stop expressing before a breast is empty because of life's other demands. They can return to it as soon as time permits. Milk and any expressing equipment can safely stay at room temperature (25°C [77°F] or less) for up to four hours, or they can be put in the refrigerator until mothers can get back to expressing.