Some mothers have a remarkable ability to breastfeed and express without problems and none of the suggestions below will be of any importance. Other mothers however, can get into trouble. The only way to identify these two types is trial and error.
1) How to express
If the baby takes both breasts at each feed, you can express the first breast while the baby is feeding on the second or you can express both at the same time after the baby has finished.
If the baby only takes one breast at each feed, you can express the unused breast during or after the baby’s feed.
Mothers with a large milk supply often find that constant suction pumps are very effective.
2) Start slowly
Emptying of the breast, especially complete emptying, will increase the amount of milk made. For mothers with very active breasts, this happens within a few hours after one thorough expression. Milk production will decrease if the mother does not continue to express but this can take days.
Expressing is generally easy for mothers with a large milk supply. They may be able to express up to 180 ml (6 oz) at one sitting, but this often leaves them full for the rest of the day as the breasts quickly ramp up production.
Start by expressing just 60 ml (2 oz) and see how your breasts feel for the rest of the day. If they are not too full or tender, you can try to express 90 ml (3 oz) the next day.
Some mothers have a large storage capacity and their breasts can handle larger amounts of milk moving through them. Others feel overfull for the rest of the day when expressing as little as 60 ml (2 oz).
3) Split your expression
You are less likely to increase the amount of milk you make if you split your expression.
For example, if you need 120 ml (4 oz) for one feed while you are away from the baby, express 60 ml (2 oz) in the morning and 60 ml (2 oz) in the evening instead of 120 ml (4 oz) at one time. Expressing in this way is less likely to empty the breast completely and minimizes the risk of making too much milk.
4) Don’t over-express
The larger the amount of milk expressed, the greater the risk of complications. Should you choose to express large amounts, ensure that there is a need to do so and that you are otherwise well.
5) Be consistent
If you are expressing regularly for amounts over 150 ml (5 oz), you may need to express a similar amount each day to avoid being too full on the days you don’t express.