Mother's own milk

What about supplementing with my own milk?

If mothers need to supplement their baby, it is nearly always best to use their own breast milk or colostrum. To do this, mothers need to express by pumping, by using their hands (manual expression), or by a combination of the two. A hand pump may be good for occasional expression, but a double electric pump, which pumps both breasts at the same time, is generally considered better at maintaining milk production if mothers are pumping regularly. They are also generally more effective than single pumps and produce more milk in less time. Milk can be expressed after the baby has breastfed or instead of breastfeeding and stored for the next feed or frozen for later use. Colostrum can be expressed by pregnant women and stored frozen for use after the birth of the baby.  

A) Describing using mother’s own milk for supplementing

Mothers are encouraged to breastfeed whenever possible instead of expressing their milk.

However, babies do need supplementing with milk when the mother and baby are apart, and a few babies need supplementing for medical reasons. Some mothers choose to supplement for non-medical reasons.

It is nearly always best to use the mother’s own milk or colostrum to supplement the baby. It’s especially good for premature babies, who get unique benefits from mother’s milk and colostrum and are extremely vulnerable.

There are only a few reasons for not using the mother’s own milk and colostrum.

B) Expressing for the baby’s supplement

To obtain their own milk or colostrum for the baby, mothers need to express. This can be done by:

For occasional expression, a hand pump may be a good option. For regular expression, a double electric pump is generally better at maintaining milk production. Double expressing is also generally more effective than single and mothers get more milk in less time. Breast compression can be added to help empty the breast. Some mothers prefer manual expression.

Milk can be expressed after the baby has breastfed, or instead of breastfeeding and has been supplemented and is settled.

C) Low expressed amounts

If you express less than expectedconsider that some mothers have normal amounts of milk but cannot express effectively. Others may have a low milk supply.

D) Expressing before delivery

Mothers whose babies are likely to need supplements for a short period after birth may consider expressing colostrum before delivery (prenatal expression) and freezing it. It is used as the baby’s supplement in the first few days after delivery until the mother’s milk comes-in and may limit or remove the need for infant formula (Forster 2014).

At-risk babies include those who:

  • May be born prematurely.
  • Will be born with abnormalities that can cause feeding problems.
  • Are likely to have low sugar levels after birth, as when their mother has diabetes.
  • Have a mother whose milk may come in late.

Before proceeding, mother should discuss prenatal expression with their health-care providers as there is a risk that it can stimulate early labour.

Mothers can start manually expressing colostrum between 36 and 37 weeks and freeze it for later use (Forster 2017; Singh 2011; Soltani 2012). Expected amounts are roughly 5 millilitres (1 teaspoon) at each expression (Forster 2017).

In this situation, manual expression is preferred over pumping as:

  • Mothers can get more colostrum (Ohyama 2009).
  • The small amounts of colostrum are easier to collect (Ohyama 2009).
  • Manual expression may be less likely to stimulate labour (Kavanagh 2005).
  • Manual expression has been shown to cause milk to come in earlier (Lamba 2016).

Having a store of colostrum available has been shown to boost a mother’s confidence about her ability to make milk (Demirci 2019).

E) Mixing breast milk and infant formula in one bottle

Mothers may be able to provide some but not all of the baby’s milk supplement and their babies will also receive infant formula. Mixing expressed breast milk and infant formula in the same bottle is not wrong but can result in throwing out breast milk if the baby doesn’t empty the bottle.

References

Demirci JR, Glasser M, Fichner J, et al. "It gave me so much confidence": First-time U.S. mothers' experiences with antenatal milk expression. Matern Child Nutr. 2019 Apr 4:e12824
 
Forster DA, Jacobs S, Amir LH, et al. Safety and efficacy of antenatal milk expressing for women with diabetes in pregnancy: protocol for a randomised controlled trial. BMJ Open. 2014 Oct 30;4(10):e006571
 
Forster DA, Moorhead AM, Jacobs SE, et al. Advising women with diabetes in pregnancy to express breastmilk in late pregnancy (Diabetes and Antenatal Milk Expressing [DAME]): a multicentre, unblinded, randomised controlled trial. Lancet. 2017 Jun 3;389(10085):2204-2213
 
Kavanagh J, Kelly AJ, Thomas J. Breast stimulation for cervical ripening and induction of labour. Cochrane Database Syst Rev. 2005 Jul 20;(3):CD003392
 
Lamba S, Chopra S, Negi M. Effect of Antenatal Breast Milk Expression at Term Pregnancy to Improve Post Natal Lactational Performance. J Obstet Gynaecol India. 2016;66(1):30-34 

Ohyama M, Watabe H, Hayasaka Y. Manual expression and electric breast pumping in the first 48 h after delivery. Pediatr Int. 2010 Feb;52(1):39-43
 
Singh G, Chouhan R, Sidhu K. Effect of Antenatal Expression of Breast Milk at Term in Reducing Breast Feeding Failures. Med J Armed Forces India. 2009 Apr;65(2):131-3.
 
Soltani H, Scott AM. Antenatal breast expression in women with diabetes: outcomes from a retrospective cohort study. Int Breastfeed J. 2012 Dec 1;7(1):18