When we all know that ‘Breastfeeding is best feeding’, why do we need to discuss Expressed Breast Milk or EBM? It is simply because in certain situations when direct breastfeeding is not possible or convenient, expressing breast milk can be a valuable practice that enables mothers to provide their babies with breast milk.
In this article, we will see when expressed breast milk is advisable, what are the breast milk expression techniques, the storage recommendations and all that is needed to know to practice EBM feeding.
Table of Contents
When is Expressed Breast Milk advisable?
Expressed breast milk may be advised in following conditions:
- Prematurity: Premature infants may have difficulty directly breastfeeding due to their immature sucking and swallowing reflexes. Expressed breast milk can be given through a feeding tube or bottle, providing them with the necessary nutrients and antibodies for optimal growth and development.
- Low Birth Weight: Infants with low birth weight may have challenges with breastfeeding effectively. Expressed breast milk can be given to support their nutritional needs and promote weight gain.
- Inability to latch or suck effectively: Some infants may have difficulties latching onto the breast or establishing an effective sucking pattern. Expressed breast milk can be provided through alternative feeding methods, such as cup feeding or using specialized feeding devices, while working on improving breastfeeding skills.
- Maternal medical conditions: Certain maternal medical conditions or treatments, such as infections, medications, or surgeries, may temporarily or permanently hinder breastfeeding. Expressing breast milk allows mothers to provide their infants with the benefits of breast milk even when they cannot breastfeed directly.
- Infants with oral or facial abnormalities: Infants with conditions like cleft lip or palate may have difficulty latching onto the breast. Expressed breast milk can be given through alternative feeding methods tailored to their specific needs.
- Separation from mother: In situations where the mother and infant are separated due to hospitalization, work, or other circumstances, expressed breast milk ensures that the baby continues to receive the benefits of breast milk until they can be reunited for direct breastfeeding.
- Insufficient milk supply: Some mothers may experience challenges with milk production or supply. Expressing breast milk can help stimulate milk production and maintain milk supply while also providing the infant with the necessary nutrition.
While starting EBM, it is important to consult with healthcare professionals, including lactation consultants or pediatricians to get personalized guidance based on the specific needs of the baby and the mother.
Is EBM a better feeding choice than Formula Milk? (Expressed Breast Milk Advantages)
Yes, indeed! Expressed breast milk offers several advantages for both infants and mothers:
a. Optimal nutrition: Expressed breast milk provides the ideal balance of nutrients for infant growth and development.
b. Immunological benefits: Breast milk contains antibodies and immune factors that help protect infants against infections and diseases.
c. Convenience and flexibility: Expressing breast milk allows mothers to store and feed their infants on their own schedule.
d. Bonding and emotional connection: Expressed milk can be fed to the baby by other caregivers, promoting bonding and shared responsibility.
e. Support for breastfeeding: Expressing breast milk helps maintain milk supply and facilitates the transition between breastfeeding and bottle feeding if necessary.
What are the different breast milk expression techniques?
Several techniques can be employed to express breast milk effectively:
a. Hand expression: A manual technique involving the use of hands to compress and express milk from the breast.
b. Manual breast pumps: Simple devices that utilize hand-operated mechanisms to extract breast milk.
c. Electric breast pumps: More efficient and convenient devices that use mechanical suction to express milk from the breast.
d. Combination techniques: Mothers can combine hand expression and breast pump usage for effective milk extraction.
How is breast milk expressed by manually? (What is the breast milk hand extraction technique?)
Manual breast milk expression is a technique that involves using your hands to express milk from your breasts. It can be a convenient and cost-effective method for mothers who prefer not to use or have access to a breast pump. Here are the details of manual breast milk expression:
Preparation:
a. Wash your hands thoroughly with soap and warm water before expressing breast milk.
b. Find a comfortable and quiet place where you can relax and focus on the expression process.
c. Have a clean container, such as a sterile bottle or breast milk storage bag, ready to collect the expressed milk.
Stimulation:
a. Gently massage your breasts in circular motions, starting from the outer areas and working toward the nipple. This helps stimulate milk flow.
b. Applying a warm compress to your breasts or taking a warm shower beforehand may also aid in milk letdown.
Positioning:
a. Sit in an upright position and ensure good back support.
b. Place a clean towel or cloth over your lap to catch any spills.
c. You can choose to express milk from one breast at a time or both breasts simultaneously, depending on your comfort level and milk supply.
Expression Techniques:
a. C-Shape Technique:
- With your thumb on top and fingers underneath your breast, position your hand in a C-shape around the outer edge of the breast, away from the areola (the dark area around the nipple).
- Gently press your fingers back toward your chest wall while maintaining a firm but gentle grip.
- Release and repeat this motion rhythmically to express milk. Adjust the hand position slightly to cover different areas of the breast.
(Image courtesy: Verywell Family, Mira Norian)
b. Reverse Pressure Softening Technique (RPST):
- This technique can help soften the areola and reduce any swelling or engorgement, making it easier to express milk.
- Use your fingertips to apply gentle pressure in a circular motion around the edges of the areola, starting from the outside and working toward the nipple.
- Continue this technique for a few minutes before attempting milk expression.
Milk Collection:
a. As you express milk, allow it to flow into the container you prepared earlier.
b. If the milk flow slows down, reposition your fingers or try massaging your breast again to stimulate further milk release.
c. Switch breasts when the milk flow slows down or if you feel more comfortable expressing from the other breast.
How is EBM stored? What are the Expressed Breast Milk storage guidelines?
Proper storage of expressed breast milk is essential to maintain its quality and safety for your baby. Here are the details of storage guidelines for expressed breast milk:
- Storage Containers:
a. Use clean, BPA-free containers specifically designed for storing breast milk. Options include bottles, breast milk storage bags, or containers with tight-fitting lids.
b. Ensure that the containers are sterile or have been thoroughly washed with hot, soapy water and rinsed well before use. - Freshly Expressed Breast Milk:
a. Room Temperature: If you plan to use the milk within 4 hours, you can safely store it at room temperature (up to 77°F or 25°C).
b. Refrigeration: If you will not be using the milk within 4 hours, promptly transfer it to the refrigerator. Store breast milk in the back of the refrigerator, where the temperature is the coolest. Avoid storing breast milk in the refrigerator door, as it may be subject to temperature fluctuations.
EBM can be stored in the refrigerator for up to 4 days (check guidelines for exact duration from reliable sources).
- Frozen Breast Milk:
If you do not plan to use the expressed milk within a few days, freezing it can help preserve its quality. Use breast milk storage bags or containers designed for freezing. Leave some space at the top of the container or bag to allow for expansion during freezing. Label each container with the date of expression.
a. Regular Freezer:
In a regular freezer compartment within a refrigerator, breast milk can be stored for up to 3 months.
b. Deep Freezer:
Breast milk can be stored in a deep freezer at a temperature of 0°F or below for up to 6 months.
How to prepare the stored frozen EBM for feeding?
Frozen EBM needs Thawing and Warming to make it ready for feeding.
When you are ready to use frozen breast milk, thaw it using one of the following methods:
- Place the container/bag in the refrigerator overnight.
- Hold the container/bag under warm running water (around body temperature).
- If you need to thaw it quickly, you can use a bowl of warm water, but avoid microwaving breast milk as it can cause hot spots and destroy valuable nutrients.
- Gently swirl or shake the container to mix the separated layers of the milk, as breast milk may naturally separate during storage.
- Do not refreeze thawed breast milk. Once it is fully thawed, use it within 24 hours.
General Guidelines:
a. Do not add freshly expressed breast milk to already frozen milk.
b. Avoid shaking the milk vigorously, as this can break down some of the beneficial components. Instead, gently swirl the container to mix the milk.
c. Always follow guidelines from reliable sources such as the CDC, NHS, AAP, WHO, or your healthcare provider for specific storage durations and recommendations.
Remember, proper hygiene practices are crucial throughout the process of expressing, storing, and feeding breast milk. Wash your hands before handling the containers and ensure they are clean and sterilized. If you have any concerns or questions regarding breast milk storage, consult a lactation consultant or healthcare professional for guidance tailored to your situation
Summary:
- Expressed Breast Milk is advisable in situations where breastfeeding is not possible or convenient.
- Expressed Breast Milk provides most of the advantages of breastfeeding and is a better feeding choice than formula milk.
- Breast Milk is expressed by Manual (Hand) expression, Manual Pump Expression, Electrical Pump Expression or combination of these methods.
- Preparation, Stimulation, Positioning, Expression, Collection and Storage are the steps in this process.
- Freshly expressed EBM can be stored and used up to 4 hours at room temperature, up to 4 days in a normal refrigerator compartment, up to 3 months in the freezer compartment of refrigerator and up to 6 months in a deep freezer.
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