Expressing and storing breastmilk

A lactation consultant, the same one who proofs my posts on breastfeeding when I address more technical issues, suggested I share my experience on expressing and storing breastmilk. Before going into hospital to deliver my baby I didn’t own a pump. I was certain I wouldn’t need one! However, with a premature baby who was in neonatal care, born from a c-section… well, I either got to pumping or there is no way he’d ever get to taste his mommy’s milk. And so I started to express. Every three hours I rendered my best impression of a milking cow, strapped to a machine that sucked my nipple so far forward it made me cringe. It’s amazing how much they stretch, I realised.

The first time I did this was 6 hours after giving birth. A nurse turned up with an electric pump (it was a huge contraption) and briefly explained what I’d have to do. I felt lost… Even more so because the first 4 or 5 times, nothing came out. It takes a lot of strength to persist, let me tell you. I recall expressing once while still in hospital with Mr B by my side, making me laugh. That was a good session. Meanwhile, the baby next door (or on the other side of the curtain next to my bed) started crying and I saw the real effect of oxytocin for the first time… The milk started flowing down the bottle. I may have told Mr B to make the baby cry again so I could express some more. Kidding, of course.

When I was discharged, without Baby S, I continued using the same brand of pump – Medela, but the slightly more toned and homey version, called Swing. I think that to this day I have nightmares with the sound of the pump… that whizzing sound sticks. Let’s just say that now, whenever I need to express, I do so by hand. It feels much less invasive. But at the time, I continued to express every 3 hours. I don’t think there was one spot in the house I didn’t use, our pug Tug staring at me, visibly intrigued. I expressed while in bed, almost falling asleep quite a few times. I expressed in the living room, sitting on a chair, drinking some milk enhancing tea and listening to relaxing music. I expressed on the living room sofa, watching TV. I even managed to express in Baby S’s room, when I finally built up the nerve to go in there… I also did it often while out and about, which was slightly more challenging… not to mention, awkward.

Well, yes then, how did you store the milk, I hear you ask? I didn’t have to worry about while he was in neonatal care. They gave me the glass jars where the milk was to be stored, I’d stick a label on them with our names, also given by the hospital and jot down the date and the time I started expressing. I would put them in the fridge, remove them the next day and take them along with me. They handled the rest. But what about at home? I couldn’t use the glass jars any more, I had no room for them in my freezer! So I had to use the Medela storing bags. Yet, this only lasted one day, as he moved on to breastfeeding exclusively the very next day!

Unlike my personal experience, to those mums who have their babies close, I would recommend to breastfeed on demand (read post here), as expressing before 2-3 months is not really an interesting option. This is because it’s the time the body takes to adjust completely to our baby, plus there’s a major growth spurt happening at around 3 months that is challenging in itself. In fact, many mums question their milk at this time. To you, I say this: hang on tight. Your body WILL adjust. And there’s no such thing as “weak” milk.

I still breastfeed on demand when I’m with Baby S, but I did eventually return to work and so started to express a few weeks beforehand, for an emergency. And something curious happened at the time. My body was so in synch with my baby’s needs that I only produced the necessary milk. When I tried to express (by hand), all I got was 10ml. I almost had a heart attack. Until I realised this was a good thing – it meant my body and his were fully aligned. I wouldn’t want to waste a freezing bag with 10ml, so I would join several expressing sessions and, once milk was all at the same temperature, I’d freeze in bags of 50 to 100 ml (whatever I managed).

Please find below the ABM guidelines for storing breastmilk, the ones I always followed (For full protocol, please refer to: https://abm.memberclicks.net/assets/DOCUMENTS/PROTOCOLS/8-human-milk-storage-protocol-english.pdf)

Milk at room temperature: 4 hours is optimal, but can be kept for 6 to 8 hours, under very clean conditions (always close the lid and use sterilised containers). People who live in hot climates should be more attentive.

Milk in the fridge: 1 to 4 days is optimal, but can be stored from 5 to 8 days under very clean conditions. NB Milk must be stored in the colder section, that is, at the back of the bottom shelf. Do not store milk on the door, as this areas suffers from great variations in temperature, from opening and closing the fridge.

Milk in a freezer at the bottom of a mixed refrigeration cabinet (fridge and freezer at the bottom): up to 3 months

Milk in an open top freezer: up to 6 months is optimal, but can be stored up to 12 months.

Never mix milk at different temperatures. What I used to do is express (by hand) into Avent pots, placed them in the fridge and then I’d only freeze the milk once it was all at the same temperature. Ok, there’s no need to use a thermometer here, common sense will do ;). The ideal scenario is to freeze as soon as you express it, but freezing 10 to 20 ml in one go is not worth the amount of bags you use up (it is single use plastic, after all).

To thaw milk: ideally at room temperature. However, to speed up the process, sometimes I put the bags in a water bath, without bringing the water to the boil, I’d simply dunk the bag or bottle with milk in the water and wait. Placing it under hot running water will also do the trick. Often times I used the surplus milk for Baby S’s soup or purées, not just to give them a smoother texture, but also to add a taste he was familiar with. NB never bring breastmilk to the boil or heat above 40ºC, as it loses its properties.

Nowadays, I only express sporadically, when I’m a few more hours away from him and I know he’ll want to have that bottle in the morning, as I dropped him off earlier. By the way, I only own two glass bottles from Philips Avent. And the only reason I have two is so I can have one at my place and one at my mother-in-law’s. See, when you breastfeed exclusively, you ca save a lot of cash