ISSN Energy requirements in Chilean infants. Breast volume and milk production during extended lactation in women. Exp Physiol. The Helen Keller international food-frequency method underestimates vitamin A intake where sustained breastfeeding is common. Food and Nutrition Bulletin, vol. Blood and milk prolactin and the rate of milk synthesis in women.
Neville MC, et al. Studies in human lactation: milk volumes in lactating women during the onset of lactation and full lactation. Am J Clin Nutr. Start trying with a small amount of expressed milk, in a relaxed and unhurried way, a couple of weeks beforehand. Gradually build up to giving a full feed of expressed breast milk from a bottle. Ideally your breastfed baby should be alert, but not too hungry, the first time she has a bottle of expressed milk, so that she is as relaxed as possible.
Try dipping the bottle teat into some expressed milk before offering it, so it tastes and smells of your breast milk. Feed your baby on demand and cuddle her in a semi-upright position. Go at her pace, with as many pauses as she needs — you can even try switching sides during the feed.
If she pushes the bottle away or becomes upset, comfort her and wait a few minutes before trying again. Try again with the bottle at a different time of day. Every baby is different. Research shows that in babies aged one to six months, one baby may take as little as 50 ml during a feed while another may take as much as ml.
Start by preparing a bottle with around 60 ml, and see if your baby needs more or less. Always clean and sanitise your breast pump set and bottles according to the instructions, and wash your hands before pumping, handling milk or feeding your baby. Follow our guidelines for storing and thawing your expressed milk safely. Never warm breast milk in the microwave or on the stove top. Mums sometimes worry that if they introduce a bottle too soon, their baby will get accustomed to the artificial teat and struggle to return to breastfeeding.
Experts disagree on whether nipple confusion is really an issue. And some babies do seem to have a preference for breast or bottle, and never take to the other. Place a finger and your thumb either side of the nipple at the base and gently stretch and roll the nipple. Place your thumb above your nipple at the edges of the areola dark area around the nipple , or about 2 cm from your nipple and your first finger below.
Using your thumb and finger, gently press your breast tissue back towards your chest wall and squeeze. The breastmilk will move down the ducts. Drops of breastmilk should soon appear on your nipple. There is no need to move your fingers towards your nipple while squeezing, the milk will flow when you compress your breast. Rhythmically squeeze about once per second.
The breastmilk will soon begin to flow — sometimes even squirting out. Sometimes your hand may become tired so switch hands regularly. Once the breastmilk dwindles to a few drops, try moving to another area of your breast and continue to press and squeeze.
Expressing by hand takes time You will need to set aside adequate time to express each breast. Breast pumps Many mothers prefer to use either a manual or electric breast pump. A breast pump must be: effective comfortable easy to use safe to use — that is, it should not damage the nipple or areola, or cause muscle strain economical.
Getting started Suggestions for using hand-held and electric pumps are as follows: Stimulate the let-down reflex by hand. Once the milk has started flowing, start using the pump. Place the pump shield directly over your nipple make sure your nipple is in the centre and hold it firmly against your breast. Rhythmically squeeze and release the hand pump handle. Or with an electric pump start with low pressure and then slowly increase the pressure to your level of comfort.
If it is painful, check that the breast shield is centred directly over your nipple and reduce the suction. Milk will begin to flow into the collection bottle. Adjust the suction strength so that it is comfortable and not causing any pain or discomfort. Excess suction will not result in the removal of extra milk, and may result in pain and nipple damage. Finish expressing by hand for a few moments to help with getting as much breastmilk as possible. Electric breast pumps Some mothers choose an electric breast pump.
General tips for expressing breastmilk General suggestions for expressing breastmilk include: Give yourself time to learn how to express breastmilk. Express as often as you would breastfeed in order to maintain your breastmilk supply. For example, if your baby feeds 8 times over a hour period, you need to express at least 8 times. Express more often if you find you need to increase your breastmilk supply. You can express every 2 hours during the daytime for one to 2 days.
If your baby cannot breastfeed and you are trying to establish your milk supply, you will need to express 8 to 10 times over a hour period. Express at least once overnight to maintain your breastmilk supply. Babies normally breastfeed at least once overnight, and you are trying to express as though your baby is breastfeeding. Most women will use a bottle to give their expressed breastmilk to their baby, however some may choose to use a cup. It is best to discuss the best way to feed your expressed milk to your baby with your maternal and child health nurse.
Remember to write on the date and time of expressing. EBM can be transported to the hospital in an insulated bag containing ice bricks to keep it cool. When your baby is discharged home from hospital you will be asked to take your breast milk home with you. If your baby has been discharged and you have forgotten to take your breast milk home, we will make every attempt to contact you on the phone number you have provided us with.
After expressing your milk, complete the EBM label. Attach a new label to each container. EBM is stored at the ward level in an individually labelled storage container in the fridge.
The nutrition assistant will transfer any excess EBM from the ward fridge to the formula room freezer. The formula room freezer is able to store up to 48 containers of your breast milk.
Your nurse can access your frozen milk at any time during your stay. Please remember to collect your stored breast milk on discharge. Note: Breastmilk can be stored in the ward fridge and used for up to 96 hours from when it was expressed. Literature review Infant Feeding Guidelines National Health and Medical Research Council. Infant Feeding Guidelines. Australian Breastfeeding Association. Expressing and storing breastmilk Cited on www. Mannel, R. In Core curriculum for lactation consultant practice 3rd ed.
Morton, J. Combining hand techniques with electric pumping increases milk production in mothers of preterm infants. Journal of Perinatology, 29 11 , Fok, D.
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