Expression of front milk. Do I have to express my milk after every feed? Breastfeeding: Oxytocin

Expressing issues breast milk not only freshly baked mothers are interested, but also nursing with experience, because there are so many conversations, myths and theories around this process! Some say that this is a completely optional procedure, others will convince you that you need to express after each feed. Who is right, and who to listen to? Do I need to pump my breasts, and if so, in what situations? Or is it a waste of time? We hope this article gives you all the answers.

Is it necessary to express milk?

Young mothers tend to seek advice from more experienced women — their mothers and grandmothers — asking “Should I express my milk after every feed?” and get a categorical “Yes! To the last drop!". Unfortunately, this advice is classified as harmful.
Before following these recommendations, it is worthwhile to understand a little about how breast milk is produced.

Nature is wise enough, and if you have established the breastfeeding process correctly, the amount of milk will adjust to the needs of your baby, grow with his needs and decrease when needed. Expression - imitation of the baby's sucking movements, that is, additional stimulation of the breast. By imitating in this way the increased needs of your child, you are deceiving your body, and it reacts to it in the most natural way - it starts producing more milk. But a healthy baby will eat exactly as much as he needs and not a drop more, and the excess milk will remain unspent, which is fraught with the formation of stagnation or otherwise lactostasis, which, in turn, can lead to more serious complications, for example, purulent mastitis.

Thus, it becomes clear that it is not necessary to express milk after each feeding just like that, unnecessarily.
There are, however, situations in which the expression of breast milk cannot be avoided. We will talk about them below.

We fight lactostasis. How to express milk when stagnant?

Milk stagnation or lactostasis is a very unpleasant phenomenon that can happen to a woman not only immediately after childbirth, but also several months after the start of breastfeeding, when it seems that you already know all the rules of the game. It is also very common for women to face this problem when completing breastfeeding.

In this article, we will briefly describe how to alleviate an unpleasant condition by expressing, and read about the causes of lactostasis and the full range of measures to prevent milk stagnation here.

Your baby is the best helper in the fight against stagnation, but if for some reason the baby refuses to breastfeed, pumping comes to the rescue. It is allowed to use a breast pump, although expressing by hand with stagnant milk will be much more effective, so you can work out all areas with seals. You can take a warm, relaxing shower before expressing, but do not stay under the running water for more than 5 minutes, as this can cause a strong milk flow. Warm compresses can also reduce pain.

Scheme of breast massage for stagnant milk.

Here are step-by-step instructions on how to express breast milk when stagnant:

1. Get into a comfortable position and try to relax.
2. Give a light breast massage.
3. Feel for one of the lumps in your chest (if there are several). We will need to work through each one.
4. Grasp your chest with your hand so that your thumb is on top - at the base of the chest above the lump, and the other 4 fingers are under the chest.
5. Begin to slowly massage the breast with your thumb towards the nipple, in a circular motion, as if pushing milk and kneading stagnation.
6. You need to work in this way every milk lobe in which there is a blockage of the milk duct.
7. If expressing milk by hand is too painful, try using a breast pump.
8. When the breasts feel softer, you can try to attach the baby. Babies, as a rule, are more willing to suckle after a massage, because it makes it easier for them to extract milk from it.
9. At the end of the process, you can apply cool (but not ice-cold!) Compresses to your chest to relieve inflammation and irritation.

If you have not succeeded in straightening your breasts either manually or with a breast pump, be sure to seek help from a medical institution! Don't wait for the condition to worsen!

Knowing how to express stagnant milk correctly and having learned self-massage techniques, you can always provide yourself with first aid in such an unpleasant situation.

Should I express my milk after breastfeeding if I have problems with lactation?

Perfect fit baby, excellent weight gain, no congestion and enough milk in the first days after childbirth is an idyllic picture, but by no means so common. A woman who decides to feed sometimes faces many difficulties at the beginning of her journey, but not everything is so scary if armed with knowledge!

In some situations, pumping will be the key to further longevity, we are talking about situations when:

• The baby was born with a reduced sucking reflex
• The kid is lazy to suck on the breast and quickly falls asleep
• The baby lost more than 10% of weight after birth

Expressing your breasts will help in all of these situations.

In the first three to four months, the formation of lactation occurs. You and your baby get used to each other, a certain rhythm of feeding is developed. It is no coincidence that the first so-called milk crisis falls on the third or fourth month. In addition to the sharply increased needs of the baby, to which your body has not yet had time to adjust, it can be caused by initially improperly organized breastfeeding. It's just that in the first months, milk is supplied, as a rule, in excess, and later only the required amount. Accordingly, if there is insufficient breast stimulation in the first months of breastfeeding, this unpleasant moment will probably not be avoided.

That is why, when faced with the problems described above, it will be useful to express milk after each feed in order to increase its amount. However, one should not get too carried away with this process, expressing the breast to the last drop. So you can cause hyperlactation and you have to solve the problem of stagnation. Instead, try pumping your breasts until they are soft, so that you feel comfortable. This pumping has a beneficial effect on lactation, preventing it from decreasing.

If your baby is classified as a baby or is too weak to suck all the milk out of the breast on its own, after consulting a pediatrician, it is possible to supplement with expressed milk from a special spoon, syringe or SNS system. Do not use a supplement bottle, especially in the first months! The technique of sucking the nipple and nipple is very different from each other, the baby's head is confused, so using a bottle in this case can only aggravate the situation.

Cessation of lactation.
Do you need to express milk when you stop feeding?

Completing lactation, women also have something to worry about: it can be stressful for both mom and baby, but first of all, this is a transition to a new stage of your interaction. There are many related questions about how to properly end breastfeeding, avoid lactostasis and maintain the beauty of the breast.

To understand whether it is necessary to express the breast when you quit breastfeeding, you need to remember again how the lactation process takes place. Milk in your breasts is produced by the continuous and coordinated work of hormones and your breasts. In simple terms, breast stimulation sends signals to your brain about the increasing and decreasing needs of your baby. In accordance with them, there is a natural decrease or increase in the amount of milk.

This is how clogged milk slices look like with lactostasis.

If you feel good, your breasts are not hardened, poured or lumpy, you do not need to express milk!
If you experience discomfort, your breasts are full and hard, in this case it is allowed to express milk until you are relieved, that is, a little. So your body will understand that there is too much milk and will gradually reduce, and later stop, milk production.

When else might you need to express breast milk?

If you plan to go to work early, or your baby needs medical attention and will be away from you, but you plan to continue breastfeeding, you will need to learn how to express breast milk. Also in this case, you need to know how to properly collect, store and give expressed milk.

Do I need to express milk? A quick cheat sheet for doubters:

• Are you concerned about stagnation or lactostasis?
• Do you have insufficient milk?
• Does your baby fall asleep quickly on his chest, not having time to eat?
• Has the baby lost more than 10% of its weight at birth?
• Is the baby born prematurely or is it in the hospital?
• Are you planning on going away leaving your child with another adult?

If you answered “No” to all of these questions, you probably don't need to pump.

If you answered “Yes” to any of these questions, you will most likely need to express breast milk.

Young mothers have many questions about pumping. When to do this, why, how and should you pump at all? Is it better to use a breast pump or is it better to express by hand? Let's figure it out together.

Why pump?

With normal lactation and competent organization of feeding the baby, there is no need for pumping. Mothers and grandmothers may strongly advise you to express the remaining milk after each feed, but these are just relics of the past. The recommendations of modern pediatricians and experts on hepatitis B are opposite: the baby normally sucks as much as he needs, and the same amount of milk is produced for the next feed. The mode of feeding on demand, which is now recommended for mothers, assumes that the baby will receive its portion of milk.

However, pumping becomes necessary in some situations:

• when the baby is weak and it is difficult for him to suck milk from the breast (it becomes necessary to feed the baby with expressed milk from a bottle);
• in case of (milk stagnation) in a nursing mother;
• with insufficient production of breast milk, lactation crisis;
• with an excess of breast milk, the crumb begins to choke, so it cannot suckle;
• if the mother is taking medications that prohibit breastfeeding, but wants to resume lactation after completion of treatment;
• when mom needs to go somewhere else she goes to work;
• if you need a supply of breast milk.

When to pump?

1. Expression makes the glands work harder and produce more milk. So you shouldn't abuse it.
2. If the mother is going to go somewhere or go to work, it is recommended to start pumping in advance so that the mammary glands "get used" to the new regimen and the required volumes. If possible, at the time of separation from the baby, if there is a rush of milk, it is also useful to express to reduce the risk of milk stagnation.
3. If you have excess milk, it is recommended to express a little before feeding. This will reduce the volume of liquid milk ("front"), so the baby will stop choking and will immediately take the breast.
4. If you are worried about lactostasis, you need to express milk until the symptoms are relieved - pain and swelling are relieved. Then the mother should often apply the baby to her breast to prevent further milk stagnation.
5. In case of insufficient milk production, pumping should be strictly after feeding - this stimulates the work of the glands.
6. When taking medication, pumping should be carried out in the usual feeding mode - at the moments when the milk rushes.
7. It is convenient to store milk when the baby skips a feed - for example, he sleeps longer than usual ().
8. If milk flows when parting with the baby, it is useful to express it to reduce the risk of developing lactostasis.

How to pump?

You can use breast pumps, which are manual and electric, or manually express your breast. The devices perfectly collect the "front" milk, but they do not always cope with the "back" milk. It is thicker, which makes it harder to pump.

The manual method is much more efficient. Place your thumb and forefinger on opposite edges of the areola, separate them from the skin and slide them inside the breast, stimulating the milk canals, not the nipple. With the other hand, you can knead the base of the chest in parallel. After several taps each time, move your fingers around the areola to cover all the lobules of the breast. Do not press hard, rub the skin. With the correct procedure, pain should not be felt.

When breast engorgement and hard nipples are painful when expressing, we recommend using the warm bottle method. You will need a bottle with a wide neck that easily wraps around the nipple and areola. Pour boiling water into the container. Then wait a little and attach the neck to the areola area. As the bottle cools down, the nipple will be drawn in and the milk will flow out.

The warm bottle method is convenient but does not drain completely. Therefore, it is best to end the procedure with normal manual pumping. The breasts will already be softened, so there will be no soreness.

Note to moms!

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How to stock up?

A nursing mother should make sure that she always has at least a modest supply of expressed milk. This will help out in case of an urgent departure, illness and in other unforeseen situations, when you have to temporarily part with a baby.

At room temperature up to 25 °, breast milk is stored for 3 to 6 hours, in the refrigerator - 24 hours, and in the freezer longer - from 1 to 3 months. Therefore, to create a long-term supply, it should be frozen in special containers or sachets. Before being sent for storage, breast milk should be kept in a sealed container for about half an hour so that it retains all its valuable qualities. Each portion of milk must be packaged separately, indicating the date of expression, so you can control its freshness.

It was customary to express breast milk in order to feed the baby at a specific time. This was considered correct in the past, but modern doctors have a slightly different opinion. The previous technique was rejected, considering it unnatural, but the custom of decanting after feeding to the last drop remained.

Women produce milk in different quantities. It is really hard for some mothers who have a lot of untreated milk after feeding their baby. But basically, the body gets used to producing exactly the amount of food that is needed for this particular child. The modern on-demand feeding method ultimately helps to solve the production problem.

Moreover, it is not clear why to pump if the child has enough food. When expressing after feeding, the body tends to quickly make up for the lack of milk, and as a result, it is produced in much greater quantities.

Do I need to express milk at all

However, in some cases, pumping is necessary. This can be, for example, when more milk is produced than the baby can swallow, and the mother is constantly experiencing discomfort due to overcrowding of the breasts. By draining the excess milk, you can return to normal without discomfort in the chest. If pumping is done little by little, there will not be a sharp increase in the amount of milk, but possible problems with the glands will be eliminated.

Expressing is also permissible in cases where the baby, for example, is sick. During this period, he may refuse to eat or suck out very little breast milk. If there is no demand for reserves, the mother's body can begin to produce milk in smaller quantities. The result is that after the child recovers and wants to return to the previous norm of the usual food, it may not be enough. By pumping, it is possible to keep lactation at the same level.

Milk is also expressed by those mothers who often have to leave their baby to other people. Then the milk is collected in a sterilized container, you can store it in the refrigerator and then serve it to the child, warmed up.

Expressing milk after feeding is completely optional, but if circumstances develop in a certain way, you can do so. It is much better for women's health to get rid of surplus milk naturally, that is, by feeding the baby.

In order to determine if it is necessary to pump, you need understand the physiology of milk formation... Provided that the mother breastfeeds the baby when he needs it, the body produces exactly the amount that the child needs for this moment... The whole process is controlled by the mother's hormonal system.

Under what conditions does breast milk form occur: physiology of the process

The hormone prolactin is responsible for the lactation process. When a baby begins to suckle at the breast, a signal is transmitted along the nerve endings of the areola to the pituitary gland, which produces prolactin. The more often and more actively the child sucks, the more hormone is formed and the more milk will arrive to next feeding... If the child is rarely brought to the breast and given a nipple, it starts to accumulate, which reduces the amount of hormone in the future. You can increase the inflow by more frequent latching of the baby to the breast.

Oxytocin is responsible for its release directly during the feeding period. It acts on the muscles surrounding the mammary gland, which contract and push the accumulated fluid towards the nipple. If the oxytocin is low, both feeding and pumping will be very difficult even when the breasts are full. This physiological aspect can completely debunk the myth of the need for complete expression. Indeed, next time, not only the amount required by the child is formed, but also the volume that was expressed the last time. Increased production of this product called hyperlactation, which entails the development of lactostasis and further mastitis.

Breastfeeding Tips: Should You Express After Feeding?

The first and most basic recommendation is not to wash your breasts before and after feeding, while using any hygiene products... It would be more correct to use clean water. Strong smells of gels or soaps can scare a baby away. It is best if the breasts have a milky smell.

Mother's milk is conventionally divided into two types: front and back. The foremilk is bluish. It provides the baby's need for fluids, rich in protein and milk sugar (lactose). There is no need to constantly express after feeding, sometimes it can even lead to unpleasant consequences for the baby. If a woman expresses after each feed, the baby receives mainly foremilk, which can lead to excess lactose in the intestines... The baby's digestive system cannot handle such amounts of sugar, causing fermentation and abdominal pain. The stool becomes greenish and runny.

Such consequences can be avoided if the child also receives hind milk. It is thicker and fatter. It contains a large amount of the enzyme lactase, which breaks down milk sugar and helps it to be absorbed better. In addition, there are a lot of nutrients in the back, necessary for the child... Therefore, it is not worth weaning the baby from the breast before hind milk begins to be released. After feeding, be sure to squeeze out another drop and lubricate the nipple. This simple technique will help you avoid cracking.

Do I need to express milk after feeding?

Nature does not provide for such a frequent production of large volumes of milk in women, which is provoked by frequent expression. There are two options for feeding babies:

In the case of an established lactation process, when the mother is healthy, the baby is full-term, he grasps the nipple well and is correctly applied to the breast, both feeding methods will be acceptable, and pumping may practically not be required.

When should you pump?

The first step is to prepare the dishes before expressing. It should be washed clean and sterilized. Then the woman herself must prepare for pumping. Will greatly facilitate the pumping process relaxing environment, close contact with the child and positive emotions. Stress and bad mood make it difficult for milk to flow. It is recommended that you take a hot shower and rub your body with a towel before expressing. Drinking warm drinks can also help make pumping easier.

If your mom doesn’t have any experience with pumping yet, it is advisable to see a breastfeeding specialist or doctor. Midwives in the maternity ward can also help with the first expression. Subject to correct technique process, pumping will be successful and painless.

Expression is also favored by massaging the mammary glands towards the nipple. It will stimulate the production of the hormone oxytocin, which will help increase flow. When expressing, the breast should be squeezed in the area of \u200b\u200bthe areola, since milk accumulates there.

You can pump as with using a breast pumpand manually. If a woman chooses to use a breast pump, she will need to make sure it is clean and sterile before each pumping, and that there are no cracks in the nipples. The device will work best with full breasts. When expressing, you should firmly press the funnel, change the position of the nipple relative to the breast pump, and take short breaks. When correct use The device makes the pumping process much easier, however, if the breast becomes limp, the milk will have to be pumped with your hands. The movements should be performed smoothly and slowly, without applying unnecessary effort. Otherwise, it can badly affect the milk alveoli.

The milk is expressed until the breast is completely soft, which can take anywhere from twenty minutes to half an hour. No lumps should be felt in the mammary glands. If compacted area found, it needs to be purposefully kneaded. On initial stages When expressing, it may turn out that the milk stops flowing, although the breast feels full. In this case, you need to take a break and either start expressing the other breast, or get a little distracted and take a break.

How much breast milk should you express?

The amount of milk you need to express will depend on your goals. If it is necessary to stimulate lactation as much as possible, you will need to express the breast completely. If pumping is carried out to ensure a supply of milk for future use, the amount required for one feeding is required. When stagnant, it is recommended to express quite a bit to relieve tension in the chest.

Milk storage methods depend on the period of time for which it is planned to store it:

Each woman will have to decide for herself whether to pump after each feed or not. However, no professional will recommend pumping after every feed. After all, the more milk arrives - the more a woman expresses it, which is not always necessary and takes a lot of time and effort.

"If you want to breastfeed, don't be lazy and express your milk after each feeding!" - for many decades, doctors have professed this doctrine, believing that it is a prerequisite for good lactation and breast health in the future. The confidence in the need to express breast milk was so great that mothers spent all the time from one feed to the next, complicating their lives.

Do I need to express milk?

The myth about the total benefits of diligent expression of breast milk is based on the observation that if you take every last drop of milk from your breast, then more will come. But this rule has other characteristics as well. Firstly, it only works with a single use: if after the morning feeding the mother expresses her breasts to the last drop, then the next day more milk will actually accumulate. If the woman does not repeat the procedure, the volume will still gradually return to normal. The second circumstance: when the baby suckles himself, the amount of milk formed and eaten is approximately the same. By expressing the valuable liquid, a woman disrupts the natural balance between the baby's need and the amount of milk produced. They always express more than the crumb would eat, so by the next feeding, too much milk will come, the breast will overflow, but the baby still will not eat more than he needs. If you do not decant the residues, there will be a threat of lactostasis. Mom gets to work, and in response to her efforts, more milk will come again than needed.

A vicious circle of breast milk expression will form, which cannot be broken painlessly. Milk that is not required by a child is a signal for the pituitary gland to reduce the production of hormones responsible for breastfeeding. The answer will be to reduce the amount of "baby food". Noticing that there is less milk, the mother takes measures: she spends even more time on pumping, stretches the breaks between feedings in order to "accumulate milk", introduces supplementary feeding ...

As a result, the baby breastfeeds even less, and the mammary gland is deprived of the natural stimulation it needs. The normal feeding scenario is disrupted, and the baby gradually becomes artificial ... The conclusion is obvious: continuous pumping is fraught with complications, and it is better not to start it. It leads to stagnation of unclaimed milk, threatening the health of the mammary glands, and interferes with normal lactation.

When should you express breast milk?

But it is not worth excluding the expression of breast milk completely from the life of a young mother. A baby's normal breastfeeding cycle lasts at least 1 year. During this period, a nursing mother will more than once find herself in circumstances where pumping is indispensable. More often than others, three situations are repeated, and each involves its own pumping tactics.

The first story. The first arrival of milk.

Usually milk appears in the breast on the third day after childbirth. And it is not always possible to guess how much it will come. Sometimes the income is so large that most of it remains unclaimed by the newborn and complicates the life of his mother, who has not yet recovered from childbirth. A woman's breast increases in size, becomes heavy, if you press on the glands - you feel pain, they lose their usual softness and become rude. If you do not take action in time, inflammation develops: the temperature rises, the state of health worsens.

What to do?When breast engorgement, a compress from cabbage leaves helps. It has a cooling effect by absorbing vapors from the surface of the skin. Wash with warm water a few large fresh leaves cabbage and cover the whole gland with them for about an hour. The next point of help should be gentle massage and pumping. One or two sessions will soften the breasts, helping to normalize milk production.

Since at the moment of the rapid arrival of milk, the breast becomes very painful at the slightest touch, you need to prepare for pumping. Start by massaging the least affected areas, gradually expanding the area. Try to relax, take long exhalations - this will help remove the mammary gland from the state of "shock", then the elastic muscle tubes - milk ducts - will begin to contract more actively, and the milk will flow by itself.

After 7-10 minutes of massage, try to place your fingers with a pinch on the areola and squeeze and release them rhythmically several times. If a drop of milk comes out, start expressing - by hand or with a breast pump, if not - continue to massage.

Expressing milk with your hands, place your palm with four fingers under the breast so that the index finger is on the bottom of the areola, and the large one is on top. When you squeeze all your fingers, the nipple should move forward. Now lift your chest, press it against the chest and squeeze and unclench your fingers around the areola several times. If milk starts flowing, continue pumping until the hot flush ends. To make the glandular lobules empty evenly, move your fingers around the areola.

Important details. Expressing with a breast pump has an important advantage: the resulting product is easier to store, because the milk goes directly into a sterile bottle or bag for freezing milk. When working with your hands, some of the valuable liquid splashes out. When trying to express milk for future use, do not get carried away. Expressing too recklessly will lead to the fact that tomorrow there will be even more milk, and you will again wake up with painful breasts.

The second story. Milk stagnation leads to lactostasis.

At first, mom discovers a small lump in her chest, which hurts when pressed, as many women say, like a bruise. With lactostasis, the milk ducts, which are supposed to push milk out, lose elasticity and stop contracting. No more liquid is formed than usual, but it cannot come out. If you do not take action, redness will appear. If you continue to inactive, mastitis will begin - inflammation of the mammary gland.

What to do? An excellent remedy for the treatment of lactostasis is all the same expression. It should be started with a similar breast massage - it will soften the seal, restore blood flow in the stagnation zone and activate flaccid ducts. Painful sensations should be avoided: the response to pain will be an even greater spasm of the ducts and aggravated lactostasis. The entire gland should be massaged - not strongly, but quite deeply. First, make several stroking movements along the gland from the periphery to the nipple, lift it, tap with your fingers from below, from the side, approaching a particularly sore spot. To help your fingers glide better and not injure delicate skin, apply nipple cream to them.

Important details. You should proceed to expressing itself when you feel a rush of milk (usually, heaviness, itching, tingling appears in the breast) or you see that it begins to drip. You can manually strain into a wide bowl, leaning over a low table: this is how the chest is in a position that stimulates outflow.

Third story. The child is not gaining weight

The baby is already a month old, he sucks normally, and nothing bothers mom. But on the very first visit to the doctor, it turns out that in a month the crumb has hardly gained any weight. It turns out that he does not have enough food and urgently needs additional food? The reason for the misunderstanding is that an inexperienced mother cannot always determine when her baby is just sucking on the breast like a dummy, and when she is eating. She does not notice that the baby just lies with a nipple in her mouth, smacking her lips, and does not swallow anything. This behavior creates a sluggish milk order. If you accept this tactic, then pretty soon the breast will empty, the baby will turn away from it, and lactation will stop almost immediately.

What to do? Milk is released in waves in response to the baby's sucking. It is advisable to avoid long breaks between tides. If the baby falls asleep at the chest, shake it, lift it to an upright position for a few seconds, offer one or the other breast. To activate the flow of milk, you will have to spend your free time on stimulating massage and pumping. At first, these procedures should take several hours a day: 3-4 sessions of 30-45 minutes will be required. After a few days, you will notice an improvement and the duration can be shortened. During massage and pumping, you should be comfortable: make yourself comfortable, turn on calm music, tune in to pleasant thoughts about your baby. Breast massage - stroking, shaking, tapping - should be alternated with squeezing and unclenching the nipple for 1 minute. As soon as the gland becomes softer, pump out some milk and start feeding.

Important details. Expressing is not your task a large number milk, save the main portion for the baby. After all the effort, he'll probably be able to finally have lunch on his own.

If the mother managed to collect milk, expressing it as needed, then sooner or later she will be able to create her own "milk bank" in the freezer. The product will definitely come in handy when you need to go away for a long time or take a medicine that is incompatible with breastfeeding.

It is worth preparing for the rapid arrival of milk. A day after the birth of the baby, you should limit fluid intake - drink a little and only still water. Soups, tea, compotes exacerbate thirst. When milk production returns to normal, the prohibitions can be canceled.