Session 15 Expressing Bm

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Expressing Breast Milk Session 15

Expressing breast milk After completing this session participants will be able to:





know the situations when milk expression is useful Explain how to stimulate the oxytocin reflex Explain the steps of expressing breast milk by hand Describe how to prepare a container and store expressed breast milk

In what situations is it useful to express breast milk (BM)?

In what situations is it useful to express breast milk (BM) ?

Expressing BM is useful to:








When mom goes out or goes to work Feed LBW who cannot breastfeed Feed sick baby who cannot suckle enough Keep up the supply when mom / baby is sick Prevent leak when mom is away Help baby attach to a full breast / engorged Transition to another method

RECALL How to stimulate oxytocin reflex These help reflex

These hinder reflex

• Thinks lovingly of

baby • Sounds of baby • Sight of baby • Touches baby • Confidence

• Worry •Stress • Pain • Doubt •(temporary)

How to stimulate oxytocin reflex




Help the mom psychologically






Build her confidence Try to reduce source of pain or anxiety Help her to have good thoughts and feelings about her baby

How to stimulate oxytocin reflex - cont

Give mom PRACTICAL advice/ help







Sit quietly / privately or with supportive friend Hold baby with skin to skin contact if possible ( baby on lap / look at baby / picture ) Warm the breast; take a warm shower Stimulate nipple Massage or stroke breast lightly ( fist / comb / finger tips ) Ask helper to rub her back




Massage of the breast using a ‘fist’ and rolling action.

This is for teaching purposes only. This cannot be published.

Back massage With the hands placed flat on the back, the tips of the fingers facing towards the vertebral column

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Back massage With the hands placed flat on the back, the tips of the fingers facing towards the vertebral column

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Stroking

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How to rub a mother’s back 1. Head resting on the table 2. Mother is naked with the breast hanging 3. Rub with the thumb both sides of the spine in a circular motion from the neck to the shoulder blades

Practicum :

Rub the back of your friend now !

How to express breast milk by hand Pointers:






Most useful way Anywhere / no appliance needed Show her how to express DO NOT touch her body Be very gentle

Prepare container :











Cup / glass / jug / jar with wide mouth Wash cup with soap and water Pour boiling water into the cup & leave for a few minutes to kill bacteria Pour the water out when ready to express

Breastmilk expression

POSITION PUSH PRESS RELEASE ROTATE

Important pointers Demonstrate it as much as possible with your own body or a breast model or soft part of your arm or cheek

How to express breast milk by hand Put her thumb on her breast above the nipple and areola and her first finger on the breast below the nipple and areola opposite the thumb

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Press her thumb and her first finger slightly inwards towards the chest wall

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Press her breast behind the nipple and areola between her fingers and thumb. Sometimes in lactating breast it is possible to feel the ducts like rods and peanuts

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Press and release , press and release

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Press the areola in the same way in the sides to make sure that milk is expressed from all segments of the breast

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Express one breast for at least 3-5 min until the flow slows ;then express to the other side and repeat on both sides. Adequate milk expression takes 20-30 min

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Avoid squeezing the nipple itself

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How often to express ? It depends on the reason for expressing BUT usually as often as the baby would breastfeed

How often to express ? 1.

To establish lactation, to feed LBW or sick newborn




Do immediate latching Start on first day Few drops of colostrum but it helps BM production to begin Express at least every 3 hours INCLUDING night








How often to express ?

2.

To keep up her milk supply to feed a sick baby - at least every 3 hours

3.

To build up milk supply which seems to be decreasing – every 1-2 hrs for a few days
and at least every 3 hrs during the night


How often to express ? 4. To leave milk for her baby while she is at work Express as much as possible BEFORE she leaves And express while at work to keep supply

5. To relieve symptoms such as engorgement or leaking at work Express only as necessary

Practicum :

Rolling action of fingers on the breast model or arm Breastmilk expression – on yourself

Breast pumps Use if available – for engorged and painful breast Manual breast pump or automatic breast




Automatic breast pump

Summary on page 85-90