Breast milk is the perfect food for babies. This includes full term, pre-term and sick babies. Each mother’s own breast milk is ideally suited for her own baby.
Breast milk is easily digested by babies and is packed with essential nutrients for growth. It also contains millions of living cells that work to protect your baby from disease.
Establishing a breast milk supply
How often should I express?
When you are expressing breast milk it is best to copy breastfeeding as closely as possible. Newborn babies breastfeed around 8-10 times each day. If your baby is not breastfeeding, you will need to express to remove milk 8-10 times each day, including at least once overnight. The longest break between expressing sessions should be no longer than five hours. This is very important in the first 2 weeks to build a good milk supply.
Some mothers can reduce to 6 times per day when their milk volume reaches approximately 750ml per day. Other mothers will need to express 8 times each day with one session overnight to maintain their milk volume.
Breast massage and the use of warm compresses before expressing assists your breasts to release milk for your baby. Gently massage the breast towards the nipple. At the same time, assess each breast for lumpy areas within the breast and massage any lumps while expressing.
Any lump within the breast that does not resolve with breast massage and regular expressing needs to be reviewed by a lactation consultant or your doctor.
The amount of colostrum (first milk) expressed in the few days after birth may only be a few drops or it may be several millilitres. Expressing for 15 to 20 minutes, alternating between breasts, usually results in multiple let-downs and more colostrum being collected.
Once you have started to regularly express, milk volumes should start to increase from days 2 to 6 after birth. Signs of increasing milk production include warming, tingling and firming of the breast.
Follow the steps below to hand express:
- Wash your hands before expressing
- Gently massage the breast towards the nipple
- Place the thumb and forefinger approximately 3cm back from the nipple, keeping the thumb in line with the forefinger
- Position a clean container under the breast/nipple to collect the milk. A syringe may be used for smaller volumes.
- Press the thumb and forefinger towards the chest, then compress the thumb and forefinger together
- Repeat compressing with a rhythmical movement – milk may come in drops or a flow
Hand expressing should not hurt. More information is also available at Hand Expressing Technique (health.qld.gov.au).
Milk volumes will vary from mother to mother and throughout the day. All mother’s breasts have a different capacity to hold milk and this is not determined by breast size but by the amount of glandular (milk producing) tissue in your breasts.
As a general guide your body may produce the following volumes of milk each 24 hours:
- First 2 days after birth: less than 100 mL*
- Day 4 to 5: 500 mL
- From 2 weeks: 750-1000 mL
*In the first few days, you will have colostrum. It’s common to only express a few drops of colostrum. Milk usually ‘comes in’ between days 2 and 6. It takes at least 2 weeks for milk production to establish and become consistent.
Milk production can vary throughout the day. Amounts are usually greatest in the morning, gradually decreasing as the day progresses.
Ways to help you express more milk
- Cuddle your baby skin to skin. This will help to release the hormones that make your milk flow.
- Rest when possible and eat healthy foods
- Drink water when you are thirsty (keeping a drink bottle with you may help)
- Sit near your baby or look at a photo of your baby
- The smell of your baby may enhance milk flow
- Apply warm compresses and massage your breasts before and during expressing
- Listen to calming music.
Stress, pain, anxiety and illness may decrease your supply. If you have ongoing concerns about expressing your breast milk, please talk to your GP, a child health nurse, an Australian Breastfeeding Association counsellor or a lactation consultant.
All milk given to your baby is valuable and your efforts are appreciated. Remember, every drop counts. No matter how small each expression, always save the milk for your baby.
For more information
Children’s Health Queensland fact sheet | Breastfeeding: Increasing your breast milk supply
Children’s Health Queensland fact sheet | Increasing your milk supply when your baby is not breastfeeding
Australian Breastfeeding Association | breastfeeding.asn.au
Breastfeeding Helpline | 1800 686 268 (24 hours / 7 days a week)
Child Health Service | childrens.health.qld.gov.au/child-health-service
How to express breastmilk (Global Health Media) | globalhealthmedia.org