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Expressing breast milk for a premature or ill baby

Why expressing breast milk is important if your baby is too small or sick to breastfeed

If your baby is born premature, the breast milk you produce is especially suited to your baby's needs.

This milk is slightly different than breast milk produced for a full-term infant. Premature breast milk is higher in protein and minerals. It contains different types of fat that your baby can more easily digest and absorb. The fat in breast milk helps to enhance the development of your baby’s brain. This is especially important for your premature baby.

Breast milk benefits

Breast milk is easier for your baby to digest than formula. It also means that you can avoid exposing your baby's immature gut lining to the cow’s milk proteins found in premature infant formula. Premature babies who are breastfed are less likely to develop infections of the digestive tract than babies who are formula fed. The milk you produce in the first few days contains high concentrations of antibodies to help your baby fight infection.

Baby is too small or ill to breastfeed

Even if your baby can't breastfeed yet, expressing breast milk from the start will help maintain your milk supply. If you are unwell following the birth, your midwife will help you to hand-express as soon as you feel well enough.

You will likely need to hand-express for the first few days. You can use a breast pump from around day 3 when your milk changes from yellow colostrumto white-coloured milk.

Hand-expressing colostrum

Begin hand-expressing your colostrum as soon as possible after the birth of your baby. Research has shown that mothers who expressed within 1 to 2 hours after birth produced more milk later on.

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How to express breast milk

Once you have started, try to express at least 8 to 10 times every 24 hours.

If possible, express at least 1 time between midnight and 6 am. This is because prolactin (the milk-making hormone) is higher at night so expressing at this time will help to boost your milk supply. This is especially true in the early weeks after your baby’s birth.

Try not to be disheartened if there is no milk the first few times you express or if you produce a very small amount. Keep trying and you will soon see your colostrum flowing. Every single drop of your milk is important for your baby. The tiny drops you make at this point are precious and will help your baby.

In the first few days, it can take 15 to 20 minutes to hand-express.

Midwife Rebecca O'Donovan shows mothers how to hand express milk

Switching to breast pump

When your body starts to produce more breast milk, the colour changes from yellow colostrum to more white-coloured breast milk. This generally happens from around day 3. At this point, you can switch to using a breast pump.

Your nurse or midwife will show you how to hand-express and how to use a breast pump.

Draining your breasts

There is a protein in breast milk called Feedback Inhibitor of Lactation (FIL). When your breasts are full of milk, there is lots of FIL present in your breasts. This sends a signal to your brain to slow down the production of breast milk.

When your breasts are well drained or emptied of breast milk, there is very little FIL present. This sends the signal to your brain to increase the production of breast milk. This is why emptying your breasts as much as possible at each expressing session is important. It helps build your supply and keeps the supply going strong.

Getting help

Expressing may feel like an extra challenge when you are feeling tired and worried about your baby. Remember to look after yourself also and try to get rest. Give yourself time and try not to feel rushed. This is a skill that will get easier with time.

Talk to the hospital's lactation specialist, your baby's nurse or your midwife. They can help you work out a routine that helps you achieve as many expressing sessions as possible.

Page last reviewed: 14/11/2018
Next review due: 14/11/2021

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