Neobook — clinical reference

Expressing Breastmilk

Wash hands with soap and water
Make sure mother is sitting comfortably – a little forward
Show her how to cup the breast just behind her areola
Squeeze the breast gently, using thumb and the rest of fingers in a C shape. This shouldn’t hurt(don’t squeeze the nipple directly as you’ll make it sore and difficult to express)
Release the pressure then repeat, building up a rhythm. Try not to slide the fingers over the skin
At first, only drops will appear, but if she keeps going this will help build up her milk supply. With practice and a little time, milk may flow freely
When no more drops come out, let her move her fingers round and try a different section of the breast
When the flow slows down, swap to the other breast. Keep changing breasts until the milk drips very slowly or stops altogether
If the milk doesn’t flow, let her try moving her fingers slightly towards the nipple or further away, or give the breast a gentle massage
Hold a clean (boiled) cup or container below the breast to catch the milk as it flows

Storing and Using Expressed Breastmilk

Fresh breastmilk has the highest quality.
If breastmilk must be stored, advise the mother and family to:
- Use either a glass or hard plastic container with a large opening and a tight lid to store the breastmilk
- Boil the container and lid for 10 minutes before use
- If the mother is literate, teach her to write the time and date the milk was expressed (or morning, afternoon, evening) on the container before storing
- Defrost frozen breastmilk in a fridge or at room temperature over 12 hours or by letting the container with frozen breastmilk stand in cold water to defrost
Make sure that the person who will feed the baby has been taught to cupfeed correctly (see below)

How long can breast milk be stored

Temperature	Duration
Room temperature	Up to 8 hours
Fridge	Up to 6 days
Ice box freezer (-18°C)	3-6 months

Cup Feeding (for giving expressed breastmilk or replacement feeds)

Hold the baby sitting upright or semi-upright on your lap
Hold a small cup of milk to the baby’s mouth
Tip the cup so that the milk just reaches the baby’s lips
The cup rests lightly on the baby’s lower lip and the edge of the cup touches the outer part of the baby’s upper lip
The baby will become alert
Do not pour milk into the baby’s mouth
A low birth weight baby starts to take milk with the tongue
A bigger / older baby sucks the milk, spilling some of it
When finished the baby closes the mouth and will not take any more
If the baby has not had the required amount, wait and then offer the cup again, or offer more frequent feeds.
Give volumes as per guideline

Click here to open the above content in the original PDF view

Integrated Management of Childhood Illness 2022; Young Infant (Birth up to 2 months); Counsel the Mother or Caregiver on Infant and Young Child Feeding (Birth up to 2 months);Support on Expressing Breastmilk and Cup Feeding

Last checked for updates: June 2023