Currently, the Ministry of Health does not recommend expressing breast milk. It is believed that if you feed your baby on demand and only breastfeed, there is no need to pump. However, for a number of reasons, the pumping procedure is still necessary.

Why do you need to pump?

If we go back to the times of our parents, mothers and grandmothers will be happy to tell you that pumping is an indispensable process of breastfeeding. You can find out how much trouble a young mother will have if she refuses to pump.

Today, doctors do not recommend expressing breast milk except in a number of cases: prematurity, weak sucking reflex, taking medications incompatible with breastfeeding, flat nipples, congestion and lack of milk.

Pumping for your breasts

In the first time after the birth of a child, the mother produces slightly more milk than the baby needs. In common parlance, there is such a thing as “draining the breast.” In the first days after birth, milk arrives, the breast ducts are not yet prepared, and the newborn eats very little, excess milk may accumulate in the mother, and if excess milk is not expressed, there is a high probability of developing lactostasis (milk stagnation). This can lead to mastitis, a serious condition of a woman's breasts. The first symptoms of mastitis:

• temperature rise to 38 o and above;
• breast tenderness;
• redness of all or part of the breast;
• obstructed milk flow.

To prevent mastitis, a woman should monitor her breast condition. If a lump, redness or heaviness is detected in the breast, the first aid may be to completely empty the gland of milk. Although nowadays doctors recommend not expressing milk, but putting the baby to the breast more often. However, if there is an excess of milk, the frequency of breastfeeding will not solve the problem, and then pumping will still help. The most affordable and does not require additional investment is manual expression.

Video: does a woman need to pump in the first days after giving birth?

I gave birth to my first child in 2000. Back then, newborns were kept in separate rooms from their mothers, and babies were brought in only at set times for feeding. On the second day after giving birth, my temperature rose above 40 o. The doctor on duty suspected an infection of the female genital organs. What saved me was a call to my attending physician, who diagnosed milk stagnation. It turned out that on the first day I drank a lot of liquid at the time the milk arrived, and the children were brought in for feeding according to the schedule, this provoked stagnation. Thanks to the medical staff, in particular the nurses, who helped me manually pump my breasts all night. This was 17 years ago and then there was not so much available literature and pumping equipment. This incident taught me how to behave in the future. When the next two children were born, for the first two days I partially limited myself in fluid intake and after feeding I was sure to finish breastfeeding, so I did not have such a problem as stagnation.

Video: pumping for the breast

Pumping for milk

Pumping for milk is necessary to increase or maintain lactation.

It is believed that if the baby is attached to the breast on demand, after feeding he is full and satisfied, there is no need for additional pumping of milk. After all, nature gives as much mother’s milk as the baby needs.

However, to stimulate lactation there is no way to do without pumping. When a woman, at the end of feeding her baby, pumps out the remaining milk, this further stimulates his flow. To increase the amount of breast milk, if there is such a need, the mother can express up to 8 times a day. When lactation improves, you can stop expressing or use the expressed milk to create a milk bank. That is, freeze the excess and use it when the need arises.

Until 5 months of my Makarka, I had one “illness”: I had never pumped, I didn’t understand why it was necessary. And she was a fierce opponent of everyone who does this. Then I began to develop a new “disease”. I always felt like there wouldn't be enough milk. And I started pumping after every feeding like crazy. Day and night. And I froze this milk in liters. Then, you won’t believe it, my son drank it all at 10 months. It came in handy. And now that my son has teeth and is very active, it has become easier for me to pump and feed him expressed milk. Of course, he immediately weaned himself off the breast. But there is nowhere without milk itself... The fact that milk works according to the “supply and demand” principle is 100%. So I pumped 100 ml - exactly 100 ml arrived, expressed 150 ml - 150 ml arrived...

Maria Beloshapkina

If the mother is facing separation from the baby or for some reason cannot breastfeed at a certain moment. For example, taking medications prohibited during breastfeeding, then regular pumping will prevent the milk from going to waste. And upon the mother’s return or recovery, breastfeeding can be continued. There are other cases when pumping is necessary. For example,

Child, lazy sucker. In my situation, pumping became the solution. After feeding, the breasts were practically not empty; the child woke up hungry every 15 minutes. Since I ate little, little milk came in. After feeding with expressed milk, he began to sleep normally, I knew exactly how much he ate, whether he was full, and there was always enough milk. Only thanks to pumping was it possible to maintain lactation to this day (the child is almost a year old) and to calmly wean the child off the breast (he only latched on to it at night). Therefore, if there is evidence, the statement that there is no need to express is wrong

Natalia Frolova

razvitie-krohi.ru/kormlenie-grudyu.html

How to express milk by hand, pumping technique

Breastfeeding is very beneficial for both mother and baby. However, sometimes cases arise when pumping is indispensable. The most accessible and widespread is considered to be manual expression. To do this you need:

1. Prepare a container for milk. Dishes must be thoroughly washed and sterilized.
2. The woman selects a position that is comfortable for herself, sits straight so that her back does not hurt, otherwise her muscles will quickly get tired.
3. The chest is prepared. To do this, you can apply a warm towel to your breasts or take a shower, do a light breast massage, or simply bend down to let the milk flow.

Preparing the breast before feeding or pumping - massage

It is important to place your hands correctly: with one hand you support the breast from below, with the other you stroke it towards the nipple. Then they begin the pumping process itself: the thumb is placed on top of the breast, on the border of the areola, the index finger is placed below. The thumb and index finger rhythmically press on the breast to release milk, the other fingers support it. During the entire pumping process, your fingers gradually move around the circumference of the areola to express milk from all parts of the breast. Actions should be rhythmic, but should not cause pain. If pumping is painful, then the woman is doing something wrong.

It is also important during pumping to have a comfortable, quiet and cozy environment. To do this, for example, you can turn on quiet, calm music.

How long does it take to pump?

The time required to pump is purely individual. The main thing is that at the end of pumping, the breasts become soft, without compaction.

On average, a woman pumps one breast for 5–6 minutes. When the milk stops flowing, the woman moves on to the second breast. Basically, complete pumping takes 20–30 minutes, 10–15 minutes per breast.

Also, the amount of time for pumping depends on the reasons causing the pumping process itself. If pumping is caused by the need to maintain lactation during the period of temporary separation of the mother from the child or the mother’s illness, then as much milk is expressed as is needed to feed the child and takes longer than when pumping occurs after feeding the child, when a certain amount of milk has already been drunk by the baby.

How often should you pump, pumping schedule

If pumping is caused by the need to maintain lactation during the period of temporary separation of the mother from the child or the mother’s illness, then pumping is performed according to the number of feedings of the baby, about 6 times a day. However, in the first weeks, especially with insufficient lactation, it is possible, even necessary, more often. To increase lactation, you can express milk every hour during the day, and every three hours at night. This will increase lactation.

If pumping is done simultaneously with putting the baby to the breast, then it is recommended to pump no more than three times a day in order to avoid excessive lactation.

I have breasts with inverted nipples so I never got to experience the joys of breastfeeding. However, knowing about the great benefits of breast milk for babies, I fed children up to 1 year old with expressed milk. For the first three months, I expressed milk every three hours, from the fourth - every four hours, from the eighth month to a year - every six. With my second child, from the fourth month onwards, I chose a more suitable schedule for myself and, if necessary, could slightly shift the pumping time without compromising lactation. I believe that when lactation has improved, every woman feels the time when it is necessary to express.

How much milk can you express at once?

The amount of milk that can be expressed at one time varies from woman to woman. Some have more milk, some have less. You need to proceed from the age and needs of the child. The baby becomes older every day, the number of feedings decreases, and the amount of milk consumed, on the contrary, increases. Therefore, the amount of expressed milk should be based on the baby’s needs.

Table: proportionality of breast milk consumed to the child’s age

Do not forget that all these indicators are conditional and depend on the individual characteristics of the baby’s body. The main thing is that after pumping, a woman’s breasts should become soft, without lumps, and the pumping process should not be painful.

Video: technique for expressing breast milk

Night pumping to increase lactation

If the mother does not produce enough milk to feed the baby, then a five-hour break at night cannot be taken. Otherwise, due to the lack of stimulation for the arrival of milk, the mother does not express or feed at night, and less and less milk will be produced. The breast will fill up in 3 hours, the milk has not been expressed, there is nowhere to add milk and it stops being produced. Therefore, to increase lactation, it is recommended not to take night breaks, but on the contrary, you need to express every three hours, then this will trigger the arrival of new milk and lactation will increase. When the feeding process is established, enough milk arrives to feed the baby, then you can take a night break.

For the first two months, I got up to express milk every three hours. Starting from the third month, when my son began to sleep for six hours in a row, and I had enough milk for feeding, I rested with him and did not express milk at night.

Storing and using expressed breast milk

Storing breast milk depends on how long it is used.

In the absence of a refrigerator, breast milk retains its properties and does not deteriorate for 10 hours. To extend the shelf life and avoid milk loss, for example, in summer, at high temperatures, you can use a thermos cooled with ice or a cooler bag.

For longer storage, up to 8 days, expressed milk must be stored in the refrigerator at a temperature of 0 to 8 degrees. This way we can preserve both the milk itself and the beneficial substances in it that are responsible for the formation of the child’s immunity and intelligence.

If you plan to store expressed breast milk for more than a week, then it must be frozen.

For freezing, you can use special bags that save the mother’s time, as they are already sterilized and easily sealed.

Special bags for long-term storage of breast milk

You can also store expressed breast milk in glass or plastic containers. The main thing is that the container is sterilized and tightly closed.

Glass and plastic containers for storing breast milk

Milk is frozen in small portions per feeding. Re-freezing is not allowed. It is also not recommended to mix fresh, just expressed, and frozen milk.

Freshly expressed breast milk is placed in the refrigerator to cool, and after cooling, it is transferred to the freezer. In a separate freezer, milk can be stored for six months. If the freezer is inside the refrigerator, then the milk can be stored for no more than two months. For as long as possible, up to 1 year, breast milk is stored in a separately closed chamber at low temperatures.

Before freezing milk, be sure to indicate the pumping date!

The procedure for feeding a baby frozen milk is similar to bottle feeding. Attention should be paid to the need to defrost breast milk in the refrigerator to avoid sudden temperature changes. Heat the milk in a water bath or under running warm water to a temperature of 36–37 o. To preserve the beneficial properties of breast milk, boiling it is not recommended. The number of feedings and the amount of milk corresponds to the age and weight of the child.

We must remember that the healthiest thing is fresh breast milk!

Should breast milk be pasteurized after expressing?

If after expressing milk will be stored outside the refrigerator at temperatures up to + 25 o C, it is recommended to pasteurize breast milk. Then it can be stored for 24 hours at a temperature of 15 o C, 10 hours at a temperature of 19–22 o C, 4–6 hours at a temperature of 25 o C.

To pasteurize, place a bottle of breast milk in boiling water for 10 minutes. Breast milk should not boil. You can also pasteurize at a water temperature of 65 ° C for 30 minutes.

Video: pasteurization of breast milk at home

Expressed milk separates and smells of soap - pathology or normal

Does freshly expressed breast milk have a sweet smell and taste, but after defrosting it starts to smell like soap? This question worries many mothers who express milk.

If this happens, the first thing you need to do is check that your expressed breast milk is being stored correctly. If the storage rules are followed, then the likely reason is that there is an excess of lipase enzyme in breast milk - an enzyme that breaks down fats. It is likely that lipase begins to quickly break down milk fat after expressing under the influence of oxygen.

Milk that has a soapy taste and smell can be used to feed a baby. However, with a distinct taste and smell, there is a possibility that the baby will refuse milk.

To avoid this and improve the taste of breast milk, you can use the following tips:

• It is necessary to reduce the effect of oxygen on the fats of expressed milk. To do this, the container for storing breast milk should be closed as tightly as possible.
• To prevent the breakdown of fats by lipase, immediate freezing of expressed milk in the freezer will help.
• Gentle pasteurization will help - heating at a temperature of up to 56 o.

Another question that concerns mothers is that breast milk begins to separate after storage. This occurs due to the fact that when cooled, the speed of movement of fat molecules is less and they stick and are attracted to each other, forming cream on the surface of the milk. Therefore, consuming such milk is absolutely harmless; you just need to stir the milk when heating it, and the consistency of the milk will be restored.

Breast milk is the ideal food for a child in the first year of life, providing the baby with the necessary minerals and trace elements in the amount the child needs. With breast milk, the baby receives protective antibodies and develops immunity. Breastfed children suffer less from inflammation of the middle ear, acute respiratory viral infections, intestinal infections and allergies. Therefore, loving mothers try by any means to provide their child with breast milk, even if it is not breastfeeding, but expressed milk.

WHEN SHOULD YOU NOT PRESSURE?

With normally established breastfeeding, if the mother is not separated from the child for a long time until the moment when he is able to drink and eat “regular food” in sufficient quantities, there is no need for pumping. If the baby takes the breast correctly (see article) and feeds on demand, there is no need to express after feedings in order to maintain lactation. If the baby does not have enough milk, he will begin to latch on more often (perhaps even “hang” on the chest for several days) and increase the volume of milk from the mother. However, there are quite a few situations where expressing some milk or even pumping your breasts regularly is necessary.

WHEN SHOULD YOU PRESSURE?

Express milk into your baby's mouth to soothe him and encourage him to latch onto the breast;

To alleviate the condition with strong filling with milk or engorgement of the breast, when it is difficult for the child to take a full breast;

Relieve the condition of blocked milk duct or lactostasis;

Feed a child who, for some reason, cannot yet breastfeed (a weak, low-birth-weight child, an illness in the child, a premature baby, breast refusal, a child learning to latch onto a breast with non-standard nipples);

Leave breast milk for the baby or simply maintain lactation while the mother is away or goes to work.

Expressing consists of two stages. At the first stage, you prepare clean dishes for expressing (wash with soap and then sterilize or fill with boiling water for a few minutes and then drain the boiling water), and also prepare yourself. The second stage is actually expressing milk. Hand expression is usually quite effective; if pumping is necessary for a long period of time (for example, the birth of a premature baby who is not yet able to breastfeed, going to work or school), then it makes sense to think about buying a breast pump.

WHY DOES MILK START TO FLOW FROM THE BREASTS?

Milk in the breast is stored in special “milk sacs” (alveoli) located throughout the breast (there are millions of them). From the pouches, channels with milk, milk ducts, lead to the nipple. Closer to the nipple, the ducts merge (like rivers); at the nipple itself there are small expansions of the ducts, which then go out to the nipple in narrow channels. When the baby is properly attached to the breast, he presses on the expansion of the ducts at the nipple (sometimes they feel like small beans to the touch), squeezing milk towards the nipple. Milk flows out of them and runs into the baby's mouth. In order for the expansion of the ducts to fill again, milk must flow from the ducts again. This is not a quick process. However, if the oxytocin reflex is activated, milk sprays out in streams. When does this reflex turn on? When the baby begins to stimulate the nipple, as well as in other situations (the mother hears the baby crying, thinks about the baby), the hormone oxytocin is released. In response to this, the walls of the storage pouches located throughout the breast are compressed, and milk is squeezed out of them directly into the ducts, and from there the flow rushes to the nipple and into the baby's mouth. The calmer the mother is, the more she thinks about the baby, touches him, the more her nipples are stimulated, the better this reflex works. Sometimes a woman herself feels the work of the oxytocin reflex, then she calls it “a rush of milk.” This may be compression or tingling in the breast, tingling in the nipple area, leakage of milk at the moment when the mother begins to think about the baby or feeds him with the second breast. If your baby lifts off the breast and you see milk flowing, this is a sign of an active oxytocin reflex. However, a nursing mother may feel hot flashes only during some feedings or not at all, but the oxytocin reflex will be active. When the baby begins to suck or the breast begins to be stimulated, the reflex turns on, but after a while it stops and the jets weaken. If stimulation continues, the reflex will turn on again (a new “tide” will begin).

HOW TO MAKE MILK FLOW FASTER

In fact, it often only takes a little stimulation of the breasts to get the milk flowing. But some women are helped to achieve larger volumes of expressed milk by certain tricks - often each with their own something. We offer a list of various techniques.

In order for the oxytocin reflex to turn on and the milk that has accumulated to flow from the breast, it is best to relax as much as possible. You are sure that everything is fine with you, you have milk. It is stored in millions of sacs filling your chest. You eliminate any sources of pain and anxiety, forget about them for a while. You can sit quietly in a comfortable position and drink a warm drink (but not coffee). If possible, have someone close to you massage your neck and back, which will help you relax.

Many people find it helpful to look at a photograph of a child or even hear him cry, if possible, look at the child himself or even hold the child in his arms, touching his delicate skin and smiling at him, talking to him. Give free rein to pleasant thoughts about your child. You can warm your chest - for example, put a warm compress on it or take a warm shower. It's a good idea to stimulate your nipples for a while by lightly pulling or rolling them with your fingers - this is a very effective way to trigger the oxytocin reflex.

Sometimes it helps to imagine splashing streams of water, such as a waterfall.

Some women find it helps if they gently pat their breasts with their fingertips or a comb. Some women find it helps if they gently rub their fingers across the breast towards the nipple. You can also massage your breasts. Starting from the top, make circular movements with your fingers on your chest for a few seconds and then move in a circle. Press as much as necessary for a pleasant sensation. Massage in a spiral around the chest towards the areola. After this, you can make light strokes from the edge of the breast to the nipple, along the entire circumference of the breast.

Here are examples of breast massage before pumping - video http://www.youtube.com/watch?v=oXtlqY002s0, description (another massage method, also very effective) http://www.mleko.ru/index.php?pid=4

One way to prepare is to massage mom's back before pumping. In this case, you sit down, lean forward, fold your hands on the table in front of you and lower your head on them. The chest and back are bare, the chest hangs freely down. Your assistant clenches his hands into fists, with his thumb facing out, and with his thumb begins to make small circular movements, rubbing his back along the spine on both sides from top to bottom, from the neck to the shoulder blades for two to three minutes.

After the preparatory procedures, you can proceed to pumping.

HAND EXPRESSION

Sit or stand comfortably, holding the vessel close to your chest.

Place your thumb on TOP of the areola (peripapillary circle), and your index finger BELOW the areola opposite your thumb. The remaining three fingers of the hand support the chest.

Apply gentle pressure with your thumb and forefinger to your breast as you push them deep into your breast, plunging your nipple into it. Not too deep so as not to squeeze the ducts. Then use your thumb and forefinger to squeeze the area of ​​your breast behind the nipple and areola. You need to press on those same bean-like extensions of the ducts (though they cannot always be felt, but if you feel them, press on them).

Press and release, press and release. The procedure should not cause pain. If the procedure is still painful, then the pumping technique is incorrect.

The milk may not appear at first, but after a few presses it begins to drip. It can flow in a stream if the oxytocin reflex is active.

In the same way, press the areola from the sides to make sure that milk is expressed from all segments of the mammary gland.

Avoid rubbing the skin with your fingers or sliding your fingers across the skin. The finger movements should be more like rolling.

Avoid squeezing the nipples themselves. Pressing or pushing on the nipples does not allow you to express milk. This is the same as if a child sucks only one nipple.

Express one breast for at least 5-6 minutes until the milk flow slows down; then express the second; then both again. You can express each breast with one hand or change them if you are tired. The most effective pumping scheme is 5+5, 4+4, 3+3, 2+2, 1+1

An important condition is that the mother herself must express, because... another person, especially a non-professional, could damage or injure the breast.

An important condition - do not look into the pumping container! Research has shown that you can express more milk this way (without looking into the container).

In the figure, the green arrows show the correct pressure points for correct grip and proper pumping, and the blue arrows indicate a good flow of milk. By pressing at the base of the milk storage tanks, we squeeze the milk out of them. Incorrect pressure points are shown in red; they correspond to poor milk flow.

Expressing milk properly takes 20 to 30 minutes, especially in the first few days when little milk may still be produced. It is important not to try to express milk in less time.

wonderful animation in the middle of the article! http://breastfed.info/milk-expression-2/

Manual expression video (in English, but there is translation text next to the video) http://new-degree.ru/articles/consultant/handexpression/

Pumping with a breast pump

With engorgement and sore breasts, it can sometimes be very difficult to express milk with your hands. Expressing with a breast pump helps. It is easier to use a breast pump when your breasts are full. It may be less effective on soft breasts. It happens that mothers combine two types of pumping - first, using a breast pump all the way, then with your hands, or vice versa (if the breast pump does not pump well into an overfilled breast).

A breast pump is also useful when you have to express frequently - in this case, if the milk flows normally, you can think about something else while expressing, for example, reading, watching a movie, talking on the phone, which saves time and effort. On the other hand, hands are a more versatile tool that is easy to wash, and which is always with you, in any situation, and does not cost money.

IF THE MILK IS GOING VERY BAD - WARM BOTTLE METHOD

The warm bottle method for expressing breast milk is a useful technique for relieving severe breast engorgement in cases where the breast is very sore and the nipple is very tight, making hand expression difficult. It is used if it is not possible to express milk in any other way, and it is impossible to attach the baby. Once you have pumped a little with the help of a bottle and reduced breast engorgement, you can then express by hand or attach your baby.

1. You will need a suitable bottle:

Made from glass, not plastic;

Volume 1-3 liters, at least 700 ml;

Wide neck: at least 2cm in diameter, 4cm if possible, to accommodate the nipple.

2. You will also need:

A pan of hot water to heat the bottle;

A little cold water to cool the neck of the bottle;

Thick fabric to hold a hot bottle.

3. Pour some hot water into the bottle to start warming it up. Then

Fill the bottle almost completely with hot water. Don't overfill the bottle

Quickly, otherwise the glass may burst.

4. Let the bottle sit for a few minutes for the glass to warm up.

5. Wrap the bottle in a cloth and pour the hot water back into the pan.

6. COOL THE BOTTLE NECK with cold water - inside and out. (If you do not cool the neck of the bottle, you may burn your nipple skin.)

7. Place the neck of the bottle against the nipple, touching the skin around the nipple, and make an airtight contact.

8. Hold the bottle straight. After a few minutes, the entire bottle will cool down and provide a gentle suction effect, allowing the nipple to be drawn into the neck of the bottle. Sometimes a woman feels a suction effect and may move away from surprise. You may need to start over.

9. Warmth promotes the oxytocin reflex, milk begins to flow and accumulates in the bottle. Hold the bottle until milk flows from the breast.

10. Pour the breast milk out of the bottle and repeat the procedure if necessary, or do the same with the other breast. After some time, the acute pain in the breasts will decrease and it will be possible to express milk by hand or breastfeed the baby.

SANITARY REQUIREMENTS OF SOME MATERNITY HOSPILS

In some Russian maternity hospitals, it is forbidden to give a baby milk expressed with a breast pump; only hand-expressed milk is allowed (SES requirements). In this case, it makes sense to first stimulate the breast with a breast pump for several minutes until the oxytocin reflex turns on and milk flows, then manually express the baby, and finally, continue expressing with a breast pump, which stimulates lactation. In order for more milk to come in next time, it’s a good idea to continue stimulating your breasts with a breast pump for a couple of minutes when the milk is no longer flowing. In this case, more milk will come next time.

HOW OFTEN SHOULD YOU PRESSURE?

To establish lactation, if the child after birth for some reason cannot suckle

You need to start pumping as soon as possible. Preferably within the first 6 hours after birth. It may be just a few drops of colostrum at first, or even nothing at all, but this will help your milk supply begin and speed up the process.

Then you need to express as much as possible and as often as the baby would like to eat. At least once every 2-3 hours, including at night. If night pumping is difficult to achieve, allow a night break of 5 hours. If you pump infrequently, there may not be enough milk.

To maintain milk supply

Pump at least once every three hours

To increase the amount of milk if it turns out that you are not expressing enough

For several days, express very often (every half hour to an hour) and at least every three hours at night.

To leave milk for the baby when the mother is at work

Express as much milk as possible for your baby before leaving for work. It is also important to express milk while at work to maintain a sufficient milk supply.

MILK STORAGE

There are many different standards for storing milk. In the maternity hospital you will hear some numbers, from the pediatrician - others, from friends - others. In particular, in a maternity hospital or hospital, the requirements are usually increased and it is advisable to consume milk as soon as you express it, i.e. the whole process should take no more than an hour. At the same time, at home the requirements are much less stringent. The fact is that breast milk contains protective antibodies that prevent bacteria from multiplying, even if the milk is outside the refrigerator. A scientific study published in 1987 in the International Journal of Childbirth Education found that milk expressed in a clean (but not sterile) container and left at room temperature (19-22 degrees) contained approximately the same amount of pathogens after 10 hours. bacteria, as much as milk placed in the refrigerator for the same 10 hours. However, there are few mothers so brave who leave milk out of the refrigerator for 10 hours. But, having read about such a study, you, having expressed milk with soap-washed hands into a clean, soap-washed and thoroughly rinsed container (for a full-term baby and at home and not in a hospital), will not worry that the milk will sit for 2-3 hours without a refrigerator. You can leave it in the refrigerator for a couple of days, or freeze it for longer. A very detailed article about storing milk from the site http://lllrussia.ru/hranenie_moloka/. There is a detailed article on our website: "" about breastfeeding for working mothers who pump regularly. The following numbers are given there

In summer in a room (cooled by air conditioning) – up to 6 hours

In winter in the room - up to 10 hours

In the refrigerator - not in the door, up to 5 days

In a cooler bag with ice – 24 hours

In the refrigerator freezer - not in the door, 3 months

In a separate freezer (deep freezer) - 6 months or more

References

Back to

leonika (mother of twins) about pumping

from the forum forum.materinstvo.ru

At some point during our feeding, I decided that I needed to freeze the milk just in case. For this reason, a breast pump was rented. This is where the fun began. Medelovsky two-phase breast pump. I began to express and began to worry - it was impossible to express more than 80 grams. I’m already starting to get nervous, wondering how many times I need to apply them so that they eat the norm. And I understand that it doesn’t work out. They don't eat that much. I’m thinking about where to freeze it to feed the children. I’m sitting in the bathroom, pumping, at first I’m all upset, and the milk is flowing like shit, and then I think why am I so unhappy, look at how beautiful, smart my daughters are growing up, I imagined how we’d go with them to the sea to relax, and then to grandma, and then to Bali or Cuba in general, it’s not just milk that started flowing, it just burst - 170 grams, 3 flushes in 29 minutes, my eyes popped out of my head - I’m a super milky nurse, I just need an approach to my breasts. It’s like in sex, some people need romantic interlude, while others don’t, probably my breasts need romantic interlude. I then checked the feeding of the girls. If I was in the mood, there could be three hot flashes during one feeding, and for the first time I saw that the girls began to choke on milk. Then I noticed that one breast responded more easily to hot flashes. I have each breast for each child. Clemie tried to feed the first one, then three flushes were guaranteed; it didn’t work out so well on Angelina’s breast, but she didn’t complain. To be honest, I stopped feeding at the computer, as it clearly reduced the number of hot flashes. They helped a lot when I was very tired of taking their first photos from the maternity hospital. And as for how much they eat now with complementary feeding, I understand that I’m not fattening pigs, well, sometimes the child doesn’t want to eat, well, we don’t eat 200 grams of porridge, and sometimes we don’t eat 150, and sometimes when our teeth hurt and we don’t want to breastfeed, but in general They look good, healthy, but I don’t even look at the norms, I see them and see that everything is fine with them.
In my opinion, feeding is affected by stress, fatigue and excessive demands on oneself and children. As soon as you understand that in any case the child will not die of hunger, you can tune in to a positive mood, and you will allow the child to eat as he wants and if he needs to, give him the opportunity to starve, letting go of your suspiciousness will immediately become easier.

does not work...

I began to notice that my son did not have enough milk :-(

Yesterday I sucked both breasts under frequent feeding before bed. After 4 hours he woke up hungry, I feed him, but there is almost no milk in my chest. 4 hours later I woke up hungry again. How to increase milk production?

Today after feeding I expressed the drops that were there. It’s already been 3 hours, and my chest is confused. What to do?!

and my chest is empty

Hello Tatiana

The fact is that visual breast filling usually occurs only in the first weeks. After this, the breasts are no longer heavy, soft to the touch, but still contain a lot of milk. If you still want to increase your milk supply, it usually helps to feed more often (for example, once every 2 hours or more) at each feeding.

Often there is actually enough milk, but it seems that there is not enough. The "" collection contains a lot of information on this topic. I hope you find something useful.

If my answer is not informative enough, please write more specifically - how much the baby is gaining, how often he feeds during the day and how often at night, how you alternate breasts, and so on.

Pumping

Good evening! Please tell me, I can’t find information anywhere on the correct accumulation of milk, I doubt whether I am accumulating it correctly..? Those. Can I express milk into a breast pump, then pour it into a bottle, put it in the refrigerator, repeat the same thing next time and pour the milk into the previous milk? I just pump 50 ml. Is this milk accumulation correct?

milk storage

Hello. As far as I know, you need to combine cold milk with cold milk. If you have expressed warm water, it is better to cool it in the refrigerator and then combine it. In general, do you store this combined milk for a long time?

Hello, please tell me

Hello, please tell me how the breast pump should fit to the breast and how everything should happen there. I just can’t learn how to express properly, either manually or with a breast pump, at first there are 2-3 streams, then nothing and it even hurts. Maybe my breasts are not standard and nothing suits me?

correct position of the breast pump

Hello. The breast pump should be positioned so that the funnel is clearly in the center, with the nipple in the very middle. It must fit tightly to create a vacuum. It shouldn't hurt!

In order for milk to flow, a rush must begin - this is exactly what is mentioned in the article above. When the tide is high, there are streams. The duration of hot flashes varies from woman to woman; Usually, when a woman has been nursing for some time and the milk comes quickly, the rush lasts at least a few minutes. After this, the jets dry up, after some time a new tide begins and the jets appear again.

Please tell us whether you are breastfeeding your child, and if so, how the child eats. Perhaps you simply cannot “turn on” the tide. when you express artificially.

In general, there is a large psychological component in pumping (for example, actively breastfeeding women often experience a rush when they hear a baby crying, or even think about the baby, and have not fed for several hours) - and without any breast pump))) and vice versa, with artificial pumping it can little to come out, this is not uncommon. It also happens from time to time that the breast pump does not fit. Sometimes you can find the right size funnel, sometimes not.

So if you need help, please write in more detail about your situation.

lump in the chest

On the lower left side of my chest I noticed a lump the size of a plum. I tried to strain my breasts, after 2 days the lump became smaller, like a bean, but it did not disappear. It already hurts to press the seal. tell me how to get rid of it? no temperature. I tried to give it to the child so that he could “eat it”, but it stayed that way. How long after breastfeeding should you express your breasts? I feed every 2-3 hours. baby is 1 month old. I will be grateful for a prompt response

hello Galina, situation

Hello, Galina, the situation is quite alarming. If you are in Moscow, contact Karina Oganesyan.

If not, you need to contact a GW-friendly specialist who could help you. Optimally, contact an AKEV consultant to refer you to a doctor. You may be asked to do an ultrasound or puncture to determine the nature of the contents in the lump (milk or pus?)

The seal is always there, does it ever disappear? Have you recently had a fever? redness in the chest?

Hello! I'm through

Hello!

In a few days I need to leave my baby with dad for 4-5 hours, he is completely “on tit”. Please tell me how much milk I need to leave for them so that the child does not cry from hunger. Baby is 4 months old

Hello. The question is:

Hello. The question is: when filling the breast with milk, in the center of the breast (in the area of ​​the milk ducts and ducts) when pressed, can it hurt, or is it some kind of disease? After feeding, the pain disappears, literally two days ago I finished ultrasound treatment of this breast (there was a lump on the side - everything went away).

The baby takes only one breast.

Good evening.

My daughter is 1 month old, I have been feeding her with only one breast for the whole month, because... On the second breast she does not like the nipple (inverted). I constantly express this *unloved* breast with an electric breast pump. Now one breast is twice as big as the other! Considering that my daughter has to eat more and more milk per feeding, I conclude that this difference will only increase. I don’t want to give up breastfeeding, but I also have absolutely no desire to turn myself into a Frankinstein! Tell me, if I stop breastfeeding my daughter and only use a breast pump and bottle-feed her, will the milk remain or is constant stimulation needed by the child? Maybe you can advise something in this situation.

Hello. Specify

Hello.

Please clarify, do you give your baby expressed milk? If yes, from what source?

In fact, the vast majority of women have different sizes and volumes of milk in their breasts. However, noticeable differences are less common; usually during feeding this happens when the baby eats milk from only one breast. Such mothers often write that after finishing breastfeeding, breast size evens out after some time. However, even during feeding, you want to have breasts of a similar size, so, of course, I understand that you would like symmetry, especially since there is milk in both.

When pumping, you are likely to be able to express less milk than when breastfeeding, because... The breasts are noticeably smaller. This means that if you stop feeding completely, it is unknown whether the baby will have enough milk. In addition, with pumped feeding, additional problems arise, such as a decrease in the amount of milk due to delayed pumping, menstruation, illness, refusal to pump at night, and so on. Increasing the amount of milk expressed is not easy for most women, that is, it is quite a serious burden.

Since your baby is still small, there is usually a good chance of breastfeeding at this age. Is it possible for you to invite a lactation consultant? It is quite possible that she would have helped to place the baby on the second breast. It often helps to form a fold from the breast, shift it from breast to breast (especially when half asleep), and choose a suitable position for feeding.

In any case, to equalize the size, you need to empty the smaller breast more. This is best done by a child; Before your baby takes that breast, it's best to pump more often. It is often possible to express more during milk flow, i.e. during feeding from the first.

You might find some of the following links useful

Thanks for the answer! Consultant

Thanks for the answer!

The consultant has already been invited, the postures and correctness of application have been checked. If there is a chance to straighten everything out without taking it off my chest, then I’ll do it! I freeze expressed milk)))

What city are you in? Child

What city are you in? The child is small, the consultant should help at this age.

In your case, the child lost the habit in a few days, and perhaps became offended that there was no breast, and stopped taking. Many women find the nest method helpful, i.e. carry the baby in your arms, sleep together.

I don't know how acceptable this is for you? Write please

Good evening! Daughter (2 months)

Good evening!

The daughter (2 months) fell in love with the right breast, sucks it well, the flush comes immediately after the start of sucking and then the flushes are regular as the sucking progresses. Once I counted 7 in 25 minutes. Those with an oxytocin reflex should in theory be fine.

She sucks the left breast reluctantly, sometimes cries (in different positions). After rocking and calming, he begins to suck and falls asleep while sucking. Tides are very rare. Always only after prolonged sucking, after 30 minutes and with a small number of sips, when the baby is already sleeping and sucking. Once only the tide was at the beginning, at night. I think she cries because of the lack of at least one rush at the beginning of sucking. There is milk in the breast - if I stimulate the nipple area myself, as when expressing, while the nipple is in the baby’s mouth, she sucks and eats sips. But for some reason she doesn’t want to suck it or she can’t. Our latch is fine, we invited a lactation consultant.

In this breast there are only 2 ducts in the nipple: one small, droplet-shaped; the second is a tight stream that hits a meter. Maybe she can't press hard on the areola, so the milk doesn't come out well when she sucks?

And what could be the reason for the virtual absence of tides? I count hot flashes by characteristic sips - one sip per movement of the jaw.

Could there be any anatomical features?

Hello, yes, everyone

Hello, yes, all women have left and right breasts that differ in volume and size, some have a little, some have more. The problem with hot flashes may be associated with problems with the back, for example, pinching of some nerves. How do you understand that there are no tides? There is no behavior at all, one swallowing, one sucking on this breast, right?

Try feeding from different positions, for example, from under the arm, or in a relaxed position ()

Have you tried compression on this breast? Or, for example, give it when there is a high tide in another (usually this is more or less simultaneously)?

The baby sucks not only due to compression of the areola, but also due to the vacuum. Does she have any extraneous sounds while sucking? Clicks, smacks?

There are no clicks or clatters, and

There are no clicks or clatters, and the consultant looked at the grip - it’s ok.

Yes, on the left breast there is practically no behavior at all, one sip, one sucking movement. The last time was probably a week ago, and always about 30 minutes after the start of sucking. I myself can express from 20 to 40 ml from this breast - immediately after I start pumping, without a rush (I think, without a rush).

I tried different positions, it didn't help.

In a dream, I first gave the breast with hot flashes so that it would suck out three hot flashes, then quickly changed it to this one - the child immediately begins to push, as if she was having a hard time sucking, grunting appears, tries to push off with her legs from my legs - as if she was straining a lot. As a result, she switches to small sucking movements and sucks herself 2-4 throats every 5 minutes.

With compression, small sucking movements are activated. But the “one movement, one sip” behavior still doesn’t exist.

The child is gaining little weight - in the first month 500 grams from the minimum, in the second - 380 grams, so I worry that the breast is on duty for the prescribed 1.5-2 hours without hot flashes - my daughter suffers, sucks somehow, sometimes even normally in her sleep, but she obviously drinks much less milk than from the other breast.

He writes normally.

“strong” breasts will be more stimulated and produce more milk. some generally feed the child with only one breast... (in this case, some asymmetry may occur, which for the most part goes away after feeding is completed). When feeding from a weak one, perhaps it is worth using compression every time? If you switch to it 30 minutes after the start of feeding from “strong”, will there still be no flush for another 30 minutes?

Apparently, you need to try everything to stimulate weak breasts during feeding. Maybe try to pump before feeding? Does this somehow speed up the flow of milk? or during feeding.

This happens (very different breast behavior), incl. for back problems (signals arrive in different ways). Also maybe after 30 minutes of sucking the latch changes? Watch your child.

20-40 ml is not so little, how long does it take you to express it? Are you sure. that there is no tide? How did you understand this - only drops come?

Good afternoon, I thought

Good afternoon,

I counted my peees several times - there were more than 12.

I express 20-40 ml in 10-15 minutes. I've been thinking a lot these days and am increasingly inclined to believe that there are hot flashes in a weak chest, but it cannot suck them out - there are only 2 ducts, one always has droplets, and from the second a very thin, tight stream flows under great pressure (it can only be seen if you look closely). Maybe it’s physically impossible to squeeze milk out of such ducts into one sip, since they are narrow? There are 4 streams from the second breast, thicker and not tight at all.

The child is still small, there is no routine, we have about 15-20 attachments per day, 5-7 of them at night. Almost all sucking (on any breast) ends in sleep after 20 minutes. At the same time, she can sleep while sucking for an hour. At what point in this case should you offer the second breast? How can you tell if your breasts are already empty? She doesn’t demand a second one even in the evening, she doesn’t cry. If there are whims, then immediately after application, after 10-15 minutes he sucks normally, after 20 he dozes or sleeps.

In general, I understand, I’ll try to alternate more often, and look at the gains. Thanks for the help!

Hello, 12

Hello, 12 urinations is an average number, even lower than average. Some children gain well at 15 pieces, some at 20. Everyone has a different volume of one “pee”. Our main criterion is weight gain.

You probably shouldn’t focus on the presence of hot flashes, just try to feed more in volume. A baby can suckle inactively for an hour and suck out very little...

If possible, see the increase weekly or even once every 3-4 days. Based on these figures, it will be possible to guess what will happen in a month and make adjustments. In the first month your gain was higher, maybe something was different in feeding?

At 1.5 months there was weight loss

At 1.5 months there was weight loss almost to the level of weight at 1 month. In time, this coincided with lactostasis of the milkier breast, although the consultant said that the amount of milk could not decrease so much that there would be such a loss (about 150-200 grams). I weighed myself once a week and noticed the weight loss late. Now I weigh myself every day, although this is not recommended. We are still not gaining weight very well - over the last three weeks, 340 grams; On average, per week it turns out from 90 to 140 grams, depending on the day when you count it - the weight either stands for 2-5 days, then jumps by 20-50-70 grams. And she hasn’t pooped on her own since the maternity hospital, once a week I use a candle or a straw - the weight decreases by 30-50 grams.

Now I try to give one or two breasts at one feeding.

Breasts that are without hot flashes, the daughter sucks poorly - both in behavior and quality. She still gets indignant at a weak flow, as you write - she throws the nipple, arches, but after a while I persuade her, I walk with her in my arms. I can’t stop giving this breast at all, the milk will disappear.

If I do not actively massage the area around the nipple during feeding, then sips rarely occur. She does not always suck milk out of her (although there is not a lot of it there). Sometimes immediately after feeding I can express the same 20 ml. I carried out control weighing 5 times - I ate from 0 to 20 grams.

The milky breast sucks well, but in the evening it becomes capricious in the same way as a weak breast, if there is no second or third flush for a long time. From which I conclude that the appearance of hot flashes in a weak breast would stimulate the daughter to suckle better, which means there would be more milk in her.

Since in this situation the milk breast is our main source of milk, I can’t imagine how to stimulate an increase in milk in a weak breast. I can’t start giving it a cup, because we are already gaining weight poorly - weight loss will begin. At night in her sleep she also sucks it poorly. Maybe I should just pump it all the time? Although during the day I already feed every 1-1.5 hours (with the exception of sleeping outside for 1.5-2 hours) - by the way, for 2.5 months, this is probably too frequent feedings, and indicates a lack of milk?

In short, so far my attempts to establish breastfeeding and normalize the child’s weight have not been very successful. The only good news is that the child looks healthy and she is not restless. If she had cried, as many people write, I definitely would not have been able to stand it and switched to SV.

"Maybe we should just pump her

“Maybe we should just pump it all the time?”

Yes, this is a very good option, but only if you can supplement with this milk from a spoon or cup, without sucking. This is a good stimulation of the amount of milk in this breast, the work of the tides, and the width of the ducts. But you can’t supplement your feeding with a bottle (as well as giving you a pacifier, well, I think you know that))).

"for 2.5 months, this is probably too frequent feedings"

no, there are no such laws. women in tribes feed up to 4 times an hour)))

“Sometimes immediately after feeding I can express the same 20 ml.”

This is what surprises me. Have you tried changing your position while breastfeeding? from=under the mouse?

Honestly, 9 to 1 that the latch on this breast is incorrect, if you can express so much immediately after feeding! And at the beginning the tide does not come, but then it can come - when does the grip change? ;) Are you sure your child doesn't have a short frenulum? Can she put her tongue on her lower lip? Does this happen often?

Have you tried Newman chest compressions? When you squeeze not at the nipple itself, but further to adjust the milk. many women do this intuitively.

I feed the expressed ones from

I supplement the expressed milk with a syringe; we do not use bottles or nipples. The frenulum is fine, the tongue protrudes from the mouth regularly when awake. The grip may not be ideal in terms of symmetry. Especially at night, when I feed lying on my side, stomach to stomach. But the areola is almost entirely in the mouth. I tried relaxed feeding about a month and a half ago, when my tummy was regularly hurting. But she doesn't like to lie on her stomach. Moreover, if the flow of milk is weak, then she needs to strain even more to suck from such a position.

For a little over a week now I have been changing breasts frequently: one or two feedings, changing during feedings - I read an article on this topic on your website. At first glance, the gains have improved and stabilized - we are adding 20-30 grams every day. Previously, we stayed at the same weight for 2-5 days, then there was a jump of 40-70 grams. Let's wait and see.

The day before yesterday I fed well from a weak breast from the armpit, yesterday and today from the cradle - with hot flashes with frequent sips (not many sips, but at least something). I try different positions - sometimes I get better in one, sometimes in another. Today I used compression - the pharynx seems to appear more often.

I'm thinking about buying an electronic breast pump for weak breasts to pump them out. I think if there was more milk, my daughter would drink more.

Thank you very much for your time and advice!

Hello, Daria! Thank you,

Hello, Daria!
thank you for answering))

Different women have different areola sizes, so whether it's all in the mouth or not means different things to different women. An asymmetrical grip and a wide open mouth, the chin resting on the chest - this is most often enough. If the child is not tightly pressed while lying down, depending on the size of the chest, it can help to press the baby with his stomach to you, and even put his legs a little on you, or vice versa, move him away from you so that the head is pulled closer and the grip is better (from below, where the strong the lower jaw should be grasped more than the top).

if you have a manual breast pump, an electronic one will most likely express about the same, the only thing is that you get less tired of it (less manual work), that’s what it’s used for.

Help! Lactostasis

Hello! I was literally tortured by lactostasis. In 2 months of feeding, there were 7 pieces with fever, wild pain in the chest both during feeding and when touched, to the point of tears, at the moment there is lactostasis in both breasts, it is most difficult to strain out the lumps, they are from the armpits at the very base of the breast, I go for an ultrasound. In the first and second months my daughter gained 1300 and 1300 respectively, I feed on demand, I also wake her up at night when she sleeps, I hope the latch is correct (flat nipples), I don’t use nipples, bottles, or pads. The first lactostasis happened 2 weeks after giving birth, I went for an ultrasound, it immediately happened again, it wasn’t for a month and a half, now again, one after another, there is no strength. I don’t pump after feeding (although all doctors strongly recommend it; I’m afraid that there will be even more milk and I’ll have to pump constantly). I'm pumping until I feel better now. The breasts are heavy and dense already 2 hours after feeding; after feeding, milk remains in most cases. My daughter has thrush in her mouth (plaque) - we treat it with soda, I smear my nipples with candida and soda. HELP! This is simply unbearable, I have a very hard time with lactostasis, and I also have to take care of the child (6300 kg in weight).

Mothers most often pump at the time when milk is most plentiful. For example, some people have this opportunity in the morning, others at night. If there is any left over after feeding, and the baby has eaten a lot and is full, then express after such feeding. Some express after, and others during feeding.

Just be sure to try giving your baby defrosted expressed milk. Otherwise, some refuse;) then the supply will not be useful.

If it's not a secret, are you going to be away often? For example, once or twice a week, like for an exam, for example, or every day?

3. About the increase - usually in our pediatric tables it costs 600 in the first month, then 800 each. According to WHO, the minimum is 500, but in general it depends not only on the weight, but also on the height of the baby. If you write down your birth weight and height, and your discharge weight, it will be easier for me to check this indicator for you. But you can see for yourself, are there links to WHO charts? just in case. Or are you not considering such options?

How are you doing now, are you satisfied with your feeding? Do you get enough sleep (probably also have night feedings?)? Are you doing what you planned? Is it comfortable and pleasant to feed?

do I need to pump?

Good afternoon, I'm asking for advice.

We are 11 days old. The milk arrived on the 5th day. Feeding on demand. I alternated breasts every 3 hours approximately. The chest filled equally. But one morning, I noticed that one breast was full, but the other was not. And the flow of milk from the smaller breast is very weak. The baby on this breast sucks effectively, swallowing milk for a maximum of 10 minutes, and then falls asleep. Even though there is milk in this breast, he stops sucking it. The other breast is always full. but it doesn't hurt. Just heavy.

Hello, first days

Hello, in the first days there may be too much milk, but now is an important period, it would be good for you to express no less than what the baby needs. Please tell us how many times a day do you pump, what are the breaks, including at night, two breasts or one?

You can also breastfeed after a bottle, this is very good, for example, for sleep. Didn't you do that? Do you use a pacifier, or was it unnecessary?

Hello! Daughter is 1 month old

Hello! My daughter is 1 month 3 weeks old. Because of her illness, I feed her with expressed milk. I feed 110-120 ml every 3 hours, the last time at 24:00 and then at 05:00, I don’t disturb her at night for feeding (we get sick) and she doesn’t wake up on her own. Were born weighing 3010g. height 55cm, in the first month we gained 1 kg, now we weigh 4700g, height 57cm. But the fact is that I have a feeling that the child is not getting enough to eat, I feed her, and after 40-60 minutes she begins to worry, cry, waves her arms and legs, if you pick her up, she begins to look for the breast. To calm her down, I give her a pacifier, she sucks as if she had never been fed at all: (she sleeps poorly during the day (4-5 hours for the whole day) and only on her stomach. I can’t feed more in volume because there is little milk. Tell me, her behavior does it mean that she is malnourished or is it something else? And is it possible to somehow rationalize feeding in our case? Maybe I have “poor quality” milk?

Hello. Am I right

Hello. Do I understand correctly that it is impossible to breastfeed or even let your baby suckle?

If so, you can try pumping more often if you want more milk. However, the gains are good, that is, there is enough milk. But it is difficult to understand a child’s behavior without knowing what she is sick with and why she is unable to breastfeed.

Research shows that women have milk of different fat contents and volumes, but this does not prevent children from eating enough and being satisfied. For milk to become of poor quality, the mother must actually practically die of hunger, that is, be in conditions of severe malnutrition. This is because lactation was established thousands of years ago as a very stable and sustainable mechanism for ensuring the survival of young. That is, you don’t have to worry about the fat content and “quality” of the milk; problems only arise in the form of allergies.

Hello, Anastasia. How

Hello, Anastasia.

As I understand it, you need to go for treatment and you are worried about how the baby will be fed, what, and whether he will then breastfeed.

Quite a lot of questions immediately arise.

1) quite a lot of medications are compatible with breastfeeding in one way or another, and even if something that is not compatible with breastfeeding is prescribed, very often you can choose one that is compatible. Unfortunately, doctors do not always know about this, because... It is customary for us not to feed during any treatment, but it does not take into account that if you do not feed, then there is a risk of abandonment of the breast, a decrease in milk supply, which is more harmful to the child than milk with a small amount of medicine compatible with breastfeeding. Now this concept is being revised, because It became clear that it is better when feeding is not interrupted.

2) pumping - of course, this is very individual. Women often have the best time expressing milk at night and in the morning. Sometimes they even pump before feeding, because it’s still impossible to pump everything, and the baby will still end up with enough milk for himself. In addition, there is another good option - when you feed on one breast, express the second. By the way, do you usually feed one at a time or two at once? As it turns out?

3) some women are also considering the option of going somewhere with the child together, so as not to be separated. After all, the child will miss not only milk, but also his mother. However, if the baby stays, he will be bored and perhaps you can think in advance whether he knows the person with whom he is staying well, whether the baby agrees to drink from the container from which he will be fed - this could be a cup, a spoon, etc. bottle. They don't always just bottle feed. How will the baby calm down, does he suck on the pacifier, or maybe to calm him down, they will rock him, carry him in his arms, or give him a clean finger to suck (they do this too, especially since the finger is more similar to the breast than the pacifier, so children then take better breast). I have a selection of useful materials on this topic:. And an article on this topic. Some even leave some things that smell like mom so that the smell will calm the baby.

Please tell us what you think about these questions?

Expressing breasts at the birth of a premature baby

Good afternoon I would be very grateful if you could help with advice.

At 32 weeks of pregnancy, premature birth occurred, the baby is in the premature babies department, feeding through a tube. On the 3rd day my milk “came”, in the maternity hospital they told me to express one breast every 3 hours, including at night. I still do this, and I can express 50-60 ml from one breast with a breast pump. Feeding the baby with milk is possible no earlier than after 2-3 weeks. Now I want to start freezing milk and I’m puzzled by the following questions:

1. Is it not enough to express milk from one breast at a time? (a week has passed) or should I shorten the intervals between pumping?

2. Is it enough to express only one breast every 3 hours or should I express both at once?

3. What pumping schedule would you recommend for my situation?

The question of how to express breast milk with your hands and in what cases it should be done is of concern to all nursing mothers. There is a misconception that it is necessary to express milk daily to improve lactation. However, according to WHO, this is not necessary if the breastfeeding process is done correctly. To understand how necessary this measure is, you should understand the main nuances of this process.

In what cases is pumping necessary?

Expressing milk is not mandatory, since the breasts of a nursing mother, in most cases, are filled with exactly the amount of milk that the baby requires. However, experts recommend carry out this procedure if certain prerequisites exist for this.

If these prerequisites are not present, then pumping is not required. It should be remembered that as the child develops, milk production increases, taking into account the growing needs of the baby. When the baby's sucking reflex is well developed, he will actively feed on mother's milk, which will be produced at the right level, and the woman will not need to stimulate lactation or pump.

Basic rules of procedure

Before expressing milk, a woman needs to learn a few simple rules for carrying out the manual expression procedure.

Compliance with these rules will help you do This process is the most effective and painless for mommy.

The main mistakes women make

Often, when carrying out this procedure, women encounter common mistakes, knowledge of which is mandatory. will help avoid unpleasant consequences.

How to properly express milk by hand?

So that everything goes right, you should follow the basic steps of manual expression, which are as follows.

It's important to say that sometimes a woman doesn’t always succeed Do everything right the first time, but in this case you shouldn’t despair too much. You just need to practice a little and get used to it, and everything will definitely work out.

Preliminary massage

To make the procedure easier, it is necessary to massage each mammary gland before starting the process:

When performing a massage, you should remember that strong manipulations are inadmissible, which can injure the breasts and lead to pain.

The main advantages and disadvantages of manual expression

Manual procedure for draining milk has more advantages compared to the process of expressing using a breast pump.

Rada Melnikova, lactation consultant, member of the SPPM,graduate of the ProGV Project www.progv.ru: You can still sometimes hear advice to a young mother to express her breasts “dry” after each feeding. The most varied arguments are given: so that the milk does not disappear, so that there is no stagnation, “I did this, and only thanks to this I fed it!” Indeed, in the middle of the last century there were such recommendations. There was a good reason for them: after all, another recommendation was widespread at that time - scheduled feeding. The baby was put to the breast 6-7 times a day with a long night break. As a rule, one feeding is one breast, so the baby was attached to each breast 3-4 times a day. Feeding at such a rhythm is critically insufficient stimulation of the breast for milk production. Regular pumping in this case made it possible to at least somehow support lactation.

If the mother feeds the baby on demand day and night, does not limit the duration of feedings, latches to the breast for 12 days or more, the baby gains weight and develops according to age standards, then there is no need for additional pumping!

Milk production is a law of supply and demand: the more milk is removed from the breast, the more milk is produced, and vice versa. If a mother regularly pumps her breasts, the body perceives this as a signal that the baby needs more milk than he actually sucks. This can easily lead to hyperlactation, and too much milk is no more pleasant than its lack, and can lead to stagnation, inflammation in the mother, and digestive problems in the child.

WHEN PRESSURE CAN HELP

However, there are situations in which pumping can be very helpful. Here are the most typical ones.

1. Pumping in order to establish lactation and feed a child who, for some reason, cannot yet suckle at the breast (low birth weight, premature newborn, a child with anatomical structural features that make sucking difficult, other special situations when it is difficult for a child to suck effectively).

2. Pumping to alleviate the condition of severe fullness or engorgement of the breast, when it is difficult for the child to take a full breast.

3. Pumping to maintain lactation and feed the baby if the child for some reason refuses or cannot temporarily attach to the breast (breast refusal, illness of the child).

4. Pumping to increase milk supply when really needed.

5. Mom goes to work or needs to leave home (regularly or from time to time).

6. Expressing in case of milk stagnation.

7. To maintain lactation if the mother is forced to be separated from the child for some time.

HOW OFTEN SHOULD YOU PRESSURE?

Each situation is individual and the best solution would be to seek help from a lactation consultant. The specialist will develop an individual pumping scheme and teach pumping techniques.

1. To establish lactation, if the baby after birth for some reason cannot suckle, it is necessary to start pumping as soon as possible. Preferably within the first 6 hours after birth. At first it will be just a few drops of colostrum - the first milk that is in a woman’s breast immediately after childbirth.

Then you need to express approximately in the rhythm of the baby's latches to the breast. At least once every 2-3 hours, including at night. Try to get at least 8 pumpings per day.

If night pumping is difficult to accomplish, one break of 4-5 hours is possible.

Nighttime pumping is very important for adequate milk production! Try to have at least 1-2 pumping sessions between 2 and 8 am.

Rare pumping or its absence in the first days, if the baby is not latched to the breast, can interfere with the normal development of lactation processes and provoke insufficient milk production in the future.

2. To maintain the amount of milk in the mother, if the baby is temporarily not attached to the breast, it is advisable to express at approximately the same rhythm in which the baby suckled or a little more often, since no breast pump can stimulate the breast as effectively as the baby.

But no less than once every 3 hours for a child under 6 months.

3. Regardless of how much time has passed since the last pumping, it is necessary to express a little, until a feeling of relief, if the mother feels too full. Even if, according to the developed scheme, the time to express has not yet come.

4. When working to increase milk supply or create a milk bank, everything is very individual and depends on the specific situation. Consult a specialist!

5. If you can’t pump as often and for as long as planned, it is important to remember that any breast stimulation is a “request” to the mother’s body to produce milk. Even 5 minutes of pumping is better than nothing. A child in the first months of life can be attached to the breast up to 20 or more times a day and suck from a few minutes to 1 hour or even longer. If it is not possible to express at a certain rhythm, simply express at any convenient opportunity.

WHEN TO EXPRESS. EFFECTIVE SCHEMES.

There is no single algorithm here either; a lot depends on the situation. The general principles are as follows.

1. If the baby is attached to the breast, then you need to express immediately AFTER feeding or 30-40 minutes after it (that is, between feedings), and not before. There are situations when it is acceptable and even necessary to express before feeding, but these are special cases and should be recommended by a specialist. In the vast majority of cases, it is advisable to express after the baby has fed well from the breast.

2. It is very effective to express one breast while feeding the other breast, since the baby stimulates the flow of milk in both breasts by sucking.

3. The most effective pumping mode is “5+5…1+1”: first 5 minutes on one breast, then 5 minutes on the other, then 4 minutes on each breast, then 3, 2 and finally 1.

4. Simultaneous expression of both breasts also stimulates milk secretion and milk production very well (this can be done either with a breast pump designed for simultaneous expression, or manually, after some training).

5. Usually one pumping session takes 15-20 minutes for each breast. If you are working to increase your milk supply, continue pumping for another 2-3 minutes after your milk has stopped coming out.

6. Sometimes mothers combine two types of pumping - first they express with a breast pump, and then a little more with their hands. This often allows you to express more milk.

7. Don't think too much about expressing a lot of milk. Practice shows that if a mother expresses without looking into the container or counting milliliters, she manages to express more milk.

IMPORTANT! The baby creates a stable vacuum and performs a whole range of movements (almost all facial muscles are involved in the sucking process) to extract milk. When expressing by hand or with a breast pump (even the best), it is impossible to completely imitate the baby’s actions. Pumping is a skill! The volume of expressed milk cannot judge whether the mother has enough milk.

Pumping technique

What to express?

What is the best way to express - with a breast pump or by hand? Each option has its supporters. If you are expressing milk for the first time in your life, try doing it manually. It is easier to control the process with your hands and stop immediately if the sensations become painful. By expressing with your hands, you can study the characteristics of your breast, choose effective pumping movements, speed and compression strength.

A breast pump is usually easier to use when your breasts are full. It may be less effective if your breasts are soft.

Some mothers note that immediately after giving birth, expressing with your hands is much more effective than using a breast pump.

There are women who, due to the characteristics of their breasts, cannot express a single drop with a breast pump, but they can do it just fine with their hands. Try and find your own option.

If you have to express regularly, you should consider using an electric breast pump. The best electric breast pumps are clinical devices and those that express both breasts at once.

Avoid using the simplest “bulbs” - breast pumps: they can easily injure your breasts, and the efficiency of pumping is low.

Never use a breast pump if your nipples are cracked or swollen! This may make the situation worse.

Preparing to pump.

When expressing milk, the same processes are launched in the body as when feeding a child, but weaker - after all, expressing is only an imitation of the feeding process. However, both during feeding and during pumping, the level of the hormone oxytocin, which helps milk flow from the breast, and prolactin, which is responsible for milk production during lactation, rise.

To make milk flow more easily from the breast, you can help the “oxytocin reflex” start working before you start pumping. Here are actions that can help you relax, calm down, and thereby promote easier milk release and effective pumping.

1. Before you start pumping, wash your hands and prepare everything you may need during the process (container for pumping, warm drink and snack, napkins, phone, book, etc.)

2. Sit comfortably, relax, you can turn on quiet, calm music.

3. To stimulate milk secretion, you can use a light breast massage: “tapping” with your fingertips, stroking, fingering “like lotto barrels in a bag”, you can “shake” your breasts a little, leaning forward, and lightly move your fingers from the periphery to the nipples. It's a good idea to stimulate your nipples for a while by lightly pulling or rolling them with your fingers (just be very gentle!).

IMPORTANT! Any action should not hurt you!

4. It’s very good to drink some warm drink before you start pumping. What exactly is not important, it should be tasty for you :-).

5. If there is no fever or inflammation, you can immediately warm your breasts for a few minutes before pumping - for example, put a towel soaked in warm water on it, or take a warm shower. You can warm your hands and feet in the water.

6. If possible, have someone close to you massage your neck and back - this will help you relax.

7. If the child is nearby, skin-to-skin contact helps, look at the child, touch him, hold him in your arms.

8. If the child is not nearby, you can look at his photo or keep some of his clothes nearby. Give free rein to pleasant thoughts about your child.

9. During the process of pumping, some mothers imagine a running stream of water, waterfalls.

You may feel the milk ejection reflex kick in or notice milk flowing from your breasts, but you may not feel anything. You don't need to know or feel this reflex to produce milk.

Expressing by hand.

1. Place your thumb above the areola (or about 2.5-3 cm from the nipple) and your index finger opposite your thumb under the areola. The remaining three fingers of the hand support the chest.

2. “Roll” your fingers a little, place them a little higher or lower, feel the “peas” under your fingers (they are located approximately on the outer border of the areola). These are the ones that will need to be influenced (they can’t always be felt. If you don’t feel anything, don’t worry, just keep your fingers approximately on the outer border of the areola). There is no milk in the nipple! 🙂

3. Lightly squeeze your chest with your thumb and forefinger, towards the chest, as if pressing your fingers a little inward.

4. Roll your fingers forward and when the milk is squeezed out, relax your fingers. Do it all again. Important: fingers should not move over the skin, they should remain in one place. They don’t move, but rather “roll” across the chest!

5. For the first minute or two, until the milk release reflex starts, it may be released very weakly (or not at all), it is important not to stop rhythmic pumping movements.

6. When the milk has stopped actively flowing out, move your fingers a little along the border of the areola and continue expressing. From time to time, move your fingers in a circle so that all segments of the breast are emptied evenly (with the exception of targeted pumping of a certain lobe during stagnation of milk).

7. It is good to alternate direct pumping movements with additional stimulation. If you see that the flow of milk has slowed down after the end of the flow, you can:

• put the baby to the breast (if possible),
• drink something warm
• give a light breast massage and then continue pumping.

If you feel the “hot flashes” well, then you can be guided by the fact that during the 1st “flush” about 45% of the milk comes out of the breast, the 2nd flush – more than 75%, the 3rd flush – more than 94%.

If not, then just use the pumping time as a guide (about 15-20 minutes for each breast).

Expressing with a breast pump.

1. Read the instructions carefully: is the breast pump assembled correctly, are the parts in contact with the breast and milk clean?

2. It is important to choose the nozzles that exactly match the diameter, otherwise milk may be expressed painfully or ineffectively, and cracks or swelling of the nipples may occur.

3. If the breast pump has several power levels, start with the minimum to avoid nipple injury, and then gradually increase the power until it is comfortable, but not painful.

4. Stop pumping immediately if it hurts! Further:

• make sure that the nipple is exactly in the center of the nozzle and that it is the right size for you,
• reduce power,
• Don't pump for too long, take breaks.

WHAT TO DO WHEN “THE MILK HAS COME”?

Separately, you need to talk about the correct actions at the moment the milk comes in (usually on the 3-5th day after birth). Many mothers, even before giving birth, hear stories that “on the third day my milk came in, my breasts became just stone, everything hurt, the baby couldn’t suck it out, they could barely pump it out!” And what a pain!” And this very arrival of milk and straining “until the stars in her eyes”, the mother begins to expect with fear. Meanwhile, with the right actions after childbirth, you may not feel anything at all when the milk comes in, or the sensations will be quite comfortable and the breasts will simply become fuller. What should these actions be?

1. The most important thing to do is to ensure that milk is removed from the breast from the first hours after birth. This is done by putting the baby to the breast at least once every 2-2.5 hours or by pumping, as described above.

If the first milk, colostrum, is not removed from the breast before the arrival of a large amount of milk, then in the future it literally becomes a plug that interferes with the outflow of milk from the breast (as it has a thicker consistency).

2. The key to removing milk from the breast is effective sucking. Make sure your baby has a good latch and is sucking milk, rather than just holding the breast in his mouth.

Here are signs that everything is fine:

• baby's mouth is wide open (obtuse angle 120 degrees or more),
• both lips are turned outward,
• the tongue covers the lower gum,
• in the mouth not only the nipple, but also most of the areola,
• the cheeks are round, not retracted,
• the baby's chin is pressed to the chest,
• You do not hear any extraneous sounds when sucking,
• It doesn't hurt you,
• when the baby releases the breast, the nipple is round or slightly oval (not flattened, no creases or slanting).

3. Continue to attach the baby at least once every 2-2.5 hours or express (if it is not possible to attach the baby) after the milk comes.

4. If a lot of milk comes in at first (and this is normal in the first days), and the breast becomes full to the point of discomfort, you can sometimes pump for 3-5 minutes, “until relief” between the main pumpings, if the baby does not attach to the breast . Or latch on to your baby more often, if possible.

5. Between pumping or feeding, you can apply a cool compress (for example, a diaper soaked in cool water). It relieves discomfort and swelling well.

IMPORTANT! Any manipulation of the breast should not hurt you! Under no circumstances should you aggressively massage, knead lumps, or express painfully. These actions have nothing to do with the release of milk from the breast, but can lead to injury to the mammary gland and the development of inflammation.

You can massage very carefully and put the baby to the breast more often or carefully express (if it is not possible to put the baby on).

6. If you realize that the situation is out of control:

• your breasts are very full, painful and you can’t cope with it,
• It hurts when your baby sucks
• When I express, the milk does not flow out, and it hurts to express.

Seek qualified help!

You can call a free breastfeeding support hotline, for example here:

And also ask for help.

When a woman begins to breastfeed her baby, she faces a whole host of questions. Expressing milk is one of them. A nursing mother usually has to listen to more than one point of view. Often women are encouraged to express breast milk. It is believed that pumping provides a greater flow of milk and enhances lactation. But is it really necessary to additionally stimulate the breasts, or maybe just the baby’s sucking is quite enough? In this article we will try to answer the question about the need to express breast milk.

So, is it necessary to pump for prevention?

Often, a breastfeeding woman may be advised to pump after each feeding. However, such pumping usually results in problems. Why is this happening? The more the mammary gland empties, the more milk it begins to produce. By pumping, a woman seems to be making a request for an increase in the amount of milk. But the baby is often not able to suck out as much; the “excess” milk remains in the breast. The woman expresses it again, thereby again making a request for an increase in the amount of milk. Thus, the mother begins to hyperlactate - excess milk. Excess milk often leads to mastitis - milk stagnates in the gland, does not drain well and provokes inflammation.

Another consequence of such pumping is that it tires the mother and makes her perceive breastfeeding as a very difficult and unpleasant process.

Are there situations when expressing milk from the breast is necessary?

In some cases, expressing breast milk is a necessity. You can’t do without this if:

• Mom and baby separated
• The baby cannot breastfeed
• The baby is premature or weak and cannot get enough milk
• If the mother resumes breastfeeding after a break or, for example, wants to feed her adopted baby
• In some cases, with stagnation of milk
• Mom, when the child is not yet 8-9 months old

In cases where mother and baby are separated or the baby is unable to breastfeed, expressing milk maintains lactation. To do this, you can express both breasts every 3 hours for 15 minutes each. You need to express the same amount if the baby is premature or weakened and cannot suck out milk effectively.

If feeding expressed milk is possible, it is given to the baby from a syringe without a needle.

If a mother has to go to work, and the baby is not yet 8-9 months old and the mother wants to breastfeed, then pumping is often indispensable.

Firstly, a few weeks before you are expected to go back to work, it is advisable to create a bank of frozen breast milk. In this case, the milk is expressed into suitable containers and stored in the freezer. The shelf life of breast milk can be 3-4 months in the freezer compartment of a refrigerator with a separate door, and 6 months in a separate deep freezer.

Breast milk can be expressed for freezing in different portions throughout the day, but in order to mix different portions of milk, the new one should be cooled to the same temperature as the previous one. In this way, it is possible to create a supply of breast milk over time.

However, even with such a supply, it is very advisable for a woman working outside the home to express her milk. This is necessary to maintain lactation and prevent milk stagnation. If there are suitable conditions for this at work, then the expressed milk can be saved and brought home, so that in the next absence of the mother it can be fed to the baby.

Sometimes mothers may need to express milk if it stagnates (lactostasis). This can only be done on the first day from the moment the lumps appear and only if the mother completely excludes recent breast injuries, is not sick with general diseases (colds, for example) and there is no damage to the nipples (abrasions, cracks), otherwise until a decision is made on additional If you are pumping, you should consult a doctor. It should be remembered that any stagnation of milk requires close attention! Therefore, it is advisable to contact a surgeon or an organization that supports breastfeeding as soon as possible if congestion occurs in the chest.

How to express breast milk correctly?

You can express milk from the breast with your hands or with a breast pump.
Whatever pumping method is chosen, it is advisable to first stimulate the oxytocin reflex. This is necessary so that the milk is more easily separated from the breast. Oxytocin is sensitive to positive emotions and warmth. Thus, the oxytocin reflex increases if the mother is close to the baby. It is easiest to stimulate milk secretion when the baby is sucking on one of the breasts, so in some situations, when the baby is sucking on one breast, you can express the other.

If the baby is not nearby, you can apply a damp warm compress to the breast, or do a light breast massage. You can also look at a photo of a child, or smell his clothes. In this way, the woman stimulates the milk ejection reflex.

Let's look at pumping methods in more detail.

If you choose the hand pumping method, then Dr. Newman, for example, suggests this method: we take the right breast with our right hand, and hold the container for collecting milk with our left hand. The thumb should be placed on the upper border of the areola, and the index finger on the lower border of the areola. After this, lightly squeeze your fingers evenly and pull them slightly towards the chest. Finally, express the milk using your fingers in a forward motion.

When pumping with your hands, you don’t need to put in significant effort, much less leave bruises on the skin of your breasts. Also, when squeezing, you do not need to slide your fingers over the areola, so as not to irritate the skin. The described movements must be repeated until the flow of milk weakens. Then the position of the fingers is slightly changed, moving them around the areola, and pumping continues. This is done until all the ducts that are located around the nipple are expressed.

If, some time after you start expressing, milk becomes difficult to separate, you can repeat the stimulation of the oxytocin reflex. Usually, with practice, a woman quickly understands how and where to put effort in order to express milk.

Also, once you get the hang of it, you can express both breasts at the same time, this saves time and allows you to express more milk at one time.

Double pumping takes 10 to 15 minutes per session (compared to 20 to 30 minutes for single pumping) and has been found to stimulate milk production more effectively than single pumping.

A mother can learn to express the second breast with her hands while the baby is suckling the first if the baby is well attached to the breast with the help of special or regular pillows, or sofa cushions.

Manual expression is quite effective. In parts of the world where breast pumps are not available due to their high cost, mothers always express by hand only. The effectiveness of hand expression increases if it is supported, encouraged by society and mothers are well informed about its techniques.

There are also special devices for expressing milk - breast pumps.
Examples of objects that helped mothers extract milk from the breast were mentioned in medical literature as early as the mid-16th century. At this time, references to “sucking glasses” appeared in the medical literature. This device allowed women to express milk from their breasts on their own, and was also recommended as a treatment during hot flashes and mastitis, or for expressing milk if the mother had sore nipples. In addition, "sucking glasses" were supposed to help stretch flat or inverted nipples.

Nowadays, many manufacturers produce various models of breast pumps. Although most of them work on the same principle, they vary in quality. Also, they are all slightly different from each other, just as the breasts of different women differ.

As a rule, when choosing a breast pump, mothers are guided by the fact that it can express milk quickly and in significant quantities. In an informal survey of more than two hundred mothers, a breast pump was rated extremely highly if it worked quickly (total pumping time of less than 20 minutes), expressed 60 grams or more of milk from each breast, and did not cause pain during pumping.

If mother and baby are separated for any length of time, electric breast pumps are usually most effective. Some electric breast pumps allow you to express both breasts at the same time, and adjust the pressure and speed of expression.

However, electric breast pumps also have disadvantages - since breast tissue is very delicate, they can be easily injured if the mother does not place the breast into the electric breast pump correctly. Therefore, if pumping causes pain, you should stop it and check whether changing the pressure or changing the position of the breast pump relative to the breast will bring relief.

There are also many models of mechanical breast pumps on the market today. They are cheaper than their electric counterparts.

To express milk using a mechanical breast pump, you need to place your breast in the breast shield (paying attention to the fact that the nipple must be strictly in the center). The funnel should fit tightly and evenly to the chest. When pumping, it is best to maintain a squeezing rhythm that resembles the rhythm of a baby's breastfeeding. Since the baby alternates between shallow and deep sucking during breastfeeding, when expressing with a breast pump, shallow, frequent squeezing alternates with slow and deep ones. It is often convenient for women to express while leaning slightly forward, after a light massage of the back and shoulders and/or to the sound of flowing water.

Attention! There are contraindications to the use of breast pumps. Do not express with a breast pump if your nipples are cracked or damaged.

It is also worth mentioning that breast pumps require special care. Before first use and after each pumping, all parts of the breast pump are disassembled and washed. For washing, specialized children's soap solutions are used. Then the parts are placed in a container of water, brought to a boil and boiled for some time (usually no more than three minutes). You can also use special sterilizers for sterilization. You can read more about caring for your breast pump in its instructions.

Please note the following: Even if a woman cannot express a significant amount of milk from her breast, this still does not indicate. The baby sucks milk from the breast better than any breast pump.

To summarize all that has been said, it can be noted that pumping is not the most harmless procedure and can carry with it many negative consequences if the mother pumps without reason or using the wrong pumping technique. However, the benefits of pumping at certain points in the life of a nursing mother cannot be denied. Therefore, it is advisable, as with any procedure, to approach expressing breast milk consciously, understanding why it is needed in a particular case. In most situations where pumping is still traditionally recommended and used, it is quite simple to properly organize breastfeeding.

If you have any doubts about the need to pump or are unable to organize pumping yourself, you can contact.

Literature:

1. Armstrong H., Low-tech problem-solving in a high-tech world. Presented at La Leche League 14th International Conference, July 1995
2. Auerbach K., Sequential and simultaneous breast pumping: a comparison. Int J Nurs Stud 1990 27(3) p:257-267
3. Bernard D., Hand-expression. New Beginnings 1996; 13(2) p: 52
4. Fildes VA., Breasts, bottles, and babies: a history of infant feeding . Edinburgh: Edinburgh University Press, 1986
5. Hill P. et al. The effect of sequential and simultaneous breast pumping on milk volume and prolactine levels: a pilot study. J Hum Lact 1996; 12(3) p:193-199
6. Jones E. et al. A randomized controlled trial to compare methods of milk expression after preterm delivery. Arch Dis Child Fetal Neonatal Ed 2001; 85 p: F91-F95
7. Mohrbacher N., Stock J., La Leche League International, The Breastfeeding Answer Book, Third Revised Edition, 2008
8. Newman J., Pitman T., The Ultimate Breastfeeding Book of Answers (Revised and Updated), NY, Three Rivers Press, 2006
9. Riordan J., Auerbach K., Breastfeeding and Human Lactation, Jones and Bartlett, Boston, 1999
10. Walker M., Breast pump survey, 1992

Alena Korotkova,
clinical psychologist,

Elena Nefedova,
lactation consultant