Breast Care and Expressing Milk :: Nationwide Children's Hospital

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Breast Care and Expressing Milk

If your baby cannot breast-feed while he or she is in the hospital and you plan to breast-feed when your baby goes home, it is important to care for your breasts. This means you must make sure the milk is expressed (removed) from your breasts every day at least 8 times a day. This prevents breast engorgement (swollen breasts) and ensures that milk will continue to be produced. 

Caring for your breasts will help to keep you comfortable and will help to make sure there is milk for your baby.

Image of breast-feeding

How the Breasts Produce Milk

The breasts are made up of milk-producing glands, tubes called "ducts," and fatty tissue. The glands produce the milk. When a baby sucks, the milk flows through the sinuses and ducts to the nipple openings.

How to Care for Your Breasts

  • Wash your breasts with clear, warm water daily when you shower. Wear loose-fitting clothing to prevent binding.
  • Wear a nursing bra 24 hours a day (even to bed) to give support. A nursing bra allows you to uncover the breasts without removing the bra.
  • Keep nursing pads (without plastic backing) or large, clean, folded handkerchiefs inside your bra to soak up drops of milk that may leak between feedings or expressions. The pads help to keep the nipples dry. Change pads when they get wet.
  • You do not need to wash your breasts after breast-feeding or expressing milk. Just let the breast milk dry on your breasts.

When and How to Express the Milk

Image of breast massage

Express the milk as often as your baby would nurse if you were breast-feeding (8 to 12 times in 24 hours for newborns). Also express milk if you awaken during the night.

Milk can be expressed with your hands (manual expression) or you can buy an electric, battery powered or hand operated breast pump. It takes practice and time to learn to express milk by any of these methods. Don’t be discouraged if you have trouble at first.  It’s easier to express milk if you are relaxed.

Hand (Manual) Expression

  1. Wash your hands thoroughly with soap and water for 15 seconds.
  2. Start with a breast massage (Picture 2).
  3. Place your thumb on top and your forefinger under the nipple (Picture 3).
  4. Gently push your finger and thumb back toward your chest to grasp behind the milk ducts that are the milk storage areas behind the nipple (Picture 4).
  5. Squeeze gently in a “milking” motion to remove the milk that has collected in the ducts (Picture 5).
  6. Repeat the procedure, changing the position of your grasp on the breast so that all ducts are drained.  Repeat on the other breast.
  7. Express the milk into a clean container.  Some women prefer to use a cup or bowl.
  8. If your baby is in the hospital, express your milk into the sterile containers that are provided.
Image of breasts

Breast Engorgement

Breast engorgement sometimes occurs when milk builds up in the breasts.  It usually lasts only a day or two.  Here are some things you can do:

  • Gentle massage may help open the ducts and let the milk flow.
  • A warm shower or warm, moist compresses placed on the breasts will stimulate the milk to leak out and relieve the swelling.
  • Putting ice packs to the sides of your breasts, 20 minutes on, 20 minutes off, after expressing or breastfeeding will help relieve engorgement.
  • A bra that is too tight can cut off circulation and cause the ducts to become plugged.  Loosen your bra if it is too tight.
  • If you have severe engorgement, call your doctor or a lactation consultant.

When to Call the Doctor

Call your doctor or lactation consultant if:

  • Your breasts stay swollen or painfully engorged after expressing milk several times.
  • Your breasts feel hot when you touch them.
  • You develop a fever.

If you have any questions, please call the lactation consultant at (614) 722-5228.

Breast Care and Expressing Milk (PDF)

HH-IV-61 3/82, Revised 11/12 Copyright 1982-2012, Nationwide Children's Hospital

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