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EXPRESSING BREAST-MILK (EBM)

This page contains many useful tips contributed by members of the Malaysian Nursing Mom  and the online Yahoo group support mails. Please note that these tips do work for most mothers but not necessary work for everyone. We hope you will be amused, enlightened, inspired and motivated to get your hands on expressing your breast-milk when the situation warrants it. For e.g. when you are returning to work after your maternity leaves, when you desire to keep some EBM for your baby caregiver to feed when you need to be away, when your baby is not able to nurse due to some unforeseen circumstances. Take note that expressing is not a substitute for direct nursing your baby. It is only a second choice. You are advised to consult your respective lactation consultant, breast-feeding counsellor, mid-wives or nurses to learn the proper technique to get your baby to latch on to your breast properly. Remember that you may find some contradicting information because as I mentioned earlier, one thing may works for a mother but not the other. So, read on with an open mind! 

Thank you to all moo-mies for your wonderful tips. (Message from Lilian and Szex2)

Some thoughts on Expressing

- Expressing milk is normally not recommended for the first 6 weeks. Our body works on supply and demand. Our body will get confused and start producing too much which will lead to engorgement or we'll get frustrated 'coz we're not getting much from expressing. Our baby is really is the most effective at extracting milk from our breasts. Not being able to express milk with a breastpump or hand is not an
indication of low milk supply. Expressing small amounts could also mean no let down or we're too stressed out or we've been trying to do too much. Milk supply is also usually at its lowest in the afternoon
and highest in the night.

- Teasing the nipples worked for some for a faster let down.
- Returning to work & still pumping: You will need these for successful pumping:

Breastpump - two if you have no time to wash for second pumping
Breastshell -keep those precious milk which let down when you are pumping from the other!
Face towel - to clean the desk / your outfit
2 or 4 bottles of milk bottles depending how much you want to store per bottle
cooler box (you will probably receive a few from those baby hampers)
washing / sterilising equipment

(The above tips gathered by Szex2 from her own experiences and also the other members' experiences. Szex2 is a full-time working mom but she has successfully breast-fed William exclusively for more than a year.)

EXPRESSING DURING OFFICE HOURS?

Here are some real-life experiences:

From Nazreen, a Malaysian staying abroad:

I can relate to the "expressing under any condition" experience. When I returned to work after Suraiya, I had to express in this room, which was very big, but extremely unhygienic as it was the tool/junk room. I took as much care as possible but I too had the same thoughts - my EBM will kill off any germs! I was on the 4th floor and this room was on the ground floor and getting to it (with a rucksack filled with the "kit") always brought on quite a few stares. I was very malu intially, especially
when using the breast-pump - use to try everything to minimise the sound. Things were much better after Zulaikha - had better facilities - used the first aid room. And also by this time, I had developed buffalo hide and was not bother about noise etc.

Expressing at the office once during day time. Always see pumping session as my solitude from busy office environment and a good hideout from my boss too. Doing that in office prayer room. Have been flashing my McB to most of lady collegues in the prayer room, even the single ones! Right Faz? the good thing is that, we have even inspired the mother-to-bes to follow our steps. (Fiz)

I'm a mother of a 15 months old toddler, Beatrisya. I'm a full-time working mom and also pursuing a postgraduate course. Beatrisya was exclusively on the bm for the first 9 months. Attempt to wean her slowly off the breast, so that I can plan for the second one very soon. As for myself, pumping at work, worrying about supply etc, etc was a lonely journey with only "babycenter.com" to turn to. That's why I was so excited when I read Lilian's article in the Star on that one fine day in January…even more excited when she replied my email the next day, telling that one obsessed bf mom would set up the group. Hats off to both Lilian and Sze Sze and all the other moo-mies who make this group a "happening" (strongly agree with Hafizah!) (Ros, a working and study mom)

Be an ambassador to promote BFG as your colleagues may feel awkward abt seeing your milk in the refrigerator. I once reassured a senior male manager who apologised for bumping into me taking my milk out from the refrigerator that there was nothing to be sorry abt becoz I felt perfectly normal to be able to "nurse" my baby when I'm away for work. Who knows, later your management might be pressed to prepare a lactation room becoz so many female staff pump in the office! (Sze Sze)

For the moo-mies who had just returned to work after maternity leave, it sure looks depressing because we can see the quantity of milk produced when you expressed in the office and thus starting to feel 'inadequate'. Remember that the milk quantity naturally drops because of a new routine in your life. It will and can pick up once you are used to the new routine of expressing at work and nursing at home. (Lilian)

I expressed through a simple Pureen breast pump until my baby was 5.5 mths old. So all those out there who cannot breastfeed but can pump - go ahead. It's still OK, as long as the baby is having breastmilk. (Topaz)

I pump in the store room of my office. I sterilise the table, bring in one of the office chairs and this place has been my little hut for dairy production! ;) when I have to be stationed in a new place, say a hotel, I ask for a small room and I've once park my car near a corner and conduct my biz there! (Sze Sze)

Your expressed milk can be kept at indoor air-con room temperature for 10 hours without refrigerating becoz it's full of active antibodies which would fight off any bacteria found in the milk, so it's still safe to keep it in a cooler filled with ice or even no ice for abt 10 hours. You can store your frozen milk (those you pump before returning work or on weekends) for 6 months in a freezer compartment and store refrigerated milk in the refrigerator for 24 hours. (Sze Sze)

I believe you CAN add fresh breastmilk to previously expressed chilled breastmilk within a 24 hour period, no problem. I know Lai Yin and I both keep our pump on the go for the day, topping up until we've got as much as we want, then wash and sterilize it at the end of the day. But you can NOT add fresh breastmilk to already FROZEN breastmilk (Jen)

This is how I do (to) save space for storing expressed breast milk in the freezer and also to avoid spillage when transfer to the bottle… After pumping, … I put EBM in plastic ice cube trays and after that transfer the frozen cubes into a zip bag. … It makes life easier for the child minder as it thaws quickly, and it's easy to add an ounce or two more on hungry days … I also numbered them so as to keep track of the stocks! I have in each zipper bag 10 cubes of EBM (about 4 oz.) expressed on the same time. (Geok Hong)

You will need these for successful pumping in the workplace:

  1. Breastpump
  2. Breastshell -keep those precious milk which let down when you are pumping from the other!
  3. Face towel - to clean the desk / your outfit
  4. 2 or 4 bottles of empty milk bottles depending how much you want to store per bottle
  5. cooler box (you will probably receive a few from those baby hampers)
  6. washing / sterilising equipment
    (Sze Sze)

Hand Expressing: I use a bigger size bottle, with a wide mouth. Found the normal bottle too small for my nipple. Milk tends to spray all over. Use my left hand to press, right hand to catch the milk. Thumb on the upper part, the rest of the fingers at the lower part. The angle between thumb and fingers is like a clock at 6 pm. Get it? Top and bottom. When you move, also at that angle. You can go clock-wise or counter clock-wise but the angle remains the same -opposite. Never cubit yourself. All my jari-jari NEVER move on the surface of the skin. You can get skin burn if you do that. Get a firm hold and gently squeeze to the nipple area. Don't expect milk to start flowing immediately. NEVER also squeeze on the aerola. This area is very sensitive. Once the milk flows, it really flows because they are forced out instead of being suck out. I had noticed that I get 3 gushes of milk (in an interval of about 10 mins) each time I express. The milk will flow but when you get the gushes, you can feel the breast firm up again and the milk flows more. (Lilian)

And it doesn't matter you know, even if you only manage to express a little, you could still add it to the formula you are giving - something is better than nothing right? If you continuing expressing at work it will keep your the milk supply up even if the amount expressed is very little .I know mothers who bf in the morning before they leave for work and when they return home. They do not express but they bf during weekends and also any time they are at home. The milk supply will adjust to a set routine. (Nazreen)

When I take time off from work to pump, I feel tremendously at peace and in tune with myself. May be becoz I hafta concentrate on this act or may be becoz it's a small break of 20 mins, I often feel relaxed aft coming out of the storeroom with some milk for my baby, whatever the amount is. I have learned to take things slowly through pumping for my baby. (Sze Sze)

A useful tip I got from my friend who used to express milk while at work. Stimulate let down by teasing your nipples with a face towel. That way, you will be able to express comfortably for a shorter time. Another tip is to express while nursing as our body is able to adjust to the demand. Let's say, you express while you're nursing at 11.00pm every night, your body will think that is how much your baby needs at night, therefore increases its production of milk to meet the demand (Min)

The method which was shared with me is to form a C with your thumb and forefinger. 

Place your hand just above the ariola and gently glide your hand down. Something like the right hand in the middle picture at the bottom (the grey one). Yup, just one hand. It'll help to stimulate your breast (remember the hanky? :o)) before you start expressing whether with hand or pump. (Min)

Some hilarious observation I made abt this whole pumping life: (Sze Sze)

1) You have stained your book, your desk, your radio, your keyboard, your company's annual report before. Lilian stained her Bible too!

2) And if you did any of the above, you have clumsily run out of the pumping sanctuary before --- frantically looking for a wet towel to clean up the mess only to discover that you have created quite an impression art with the sprayed milk already dried up on the surface.

3) If you pump in the office, you have battled the initial shyness of taking the X no. of bottles of EBM in your hands, striding past at least a dozen of male colleagues while on your way to the pantry.

4) Your EBM is labelled with your big name and provide a great source of amusement amongst the colleague especially on a gloomy Monday.

5) Your EBM have helped to strike a convenient conversation with the tea lady, the CEO and even the not-so-intelligent colleagues around you.

6) Because you could see your milk qty, with each subsequent pump you mentally compare your milk qty and take great concern over the level of milk output for the day/week. In fact you are only "kiasu" when it comes to this matter.

7) You save every drop of milk you could possibly get your hands on, carefully knocking down every drop of milk from the pump or breast (if you hand express) into the bottle ensuring not a single drop of antibody/nutrient in the EBM is left uncollected.

8) You are already a multi-tasker when you are both a woman and a mum. But you are even more of a multi-tasker as you pump, boil the water, catch the ASTRO's world's birthday, pick up your bawling baby, talking to a friend from Holland, reading and doing manicure altogether, all while the other free hand's busy collecting those sprayed milk from the other boob.

9) You have the latest gadget for pumping, from breastshell, canggih-manggih pump, leopard print nursing mom (LOL), steriliser, cooler box and still know exactly what you ought to buy to make pumping even easier if you have the money.

10) On weekends, you can be seen rushing to the supermarket aisle to pick up some rarely used nursing tea, herbs and whatever secret remedy you could lay your hands on to increase milk qty.