Breast care and expression of breast milk ( PART 2)

Physiological changes during pregnancy prepare breasts and nipples for breastfeeding.

The mother should understand that:

1. Breasts and nipples need no special attention or preparation. “Nipple exercises”, “breast massage” and prenatal expression have not been shown to have a positive effect on breastfeeding.

2. There is no evidence that women with fair skin are more likely to get sore nipples than women with darker skin.

3. Frequent washing, especially with soap, alcohol or other cleansing agents removes the natural oils that protect the skin of the nipples.

4. The use of special creams and sprays is unnecessary and may be harmful.

5. Washing the breasts or nipples before feeding is unnecessary, inconvenient and will remove the protective natural oils. This could lead to sore nipples. Also, the natural smell of the breast may have a positive effect on the baby.

6. Plastic-coated breast pads may make the skin of the nipples moist and vulnerable to infection.

Breast milk expression

Expression of breast-milk may be necessary if the mother is separated from her baby; if the baby is too weak to suckle; if the breasts are severely engorged; or to stimulate milk production if the baby cannot do so, e.g. in the case of a cleft palate.

Expression can be done with a pump or by hand. A variety of different breast pumps are available. Electric pumps are largely used in hospitals, but may in some countries be loaned or rented for home use. The more transportable hand-operated breast pumps come in different shapes, some useful and others less so.

Hand-expression

How to express her milk:

1. Prepare a very clean cup or jug if you want to use the milk, and wash your hands thoroughly. Preferably the cup should be made of plastic as milk fat and immune protective antibodies stick to glass surfaces.

1. Stimulate the let-down of milk .

2. Lean slightly forward and, if necessary, support the breast with a flat hand against the ribcage.

3. Place the thumb above and the index and middle fingers below the areola (see illustration ).

4. Press the fingers inwards towards the chest wall.

5. Compress the lactiferous sinuses between the fingers, then release. Press and release. Press and release. Press and Try to simulate the rhythm of your baby’s “milking” (see illustration ).

6. Be patient, even if no milk comes in the beginning. Do not squeeze, pull or push the breast or the nipple. This will not make the milk flow and may be harmful.

7. Move the hand around to get to all segments – use alternate hands.

8. Repeat the procedure from step 2, until both breasts are soft.

All breastfeeding women should learn and practice the expression technique soon after the birth. Then if there is a crisis such as hospitalization of the child, she will already be confident in this skill.