FloridaWic

Hand expression

Collect your milk in a container that has been washed in hot, soapy water, and has been rinsed well. A glass or plastic bowl works well.

• Begin by washing your hands well with soap and water. Put a warm washcloth on your breasts to help your milk flow. Note: When you are first learning, you may want to practice in the shower.
• Massage your breasts for a few minutes. Do this by placing one hand under your breast for support. Apply gentle pressure using a circular motion with your other hand. Massage from several starting points, always working from the chest toward the nipple. Repeat on your other breast.

Position, push and roll:

• Repeat steps one, two and three rotating the position of your thumb and forefingers around the nipple. You may need to move your thumb and forefingers closer to or farther back from your nipple to find the best location that empties your breast.
• Collect your milk into a clean container.When milk flow slows down, switch to your other breast. Then massage both breasts again and express some more milk. Expressing your milk gets easier with practice and works best when your milk supply is built up. Most mothers get more milk in the mornings. Do not be discouraged if you can express only a small amount at first. The more you practice, the easier it will get!

The hand pump

Most manual breast pumps are meant for use by mothers who need to pump once in a while or part-time. Read and follow the manufacturer’s instructions on how to best use the pump.

The electric pump

There are many types of electric breast pumps. Electric pumps are generally the most effective at removing milk from the breast. These pumps adapt so that a mother can pump one breast at a time or both at the same time. Pumping both breasts at the same time (double pumping) usually yields more milk and is more time efficient. Most electric pumps have adjustable suction and a suck-and-release cycle speed so you can imitate your baby at the breast and figure out what works best for you.

• Multi-user electric breast pumps are the most powerful and effective of all breast pumps and can be used by more than one mother. Each mother gets her own milk-collection kit to eliminate cross-contamination of milk between mothers.

• Single-user electric breast pumps are designed to help a mother maintain an already well established milk supply when she must be separated from her baby on a regular basis, such as for work or school. Single- user pumps should not be shared between mothers to avoid contamination issues. Single-user electric pumps are used after your milk supply is well established, which takes approximately 3 to 6 weeks of exclusive breastfeeding.

Read and follow the manufacturer’s instructions on how to best use the pump.

Ask your WIC breastfeeding educator for suggestions about types of pumps and if any are available through your local WIC office.

• Store your milk in a sterile glass bottle, a sterile “Bisphenol-A (BPA) free” polypropylene hard plastic bottle or freezer bags specially made for storing human milk. Avoid thin bottle liners—they are not meant for freezing or storing breast milk.
• Put the smallest amount of milk you think the baby will take at a feeding in each container. You do not want any breast milk to be wasted. Do not overfill.
• Put a sticky label with the date on each container. Also, include your baby’s name on the label if he or she is in daycare.
• If you are going to use the milk within 8 days, you may store it in the back of your refrigerator. Fresh milk is preferable over frozen and thawed. If the milk is not going to be used within 8 days, it is best to freeze it.
• Your milk may be stored in a refrigerator at 39°F for up to 8 days, in a refrigerator freezer for up to 3 to 4 months (freezer must have a separate door), or in a stand alone freezer that stays at 0°F for up to 12 months.
• If you do not have a refrigerator or freezer close by when you collect your milk, put your milk in an insulated container with freezer packs.
• You can add fresh milk to refrigerated milk. But first the fresh milk should be cooled in the refrigerator for about a half hour before pouring it into the older refrigerated milk.
• Use the oldest milk first.
• Do not heat your milk on the stove and do not microwave it. High heat destroys the antibodies in your milk. Also, it can make the milk dangerously hot for your baby.
• Thawing should be done overnight in the refrigerator. Then, the bottle or the bag can be set in a small bowl of warm water to warm the milk. Do not let water touch the lid of the bottle or the top of the bag because the water may get into the bottle or the bag.
• Breast milk may separate into layers. The fat will rise to the top. Gently swirl the milk to remix it when thawed or warmed. Pumped milk may vary in color, consistency and smell depending on your diet.
• Newborns need their milk warmed to body temperature. Cold milk can bring down a newborn’s body temperature. Older, larger babies may be able to handle chilled milk just fine.
• Expressed milk can be kept in a common refrigerator at the workplace or day care center.

introducing the bottle

• When learning to take a bottle, most breastfeeding babies do best with a slow-flow nipple. A nipple with a wider base at the bottom may work better too. This type of base makes the baby open his or her mouth wide. This is more like what the baby does when breastfeeding. The bottle nipple should be long enough so that the baby can draw it into the back of the mouth to where the breast should be during correct latch-on and breastfeeding. A softer nipple may be better than a firmer one.
• About 2 to 3 weeks before returning to work, begin to let your baby get used to taking breast milk from a bottle. Babies are smart — they know mother has the “real thing.” They usually learn to take a bottle more easily from someone else. It is best if someone other than the mother offers the baby the bottle.
• Every time a baby takes breast milk from a bottle, the mother should express breast milk so she can keep up her milk supply.

Work with your caregiver

• Remind the caregiver to have patience— your baby is learning a new skill.
• When beginning the feeding, the caregiver should latch the baby onto the bottle in the same way as if the baby were going to the breast.
• Touch the baby’s lips lightly with the nipple. Wait until the baby opens wide. Then let the baby pull the bottle nipple well into his or her mouth, rather than the caregiver pushing it in the baby’s mouth.
• Remind the caregiver to remove the bottle nipple from the baby’s mouth periodically to let the baby pause and catch his or her breath.
• An older baby could be given breast milk directly from a cup instead of from a bottle — probably from about 4 months old and up.

Introducing artificial baby milk

• Remember, pediatricians recommend that babies are given only breast milk for the first six months of life. However, if you plan to give your baby breast milk and artificial baby milk (infant formula) do this gradually.
• Two weeks ahead of time, slowly begin offering formula for those feedings that you will be away from your baby.
• Each week, replace no more than one daily breastfeeding with formula.
• Watch your baby closely for any signs of problems with the formula. If your baby shows any signs of problems with the formula, you can return to fully breastfeeding.