Expressing and Storing Breastmilk: A Comprehensive Guide

Expressing and storing breastmilk is a crucial aspect of breastfeeding for many mothers. Whether they are returning to work, traveling, or simply want to have a supply of milk on hand, knowing how to properly express and store breastmilk is essential. Fortunately, there are many resources available to help mothers navigate this process.

One of the first steps in expressing and storing breastmilk is to learn how to express milk effectively. This can be done manually or with the help of an electric breast pump. Many mothers find that working with a lactation consultant or joining a breastfeeding support group can be helpful in learning how to express milk properly. Once milk has been expressed, it is important to store it correctly to ensure that it remains safe for the baby to consume.

There are several factors to consider when storing breastmilk, including the temperature and duration of storage. According to the Australian Breastfeeding Association, freshly expressed breastmilk can be stored in the refrigerator for up to four days, or in the freezer for up to six months. It is important to use clean, food-grade containers with tight-fitting lids for storage, and to label each container with the date and time that the milk was expressed. By following these guidelines, mothers can ensure that their breastmilk remains safe and nutritious for their babies.

Breast Milk Expression Techniques

There are several techniques for expressing breast milk, including hand expression and using breast pumps. It is important to find a comfortable and relaxed position before starting to express milk.

Hand Expression

Hand expression is a simple and cost-effective technique for expressing breast milk. It involves using the hand to massage the breast and squeeze the milk out. Here are the steps for hand expression:

1. Wash your hands thoroughly with soap and water.
2. Find a comfortable and relaxed position.
3. Place your fingers and thumb around the areola, about an inch away from the nipple.
4. Gently squeeze and massage the breast, moving your fingers towards the nipple.
5. Repeat on the other breast.

Breast Pump

Breast pumps can be manual or electric and can be used to express milk from one or both breasts. Here are some tips for using a breast pump:

1. Choose a comfortable and quiet place to express milk.
2. Follow the instructions provided with the pump.
3. Start with low suction and gradually increase it until you find a comfortable level.
4. Use breast massage or warm compresses to help stimulate milk flow.
5. Switch breasts every 10-15 minutes or when the milk flow slows down.

Other Techniques

Other techniques that can help with milk expression include taking a warm shower before expressing, massaging the breast before and during expression, and using a breast compression technique to help empty the breast more fully.

It is important to seek support from a health visitor or breastfeeding supporter if you have any difficulties with expressing milk. They can provide guidance on techniques and help troubleshoot any issues you may be experiencing.

Storing Breast Milk

After expressing breast milk, it is important to store it properly to ensure it remains safe for consumption. Breast milk can be stored in a variety of containers, including glass bottles, plastic bottles, milk storage bags, and disposable bottle liners. It is important to ensure that the container is clean and sterile before storing breast milk.

Breast milk can be stored at room temperature for up to four hours. However, it is recommended to store breast milk in the refrigerator or freezer as soon as possible after expressing. Freshly expressed breast milk can be stored in the back of the refrigerator for up to four days in clean conditions. However, it is optimal to use or freeze the milk within three days.

Breast milk can be stored in the freezer for up to six months. It is important to label the container with the date the milk was expressed and to use the oldest milk first. When freezing breast milk, it is important to leave some room at the top of the container as the milk will expand when frozen.

Breast milk can also be transported and stored in an insulated cooler with ice packs for up to one day. When transporting breast milk, it is important to keep it away from raw meat and to avoid opening the container unnecessarily.

It is important to note that the temperature of the refrigerator should be kept at or below 40°F (4°C) to ensure safe storage of breast milk. Additionally, plastic bags should be avoided as they can puncture easily, and breast milk should not be stored in the door of the refrigerator or freezer as the temperature can fluctuate.

Overall, proper storage of breast milk is crucial to ensure its safety and quality for consumption. By following these guidelines, parents and child care providers can ensure that breast milk remains safe and nutritious for their little ones.

Thawing and Warming Breast Milk

When it comes to thawing and warming breast milk, there are a few important things to keep in mind to ensure the milk remains safe for your baby to consume.

Firstly, it is important to never thaw or heat breast milk in a microwave. Microwaving can destroy nutrients in the milk and create hot spots, which can burn a baby's mouth. Instead, thaw breast milk under lukewarm running water, in a container of lukewarm water, or overnight in the refrigerator.

Once fully thawed, previously frozen breast milk may be kept at room temperature for a maximum of two hours or in the refrigerator for up to 24 hours. If you thaw breast milk in the refrigerator, use it within 24 hours. Start counting the 24 hours when the breast milk is completely thawed, not from the time when you took it out of the freezer.

Alternatively, you can warm the milk by placing the bottle or bag of milk in a jug of warm water. Do not use boiling water or a microwave to warm the milk, as this can destroy the nutrients and create hot spots. It is also important to never refreeze thawed breast milk.

It is important to note that breast milk should be used or properly stored within four hours if it has been left at room temperature, especially if the room is warm. Freshly expressed breast milk can be kept at room temperature for up to six hours. If there is any leftover milk that has not been consumed within this time frame, it is recommended to discard it.

In summary, thawing and warming breast milk requires careful attention to ensure the milk remains safe for your baby to consume. Always avoid using a microwave and instead thaw the milk under lukewarm running water, in a container of lukewarm water, or overnight in the refrigerator. Use thawed milk within 24 hours and warm the milk in a jug of warm water, avoiding boiling water or a microwave. Finally, ensure that any leftover milk is discarded after four hours if left at room temperature.

Safe Handling and Hygiene Practices

Safe handling and hygiene practices are crucial for ensuring the quality and safety of expressed breast milk. Here are some important guidelines to follow:

• Work in a clean and hygienic environment: Before expressing breast milk, make sure to wash your hands thoroughly with soap and water. If soap and water are not available, use an alcohol-based hand sanitizer. Make sure your pumping equipment and storage containers are clean and sanitized as well.

• Use freshly expressed breast milk whenever possible: Freshly expressed breast milk is the safest and most nutritious option for your baby. If you need to store breast milk, do so as soon as possible after expressing it.

• Follow guidelines for using an electric pump: If you are using an electric pump, make sure to follow the manufacturer's instructions for cleaning and sanitizing the pump and its parts. This will help prevent contamination and ensure the safety of your breast milk.

• Use safe storage containers: Breast milk can be stored in a variety of containers, including storage bags, bottles, and jars. Make sure to use containers that are specifically designed for storing breast milk and that are made from safe materials.

• Seek support from a midwife or breastfeeding specialist: If you are experiencing difficulties with expressing or storing breast milk, don't hesitate to seek help from a midwife or breastfeeding specialist. They can provide guidance and support to help you overcome any challenges you may be facing.

• Avoid storing breast milk when sick: If you are sick, it's best to avoid storing breast milk. This is because some illnesses can be transmitted through breast milk, and storing contaminated milk can put your baby at risk.

• Freeze breast milk properly: If you need to freeze breast milk, make sure to do so properly. Use a freezer that maintains a temperature of 0°F (-18°C) or lower, and store the milk in containers that are specifically designed for freezer storage.

• Hand express if engorged: If you are feeling engorged or uncomfortable, hand expressing a small amount of milk can help alleviate the discomfort and prevent any potential issues with milk flow or latch.

• Seek breastfeeding support from partner or national breastfeeding helpline: Breastfeeding can be challenging, and it's important to have support from your partner or a national breastfeeding helpline if you need it. They can provide guidance and support to help you overcome any challenges you may be facing.

Special Considerations

There are certain special considerations that should be taken into account when expressing and storing breast milk. These considerations include the freezing of breast milk, the preservation of nutrients, and the special care that must be taken when handling breast milk.

Freezing breast milk is a common practice for mothers who wish to store milk for later use. It is important to note that freezing breast milk can alter the taste and consistency of the milk. However, if done correctly, freezing breast milk does not significantly affect the nutritional value of the milk. It is recommended that breast milk be frozen in small portions to prevent waste. Frozen breast milk can be stored for up to six months in a standard freezer, and up to twelve months in a deep freezer.

Preserving the nutrients in breast milk is important for the health of the baby. Breast milk contains a variety of nutrients, including proteins, fats, vitamins, and minerals. To preserve these nutrients, it is recommended that breast milk be stored in a cool, dark place. Exposure to light and heat can cause the breakdown of some of the nutrients in breast milk. Additionally, it is important to use breast milk within four hours of expressing it, as this is when the milk contains the highest levels of nutrients.

Special care must be taken when handling breast milk to ensure that it remains safe for the baby to consume. Breast milk should be expressed using clean hands and clean equipment. It should be stored in clean containers that have been sterilized prior to use. Breast milk should also be labeled with the date and time it was expressed, to ensure that it is used within the appropriate timeframe.

In summary, there are several special considerations that should be taken into account when expressing and storing breast milk. These considerations include the freezing of breast milk, the preservation of nutrients, and the special care that must be taken when handling breast milk. By following these guidelines, mothers can ensure that their breast milk remains safe and nutritious for their babies.

Questions? Email Jack Newman at drjacknewman@sympatico.ca, or Edith Kernerman at breastfeeding@sympatico.ca or consult: Dr. Jack Newman’s Guide to Breastfeeding (called The Ultimate Breastfeeding Book of Answers in the USA) or our DVD, Dr. Jack Newman’s Visual Guide to Breastfeeding; or The Latch Book and Other Keys to Breastfeeding Success; or L-eat Latch & Transfer Tool, or the GamePlan for Protecting and Supporting Breastfeeding in the First 24 Hours of Life and Beyond.  See our website at www.drjacknewman.com.  To make an appointment email breastfeeding@ccnm.edu and respond to the auto reply or call 416-498-0002. 

Handout. Expressing Milk, Revised May 2008
Written by Edith Kernerman, 2005
Revised by Edith Kernerman, IBCLC, and Jack Newman, MD, FRCPC © 2008

 This handout may be copied and distributed without further permission,
on the condition that  it is not used in any context that violates
the International WHO Code on The Marketing of Breastmilk Substitutes