Your baby is several weeks old and has been breastfeeding like a champ. As you think about going back to work, taking a trip or experiencing an illness, you will need to learn how to express your breast milk for those times you can't be with your baby. Whether you hand express or use a hand-held or electric pump, it's wise to practice early as you may run into some problems.
No "Let Down"
"Let Down" is the term for a tingling sensation in your breasts, followed by the flow of milk to the milk ducts, leading to openings on the nipple. This flow depends on your ability to relax. Before expressing, be sure you choose a place that is quiet and private. If you are trying to rush or feel nervous and frustrated, the milk may not readily let down. Get in a comfortable position, close your eyes and take several deep breaths to relax. To begin the flow, you may also look at a picture of your baby, gently massage your breast or add a warm, moist compress.
Not Enough Milk
You may not have enough milk because you are expressing too soon. Stick to the schedule your baby has at home. Make sure to completely drain your breasts, encouraging optimal milk production. According to WomensHealth.gov, you should wait until at least four weeks after birth to begin expressing because your milk supply should be well-established by then.
Pump Problems
You also may have problems with the pump itself. If you use an electric or battery-operated pump, the suction may be too low and you need to adjust the settings higher. Also, the shields may be too small for the areola which may cause the nipple to swell and block the milk ducts. Be sure your pump has shields large enough for your breast. If your pump is not operating correctly, you may always hand express. It's efficient and always with you, though it requires a bit of practice.
Engorgement
Engorgement is common two to five days after beginning to breastfeed. It usually occurs when your breasts become too full from not being emptied properly or often enough. After delivery, it typically occurs because your body is trying to establish the correct milk supply for your baby's needs. The breasts are swollen and hard--so hard that it is difficult to get any suction started with a pump. If you are home, take a warm bath and drape a warm, moist washcloth over your breasts, which should cause them to begin leaking. Form a "C" with your thumb and index finger, one to two inches above your areola, pressing in and down, toward the nipple. This will cause milk to spray or come out in jets. Once the areola and nipple are no longer firm, try pumping again. If engorgement happens frequently, express your milk more often. You may use a warm compress made of several paper towels if you are in a public restroom and need to drain a bit before expressing.
Illness
You may need to express milk if you become ill and need medication the baby should not ingest. In this case, express routinely and dispose of the milk until the drug is out of your system. Always remind your doctor you are breastfeeding if she wants to prescribe medication. You may need to take antibiotics if you develop mastitis, a serious infection of the breast caused by frequent engorgement, cracked, open skin around the nipples or blocked milk ducts. Mastitis is accompanied by redness, heat and pain in the breasts as well as headache, nausea and/or a fever of 101 degrees or more. If you experience a cold, flu or diarrhea, breastfeeding will help your baby by providing antibodies. It is safe to breastfeed during these minor illnesses, but consult with your pediatrician if you want to try over-the-counter medications.
