Guide to breastfeeding

Expressing milk

You may want to express your milk if you're suffering from engorgement, or if you have to miss a feeding and want to keep up your milk supply. To express your milk manually, use a large, clean bowl to collect the milk. Wash your hands, then place your thumb and forefinger on opposite sides of your breast where the areola meets the paler flesh. First push the areola back toward your chest wall with thumb and forefinger, then pull it forward while gently squeezing. Repeat, moving your hand around the areola.

If you would rather use a breast pump, manual ones are available at your pharmacy. Bulb (bicycle horn) pumps are not recommended because they can cause nipple trauma and are difficult to clean. If your baby is premature and requires long-term milk expression or you are returning to work in the first few months, battery-operated or electric pumps are recommended. Look for a full-strength pump that has a Y-connector for both breasts and a regular rhythmic pumping action. You can rent one from lactation consultants, public-health departments, or medical supply stores.

After you have collected your breastmilk, pour it into a bottle or plastic disposable bottle liner and store it in the refrigerator for up to two days. If you plan to freeze your breastmilk, use a glass or rigid plastic container, or a plastic storage bag, specially designed for freezing human milk and available from your pharmacy. Freezing milk in a bottle liner is risky because the seams may burst during freezing or leak during thawing. You can store breastmilk in the freezer compartment of your refrigerator for up to two weeks, for two months in a refrigerator with a separate freezer compartment, and in a deep freezer for up to six months.

Serve refrigerated breastmilk as you would formula. Defrost frozen breastmilk in the refrigerator, then shake well before warming. Never use a microwave to warm breastmilk.

Supplemental bottles

Nursing mothers should not provide supplemental bottles until the breastfeeding relationship is well-established, unless there is some initial concern about depriving the newborn of essential nutrition. Giving your baby supplemental bottles too early will only contribute to your breast engorgement, sore nipples, and poor milk production. Since sucking on the nipple of a bottle requires a different technique, using both at the beginning may confuse your baby. If she's only breast-feeding, your baby will perfect her sucking techniques. But once breast-feeding is established, you will be able to return to work, if you wish, while maintaining breast-feeding and supplementing occasionally with bottles.

Pacifiers/Soothers

The World Health Organization suggests that breast-fed babies not be given a pacifier or soother during the first few weeks because it may distract them from breast-feeding. As with supplemental bottles, your baby develops a sucking technique with a soother that's different from the one needed to breast-feed. Many babies who nurse satisfy their sucking needs at the breast; however, a soother may let you get rest between feedings.