Expressing Breast Milk

Expressing Breast Milk for a Preemie

There are some extra special guidelines recommended when expressing milk for a preterm baby. Some preemies need to be fed extra fortification or via tube feeding.

Here are some guidelines for expressing breastmilk, storing and handling the breast milk.

skin to skin contact

Pumping is necessary when a baby is unable to feed at the breast, or if the mother is struggling with a low milk supply. 

Pumping Guidelines:

  • Pumping early after the baby’s birth: The mother needs to pump at least 6 hours or sooner after the baby’s birth.
  • Pump frequently: At least 8 times per 24 hours. Expressing breast milk by hand alone is not recommended. 
  • Pump long enough with each pumping session: For at least 30 minutes or 2 minutes after no milk is coming out. 
  • Double action pump: Get a pump that can pump both sides at once, these pumps are more effective. An automatic hospital grade pump is best. 
  • Oxytocin and expressing breastmilk: Skin to skin contact before pumping, can help increase a mother's let down reflex. 
  • Non-nutritive suckling: Comfort feeding will:
  1. Provides practice for the baby. 
  2. Increase the mother’s milk supply.
  3. Increases bonding

How much expressed breast milk does my baby need?

Tips to Avoid Contamination of Breast Milk

  • Pumps and bottles should be cleaned well before used. 
  • All equipment should be sterilized once per day, by boiling them for 15 minutes. 
  • Store milk in glass or hard plastic containers, not in plastic bags. 
  • Wash your hands before pumping and wipe your nipples with plain water before pumping (not with soap, this will dry them out)
  • Close any containers while thawing the breast milk.
  • Label the breast milk containers with date and time. (if in hospital, the label should also show baby’s name, ID and any medications taken.) 
  • Use fresh, unrefrigerated breast milk, within 1 hour after expressing. 
  • Fresh milk should be refrigerated immediately and used within 48 hours. 
  • Freeze all milk that will be used later than 48 hours. Do not refreeze milk. 
  • Each pumping session’s milk should be stored in a separate container. 
  • Thaw milk in warm water for no longer than 20 minutes. 
  • Do not shake the milk, swirl it. 

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Parent Testimonials: Pumping for Your Preemie

Tracy Behr, CBC, CLD (CBI)

Reference: Course information through Childbirth International on the physiology of breastfeeding/expressing breast milk for preemies.

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