Expressing Milk for Your High-Risk Baby
Expressing your milk
You will have to remove milk from your breasts on a regular basis to provide enough
of your milk for your high-risk baby. Many mothers find they can appreciate their
babies' breastfeeding patterns when they understand how milk is produced. Initially,
hormones play a greater role. After the first one or two weeks postpartum (after the
baby is born), milk removal has a greater effect on the amount of milk produced.
How is milk produced?
With the expulsion of the placenta after a baby's birth, a drop in the hormones that
maintained the pregnancy soon occurs and allows the hormone prolactin to begin to
work. The placenta had been producing hormones that maintained the pregnancy. The
sudden drop in these hormones once the placenta is gone signals prolactin to begin
working. Prolactin "tells" the breasts it is time to begin producing large amounts
of milk. A mother feels the result of prolactin when her milk "comes in" at around
three to five days postpartum. Increased milk production usually occurs at this time
even if a baby has not been breastfeeding well or often. However, frequent breastfeeding
sometimes speeds up the process of establishing increased milk production. Occasionally,
a mother experiences a delay in the production of large amounts of milk.
Successful milk production
Ongoing, long-term milk production depends mostly on milk removal by nursing or pumping.
The more often milk is removed, and the more completely it is removed, the more milk
the breasts make. The opposite is also true. When milk is removed less often, or an
insufficient amount is removed, the breasts get the signal to slow milk production
and make less. Milk removal occurs when a baby effectively breastfeeds or you are
Breastfeeding requires effective sucking by the baby so that enough milk is transferred
from the breast into the baby's mouth where it is swallowed. To suck, a baby must
latch deeply onto the breast and use the structures in his or her mouth to create
intermittent (periodic) suction and squeeze milk into his or her mouth. Proper sucking
signals the mother's body to release the hormone oxytocin. With the release of oxytocin,
your milk will "let down." This is the term used to describe the flow of milk from
So if your baby is premature or sick and unable to remove milk effectively enough
to stimulate and maintain your milk production, you will need to express milk until
he or she is stronger.
Milk expression methods
Milk transfer also can be accomplished through milk expression techniques. This can
be done with your hand or with a breast pump. Hand expression is done by compressing
the breast tissue with your hand. Your milk can then be collected onto a spoon or
into a container. There are breast pumps that can remove the milk as well. Some breast
pumps are manually operated, while others are either battery-powered or electric.
"Hands-on pumping" is a technique combining breast massage and pumping, which helps
maximize milk supply in mothers of premature infants.