When to express your breasts. Do I need to express milk. Breastfeeding: Prolactin

The question of whether it is necessary to express breast milk after feeding worries, if not all, then most young mothers. Opinions on this matter were radically divided.

A few years ago, doctors believed that pumping was necessary, but today experts assure that there is no need for this and this process must be approached very carefully.

In this article, you will learn:

Interestingly, in nature, mammals do not get rid of excess milk that babies did not drink. Therefore, the question naturally arises as to why people should express it in this case. Isn't it easier to trust nature?

The mother's breast produces as much milk as the baby needs. Failures are possible only in the first days after the baby is born, since the body has not yet received a signal about how much milk it needs to produce. However, after a few days, this process is normalized, and the endocrine system regulates the amount of baby food produced by the mother's body.

Expressing milk completely after breastfeeding will signal your body to produce more. It turns out to be a vicious circle.

However, if you feel uncomfortable and feel that your breasts are as if petrified, then you need to remove the excess a little. But just enough to feel relieved.

However, there are situations when it is absolutely necessary to resort to this procedure. And this is not only the first days after childbirth, but also in other cases.

Let's consider them in more detail:

• If the baby does not want to, or there are some other reasons why he cannot take the breast. Then you will have to pump to feed your baby later. This can be done with a syringe, with a spoon, and in other ways. Expression then maintains normal lactation.
• If you are sick and temporarily unable to breastfeed your baby, you need to express yourself so as not to lose milk later. It is much easier to save it now than to try to restore it later.
• Sometimes there is hyperlactation, that is, the body produces excessive milk - much more than the baby needs. But in this case, it is worth first of all to understand the reasons for hyperlactation and undergo examination. Sometimes it is just excessive expression after feeding a newborn that leads to hyperlactation. Therefore, this process must be gradually slowed down. For example, use the so-called "routine pumping", that is, do not remove milk residues after feeding at night, and then gradually abandon this procedure after daytime feedings.
• If, for some reason, mom and baby cannot spend the first days after birth together, then difficulties may arise. So, in medical institutions, the baby is often brought to the mother strictly according to the schedule, for example, every 2 or 3 hours. But at such moments, the baby does not always feel the need for food, he can simply fall asleep during feeding, and be hungry in between. This is bad for the mother as well, as there may be a shortage of milk or its excess production. Then for relief, you need to express a little.

Caution, lactostasis!

Lactostasis is a blockage of the milk duct. As you know, a woman's breast is divided into lobes, and each lobe has ducts. Sometimes it happens that the duct is pinched and because of this there is a plug that does not allow milk to escape. Then swelling appears and painful sensations arise. With pressure, you can see that milk comes out of one part of the nipple more slowly than the other, or does not come out at all.

Lactostasis can occur due to a feeding disorder or chapped breast. It is often accompanied by a slight increase in temperature and reminds of itself with a feeling of heaviness. Sometimes the reason is:

• tight bra
• sleep on my stomach
• squeezing the breast during feeding, that is, in fact, improper feeding.
• nipple abnormalities
• stress, lack of sleep
• trauma, bruises
• insufficient fluid intake.

As you can see, there are many reasons, so no one is safe from this ailment. If you have such symptoms, then pumping the breast after feeding is not only possible, but also necessary.

You can breastfeed your baby more often, for example, once an hour. If the baby has a good appetite, then within 24 hours you will feel relief. Or, you can additionally express 2-3 times a day, but not more, as this can provoke increased milk production, and again there is a risk of blockage of the ducts.

If you do not express and do not apply the baby to the breast, then lactostasis passes into the next stage - mastitis.

By the way, if your temperature rises at the same time, this will not affect the quality of milk, so you can safely apply the baby to the breast a little more often.

How to properly express after breastfeeding

This can be done in different ways. Once it could only be done with hands - our mothers and grandmothers still remember this. This method requires some skill and time. Today the breast pump is much more popular.

Devices are also divided into types and are:

• mechanical;
• electric.

It is much easier to use them. Before the procedure, wash your hands, wipe your breasts with a sanitary napkin, lightly massage your breasts and nipples. Place the nipple in the breast pump so that the nipple is in the center.

After use, it is necessary to completely disassemble the device, rinse it in warm water and disinfect it. However, this is not difficult to do, since modern skippers are simplified as much as possible in terms of design.

If you are not yet skilled enough, it is recommended that you seek help from a breastfeeding consultant. Just one consultation will be enough for you, and in the future you will be able to express milk promptly and correctly after feeding the newborn on your own.

Once upon a time, all pediatricians and obstetricians insisted that a nursing mother, after each feeding of her baby, should express the breast to the last drop. What has changed today? Should a nursing mother pump out or is it better to forget about such a procedure altogether?

The answer cannot be unambiguous, since everyone's feeding situations are different. And there are both pros and cons to expressing regularly.

pros

• Expressing helps the mother to maintain lactation away from the baby, for example, if the mother went to school, went to the hospital, started working.
• Thanks to expressed milk, babies who are born prematurely or are in the hospital can be tube fed with their mother's milk.
• Expressing helps relieve the condition of a nursing mother if a lot of milk has come and stagnation occurs (this often happens during the formation of lactation). In this case, the breasts need to be filtered only slightly to eliminate painful overcrowding.
• Mom will have to express milk during the period when she is sick and takes medications that pass into breast milk.
• If the baby is not gaining weight well, expressing after feedings can be an additional incentive to increase lactation.

Minuses

• Although earlier doctors recommended pumping to prevent milk stagnation and mastitis, pumping is one of the provoking factors for these conditions.
• Opportunity to get into a vicious circle: too much milk will be produced due to too much pumping. To remove the heaviness in the chest, the mother will have to constantly pump.
• Mom gets tired of pumping and begins to consider breastfeeding an unpleasant and difficult process.

What's happening?

When the mother gives the breast to the baby on demand, the baby sucks out the milk he needs. Sucking stimulates the production of just as much milk as the baby has eaten for the next feeding.

If the baby's appetite increased and the breast was empty, greedy sucking will be the reason for the development of more nutrition in the breast for subsequent feeding. If the baby has eaten less and some of the food remains in the breast, milk production by the next feed will not be as active.

With more frequent and prolonged application of the crumbs to the breast, lactation will be stimulated. Expression is also such a stimulus for lactation - the more milk a woman receives from her breast, the more it will come.

When is pumping necessary?

• Separation of mother and child if a woman wants to keep lactation.
• A weakened or premature baby cannot suck out the right amount of milk to stimulate lactation.
• Resuming breastfeeding after a break.
• Mom goes to work if the child is less than 8-9 months old.
• Stagnant milk to relieve congestion in the breast.

If the baby was born full-term, actively sucks, the mother feeds the baby on demand and at the same time the mother's breast does not overflow (there is no stagnation), in this case, pumping is not necessary either after feeding or at any other time.

How much milk to express?

The amount of breast milk that can be obtained by expressing may differ at different times:

• Expression "to the last drop" is recommended for mothers who want to stimulate lactation as much as possible.
• If a mother stores milk for future use, she should try to express as much milk as the baby needs for one feeding.
• When stagnant, it is recommended to express a small amount of milk, only to alleviate the condition and relieve breast tension.

After every feeding

The previous recommendations for all women to express their breasts after each feeding of the baby are now not supported by pediatricians. This was once explained by the need to constantly stimulate lactation. However, if breastfeeding is established correctly, the female breast does not need additional stimulation in addition to the attachment of the baby. Expressing only increases the "demand" for milk production, which can be of poor service (cause lactostasis or even mastitis).

Necessity is one of the most controversial issues today. On the one hand, the young mother will have to listen to a whole notation from the "wise generation" about what will happen if you do not pump. These are horrifying stories about lactostasis, mastitis and other no more pleasant problems. The second point of view, by the way, modern doctors adhere to this position, says that it is necessary to express milk after feeding only in some situations, and in no case should it be done constantly.

So, let's try to figure out whether you need to express milk after each feed.

Expressing after feeding - when is it needed?

The more milk a nursing mother expresses, the more it arrives. This statement has been repeatedly proven by scientific research and confirmed by the practice of more than one generation. In this case, it is quite logical to assume that pumping after each feeding is not only a waste of time and effort, but also a kind of vicious circle that does not solve the problem at all, but, on the contrary, creates new ones.

In other words, if the baby is active and healthy, eats with appetite and receives mother's milk on demand, there is no need to pump out after each feeding. But, there are situations when a nursing mother cannot do without expressing. So, it is necessary to express milk after feeding.

The basics of feeding

In order to establish full-fledged breastfeeding from the very beginning, a young mother needs to know many little tricks. Then the baby will be full and healthy.

The best food for a baby is mother's milk. But why are there so few women who manage to breastfeed a baby for a long time and without problems? Because feeding is a special art that a modern mother needs to learn. Zhanna Tsaregradskaya, head of the center for perinatal education and breastfeeding support "Rozhana", answers typical questions of young mothers.

First days

After birth, a lot of milk comes, and as far as I know, a newborn baby needs very little. Do I need to express immediately after delivery?

As a rule, a large amount of milk comes in on the third or fifth day after birth. In a joint stay, when the mother can feed the baby not according to the strict regime, but on demand, that is, as often as the newborn needs, milk comes in the “demand - supply.” This means that milk is supplied as much as the baby needs. If this rhythm is debugged from the first day of the baby's life, the active arrival of milk is not dangerous and there is no need for regular pumping.When painful breast fullness is noted, you can express for two days before you feel relief, but no more than 3 Once a day As a rule, after two days the discomfort disappears.

The need for regular pumping 5-6 times a day arises if the baby is brought to the hospital to be fed according to the regimen or for some reason is not brought at all.

About pumping

Do I need to pump if I'm off-feeding my baby? And does the milk in the breast burn out if it is not expressed?

If you are on-demand breastfeeding, there is no need to express milk after each feed, it only takes the mother's time, which would be better for the baby or household chores. Expression is necessary when breast engorgement, treatment of lactostasis or mastitis, with a lack of milk, in the event of the forced separation of mother and child in order to preserve milk, etc. Whether or not you need to express is determined by your breastfeeding consultant, as extra pumping will reduce milk supply and stop lactation. But the opinion that milk can burn out in the breast, if not expressed, has nothing to do with reality. While in the mammary gland, milk cannot go bad.

Who will set the regime?

How often should a newborn breastfeed?

The frequency of feeding should be determined not by some average schedule, but by the real needs of the baby - he will set the mode himself. You can determine that the baby is hungry by the sucking movements of his mouth, by the way he turns his head or begins to cry pitifully. The baby of the first months of life should be applied to the breast as often as possible, providing the opportunity to suckle the breast when and how much he wants. This is necessary not only for the saturation of the crumbs, but also for his psycho-emotional comfort.

In the first days of life, newborns eat irregularly: they can either take the breast just a few times a day, or suck just continuously. Perhaps, at first, you will latch the baby to the breast up to 4 times an hour, and in total, babies in the first months of life may have 12-20 feedings during the day - do not worry, this is quite natural. In about a month, the little one will set a certain schedule himself, and your general regime will be streamlined.

Five minutes or an hour?

Many people say that the baby should not be held at the breast for more than 10 minutes, as prolonged sucking leads to cracks. But I heard from some mothers that their babies suckled for an hour, but they did not have cracks. Why do cracks actually occur?

The appearance of cracks in the nipples is associated primarily with the correct attachment, and not with the duration of sucking. If you properly latch your baby to the breast and feed him in a comfortable position, cracks will not occur. Experienced lactation consultants can teach this. If you are sure that the baby is sucking in the correct position, he can stay at the breast for as long as he wants: feeding should be finished when the baby himself releases the breast. Another cause of nipple injuries is regularly washing your breasts before and after each feed. If a mother washes her breasts with soap and at the same time treats it with brilliant green, she may have cracks even with proper application. Frequent washing and rubbing with alcohol destroy the protective layer (located on the skin of the nipple and areola), which is produced by special glands located around the nipple. This protective lubricant is essential to prevent moisture loss. And, in addition, it has excellent bactericidal properties and inhibits the growth of pathogenic microorganisms - it is this protective layer that prevents the occurrence of injuries to the mother's nipple.

Day and night

The doctor advised to feed his son not only during the day but also at night. And my mother is categorically against it, she believes that the baby's stomach cannot constantly digest food.

For a long time in our pediatric practice it was believed that feeding a baby at night was harmful - supposedly the stomach of the baby should rest. But the paradox is that the stomach of a newborn is practically not involved in the digestion of food, but serves as a "point of evacuation" of mother's milk into the small intestine, which is adapted to digest breast milk in unlimited quantities. First, the length of the intestine of a newborn is 6 times the length his body (for comparison, the intestines of an adult is only 4 times). Secondly, human milk contains lipase and other enzymes that help the baby's digestive system to digest fats and other nutrients contained in breast milk. And thirdly, proteins of human milk are assimilated not only through enzymes, but also through direct penetration unchanged, first into the intestinal and stomach tissues, and then into the blood.At the beginning of life, the activity of the child's own enzymes is low, but breast milk contains substances that stimulate their activity as well as a supplier of additional enzymes.Breast milk is a unique food that helps assimilate itself, which means that the baby can suck on her mother's breast without damage to her health as often as necessary. In addition, the lack of night feeds is not only difficult for newborns, but also reduces the amount of milk in the mother. At night, a woman's body produces more prolactin (a hormone responsible for milk production) than during the day, so night feedings will give you the opportunity to feed the baby for as long as you like, and you will not be aware of problems with a lack of milk. Once full, the baby sleeps soundly at night, which means that his mother's sleep will be calm. If you feed your baby on demand, including at night, you will have as much milk in your breast as your baby really needs. Mother-child symbiosis is a system that operates on the principle of supply and demand, that is, the more milk a baby sucks, the more it is produced by the mother. As a rule, with free feeding, this system is well established, so you do not need to pump after each feeding.

Both food and drink

I breastfeed my newborn son exclusively. Do I need to feed or supplement him?

Breast milk is a balanced food and drink for babies. It fully satisfies all the vital needs of the child. With well-organized feeding, which includes correct attachment, frequent and long feedings and joint sleep, the baby does not need additional nutrition until 6 months of age. To preserve full breastfeeding and the health of the baby, you should completely abandon the addition of water to the baby, not only with water, but also with various teas, dill water, etc. Previously, pediatricians advised to add water to the baby, considering breast milk exclusively as food and fearing dehydration of his body. These fears are groundless: breast milk contains 87-90 \\% water, therefore, with full and frequent breastfeeding, the baby's need for liquid is fully provided. Studies have shown that even in hot climates, breast milk fully meets all of the baby's fluid needs. In addition, the centers of thirst and satiety in the brain of a newborn are practically the same, and these needs are satisfied simultaneously. When adding water, we deceive the baby, creating a false feeling of satiety in him, and this leads to sluggish sucking and a decrease in the need for breast milk. When the child is fed, mothers lose milk and stop breastfeeding by 3-6 months.

No cracks or abrasions

When feeding, my nipples hurt, and recently abrasions and cracks began to appear. What to do?

The nipple's skin takes time to adjust to the feeding process. As a rule, soreness is felt when the baby grabs the nipple, and immediately passes when the baby has already begun to suckle. If the discomfort does not go away within a few seconds after the start of feeding, the baby has taken the wrong breast! Take it away and give it again. In case of pain, you can use creams and ointments (solcoseryl, bipanten, purlan), applying them in a thin layer, but only if there are no cracks! Nipple injuries such as calluses, cracks and abrasions are associated with improper attachment of the baby to the breast. Therefore, when they occur, it is necessary to learn how to properly apply and treat the nipples. Breastfeeding can be continued. If you have small abrasions or calluses in the nipple area, you can use the above ointments and wash them off not with water, but, for example, with an infusion of oak bark or your own milk, and make sure that the abrasions do not develop into cracks. Cracks are a very serious problem, here you cannot do without the help of specialists. In no case do not treat the nipples with any ointments or creams, in some cases gels or jellies (Actovegin, Solcoseryl) may be recommended to you. At the slightest rise in temperature, contact a specialist immediately.
Try not to wash your breasts too often, and do not use alcohol-based solutions. To reduce irritation to sore breasts, feed your baby more often while shortening the suckling time. Express a little milk before feeding and spoon it to your baby. If the crack does not heal in 3-7 days, for some time (at least 12 hours) do not put the baby to the sore breast (you may have to spoon feed him with milk expressed from the sore gland). After a couple of days, return to dual breastfeeding, initially using the diseased breast as an addition to the healthy breast. Do not remove the nipple if your baby is squeezing it tightly with his gums or has not finished sucking yet. It is necessary for him to release the nipple himself, opening his mouth. To do this, insert your little finger into his mouth, parallel to the nipple. And be consistent! In the first days after the start of treatment, the baby can make a scandal, because he is used to taking the breast in an easier, albeit wrong way: he may refuse to take a breast that smells of medicine; may stop gaining weight. All this does not harm the child, no matter how paradoxical it may seem to you.

Expressing after feeding was considered mandatory for 20-30 years in Russia, nurses in the maternity hospital and antenatal clinics told about how and when to express after feeding. Why is it advised to interfere with the natural process of lactation, what benefits will this procedure bring, and how necessary is it? Do I need to express milk after each feed if there is stagnation or too little milk when really needed? Let's take a look at various common situations. And here is the opinion of pediatricians and breastfeeding consultants.

1. Lactostasis, breast engorgement - that's when it is necessary to express breast milk. At the same time, you need to express milk after feeding the baby, you can use a sterilized breast pump or with your hands - this is as convenient as it is for anyone. You should not express to the last drop, but until it becomes easier. If the temperature is elevated, this is often the case when colostrum passes into milk, until it decreases and the pain subsides. You can also take "Paracetamol" or "Ibuprofen", this will improve your well-being. But don't forget about mechanical emptying of the breast.

2. If the baby cannot grasp the nipple correctly, with the so-called tight breast. In this case, pumping after each feed is not relevant. It is necessary to empty the breast a little, on the contrary, before feeding. Do not be afraid that the baby will not have enough milk. On the contrary, even the benefit will be, since he eats more rear, fatty milk, not rich in carbohydrates. This means that the tummy will torment less. Gas formation, colic are often associated with the abundant use of fore milk by the child.

3. With lactase deficiency. When a baby lacks the enzyme lactase, which is designed to break down lactose, a sugar found in mother's milk. We have already begun to write a little about this in the previous paragraph. Signs of lactase deficiency are frequent gas formation in the child, colic, crying during feeding, tucking of the legs. The point of expressing before breastfeeding is to remove the lactose-rich foremilk so that the baby gets more tummy-free hindmilk. But you don't need to pump a lot so as not to provoke lactostasis.

4. If the mother has little milk or a high risk of losing lactation. For example, this can happen when the mother and child are not together. If the baby is premature. Or she hardly sucks at all. This measure will serve both to preserve lactation and to prevent lactostasis. Then you need to express more often in general. It is necessary that the breast be stimulated at least once every 3 hours to maintain lactation.

But is it necessary to express breast milk after feeding, if the baby sucks well, it just seems to mom that she has little milk. You can judge whether there is enough milk by the weight gain of the child. If they are more than 500 grams, everything is normal. Do not try to "fatten" the child. But if you really want him to add a little more, you just need to apply it to your chest more often. So, expressing milk after each feed is not at all necessary, and more milk can not always improve the child's appetite.

With age, literally from 3-4 months, the child begins to be interested in something else besides the breast. This is the time of the growth spurt, when the baby already knows how to keep his head well, roll over, and some nimble ones even get on all fours and begin to crawl. Babies tend to gain less weight during these months. They can breastfeed less often and less time. Many mothers, seeing that their baby is breastfeeding for literally 5 minutes, and then turns away from her with crying, begin to express milk in the morning and at night, when there is usually a lot of it. But the fact is that this behavior of a child is often a kind of manifestation of his independence. He just doesn't want to eat at the moment. It would be much more correct to make feeding the baby the most comfortable for him. You can turn off the light, TV, remove all factors provoking the child's attention. And then he will eat much more willingly.

If a breastfeeding mother is low on milk, doctors may recommend periodically expressing milk. Namely, they are not advised to express themselves every time, but in the morning. In the evening, feed the child with expressed milk in the morning. Breastfeeding experts assess this measure as safe, but only if it is used for a limited amount of time, while the mother is trying to establish lactation, she applies the baby to the breast as often as possible. By the way, in the evening, all women have a little less milk than in the morning, but this is not critical. It is explained by daily hormonal surges, a feature of the body.

Constantly expressing milk after feeding for any purpose does not make sense. It is even, rather, harmful. After all, as you know, demand forms supply. And in this way a woman will provoke hyperlactation in herself. The condition is more than unpleasant.

04.01.2020 11:17:00 6 evening weight loss habits How you behave at the end of the day can greatly affect your weight. Even if you follow the rules of a balanced diet and move during the day, improper action in the evening can nullify all efforts. To avoid this and speed up your weight loss, use the tips from our article!

03.01.2020 17:51:00 50 tips for wanting to lose weight without dieting Do you want to lose weight, but cannot diet? Then just try the following simple tips. Thanks to them, you can easily lose a few pounds and finally find the body of your dreams!

30.12.2019 07:42:00 What happens to the body if you drink several days in a row? New Year's holidays are coming soon, and few people spend them without alcohol. Unfortunately, some people stay drunk all weekend long. But what is it fraught with for the body?