Manual Breast Manual Expression
Manual Breast Manual Expression
Manual Breast Manual Expression
PURPOSE: TO ASSIST A WOMAN TO MANUALLY EXPRESS MILK SO SHE CAN STRENGTHEN HER
MILK SUPPLY OR SUPPLY MILK FOR HER NEWBORN SHOULD SHE BE SEPARATED FORM THE
NEWBORN
PROCEDURE PRINCIPLE
1. Explain the procedure to the patient Explanations help decrease anxiety and enhance learning;
they also provide information for the patient to carry out
the procedure on her own.
2. Assemble equipment, including a clean towel and Assembling equipment aids in organization and efficiency.
collection container.
3. Wash your hands and put on clean gloves; have patient Hand washing prevents the transmission of infection; use
wash her hands. of gloves protects self and patient from possible.
4. Provide privacy and help the woman assume a The let-down reflex may not occur readily if the woman is
comfortable sitting position. tense or nervous.
PROCEDURE PRINCIPLE
5. Help the woman place her right hand on her right breast, Milk is expressed by pressure on the collecting ducts, not
with her right thumb on the top of the breast at the outer the nipple.
limit of the areola and her right fingers underneath the
breast. Tell the woman to press inward toward the chest
wall.
6. Help the woman hold the collecting jar just under her Collecting bottles should be made of plastic marked “safe
nipple for infants” as this best preserves antibodies found in milk;
having the container close by prevents waste of any breast
milk that is expressed.
PROCEDURE PRINCIPLE
7. Have the woman slide her hand forward in a milking Pressure on the lactiferous sinuses pushes milk forward.
motion, causing the milk to be expressed from the nipple
into the container
8. Encourage the woman to move her thumb and fingers Repeating the technique ensures all milk sinuses are
around her breast, repeating the technique. emptied.
9. Caution the woman not to use excess force at any point Excess force could damage sensitive breast tissue.
when using the technique.
10. After collection, refrigerate milk if it will be used Breast milk spoils in the same manner as cow’s milk if not
within 24 hours; freeze if this time is longer. protected
11. Reinforce the woman’s success with the maneuver, Manual breast milk expression is an easy technique to
regardless of the amount of breast milk expressed. carry out once it is learned, but it can be difficult to grasp
at first. Positive reinforcement enhances progress and self-
esteem.
PROMOTE ADEQUATE SUCKING
Often, a newborn being breastfed becomes sleepy at the breast, especially in the first
24 hours of life. Jaundice and hypoglycemia are also causes of sleepiness at the breast.
To both stimulate milk production effectively and ensure adequate breast milk intake, a
woman may need to keep the infant awake and urge him or her to suck. Placing the
newborn skin to skin will often provide the proper environment to arouse the newborn
to feed.
PROMOTE IMMEDIATE SUPPORT IF PROBLEMS ARISE
The nurse should provide an individual feeding plan to the mother upon discharge,
ideally in consultation with an IBCLC. Early follow-up and referral to breastfeeding
support groups will promote successful breastfeeding during the newborn period. The
first 4 weeks postpartum are usually the most challenging for a new breastfeeding
mother.
PROVIDE INFORMATION REGARDING TECHNIQUES FOR
BURPING THE BREASTFED BABY
Placing the baby over one shoulder and gently patting or stroking the back is a time-
honored position. However, this position is not always satisfactory for a newborn who
has poor head control because a parent may have difficulty supporting the baby and
patting the back at the same time.
Holding the baby in a sitting position on the lap and then leaning the child forward
against one hand, with the index finger and thumb supporting the head, is often the best
position to use.