CLC Hand Expression Competency (RATED A+)

When should be the first time you express milk? Why? - ANSWER 1 hour following birth; gives you the highest milk volume What is a difference between hand expressed and pumped milk? - ANSWER Hand expression gives more calories and fat than pumped milk. Why is early hand expression beneficial? - ANSWER It increases in energy and fat Why is hand expression the best way to extract milk? - ANSWER It is the cleanest How to hand express is... - ANSWER 1. Wash hands and gather supplies 2. Knead/rub the nipple to stimulate and get horomones flowing. 3. Create 'C' shape with outside hand 4. Squeeze areola on top and bottom 5. Pull back toward chest wall and compress your thumb and finger together gently and rhythmically, mimicking suckling or rolling on the breast. 6. Position container on table if standing and in lap if sitting, aiming spray into container. 7. Repeat in spot until milk slows and then move to another spot. Repeat. 8. Switch breasts and repeat. *Include wait time to allow milk to flow. Is milk a raw food? - ANSWER Yes, it should be handled with care. Should breastmilk be heated? Why? - ANSWER No, if you heat breast milk it should be minimally to preserve immune properties and nutrients. How to prepare formula... - ANSWER 1. Use clean and disinfected bottles/nipples 2. Use filtered/clean water 3. Heat water to "not quite boiling" (158 degrees) to kill bacteria 4. Mix powder with heated water 5. Cool to room temp before feeding into baby 6. If not using right away, refrigerate immediately until feeding. *measure water and formula outside of bottle, bottles aren't always accurate or measurable What kind of container should be used when expressing breastmilk? - ANSWER Larger container should be used for the first few expressions. Can you express milk from both breasts at once? - ANSWER Yes! Use both containers. When expressing breast milk should mom be sliding the fingers along skin? - ANSWER No, just suckling pattern and rolling. What can you do to help with engorgement? - ANSWER Expressing breast milk can help. Putting breasts into warm water will also help release some of the milk before putting baby on. Pumping is not recommended due to too much stimulation causing the possibility of blood in the milk. How can we help a mother rheumatoid arthritis to hand express? - ANSWER This can be very difficult. Medication might be needed to help with pain. Refer to PT or OT to help with motor skills. Neurological deficits might be present as well. How does hand expression impact oxytocin? - ANSWER Baby massage and nipple stretching increase oxytocin. Faster letdown is present if nipple stretching is done. How would you suggest a mother do the return demonstration for hand expression if she is scheduled for a C-section, without risking inducing labor? - ANSWER You can use the knuckle of a finger for mom to demonstrate back to you. Is it a good idea to pump during pregnancy to increase confidence? - ANSWER Increased oxytocin multiple times/day could put mom into early labor. If mom is breastfeeding/pumping throughout pregnancy, the increase in oxytocin is not related to early labor. However, it is not recommended because bradycardia was known to be found in babies. It may reinforce the scarcity of milk, which is not true. Is it normal for a mother's hands to get tired from hand expression? - ANSWER It is not uncommon, but should be discussed. Expressing breastmilk shouldn't be too hard, especially if there is not a motor impairment. When hand expressing milk. does the container need to be sterilized? Does it matter if it is going to be used immediately? - ANSWER If a fragile baby, container should even be single use container. If a baby is completely healthy, using it from the dishwasher is okay too. Why does hand-expressed milk have a higher fat content than pumped milk? - ANSWER Unknown. Maybe coming out faster. Compression pumps have higher fat (more milk); however, we don't have many of those anymore. Why is it best to hand express in the first few days versus using a breast pump? - ANSWER Hand