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17. Proper methods of breast pumping and milk storage

a. Breast massage and hand expression: These techniques may be used before feeding to bring the milk down to the baby, to relieve postpartum fullness, and before pumping or hand expressing to decrease the time spent on collection.

1) To massage, place one hand under breast; with the other hand, starting from the shoulder, stroke down toward the nipple. Also stroke under the breast and then up. Continue for I minute.
2) To hand express, put the thumb and forefinger on areola about 1 inch back from the nipple. Press back toward the chest and  squeeze together to compress the milk duct.
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b. Use of mechanical breast pump
1) Electric Breast Pump
(a) There are two purposes for using a breast pump: to stimulate the formation of breast milk in the woman who is unable to nurse her baby and to maintain an existing supply of breast milk in the woman who must temporarily stop breastfeeding her baby
     
(b) Remember, the breast pumps are very efficient,  but are neither as efficient nor as gentle as the baby nursing. The pumping schedule should be followed. The pumping mother should be instructed in the care of her nipples by her healthcare provider - typically a hospital provided RN - especially in regards to proper airing and use of Eucerin cream.
The woman should be instructed to pump at regular intervals to establish a pumping routine of every 3 hours, or 2 hours if the breasts need to be emptied. (Encourage milk let-down with warm compresses and by massaging the breast toward the nipple before applying pump.) Remember that pumping is easily put off because there is no baby crying to be nursed. However, stress that keeping to a regular pumping routine will establish a milk supply and enable the woman to give her baby her breast milk.   Cracked, sore, or bleeding nipples can occur with pumping, as with nursing. These normal problems of nursing are treated the same way as with a nursing woman. The woman should be taught to air her nipples well after each pumping session and to use a small dot of Eucerin cream massaged into sore nipples. If slight bleeding occurs from cracked nipples, the milk may still be used for the baby. The sore, cracked, bleeding nipples will heal in a few days with proper care. Eucerin cream need not be removed.
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