First, wash your hands well. Wash breast pump equipment that contacts the breast, milk, or collection containers in a dishwasher or by hand in hot, soapy water. Rinse with cold water, and air dry on a clean towel.

Expressing milk is easiest to do in the morning when the milk supply is more plentiful, or by collecting small amounts throughout the day. It's best to start when your baby has not fed for a while and the breasts seem full.

Some mothers tell me that they are most successful at expressing or pumping while the baby feeds from the other breast and stimulates the milk to let down naturally. If you are away from your baby then pump the milk at approximately the same intervals when he would be feeding. Placing warm compresses on the breasts, but not the nipples, will help the milk flow.

Ultimately when to pump depends on you and your baby's schedule. Try to pump when the baby would normally breastfeed. If pumping while your baby feeds doesn't work for you, try to pump midway between feedings.

Be flexible. If your baby skips a feed, or feeds for a shorter time than usual, or only feeds on one side, pump out the rest of the milk and save it.

If you are planning to return to work and continue breastfeeding, begin pumping one to two weeks before you return. Try to simulate what your pumping schedule will be at work so your body gets used to it.

Before pumping, get comfortably seated and relaxed. I f away from your baby it may help to look at a photo of your baby. Pump your breasts according to the breast pump manufacturer's instructions.By hand

This can work well for women who only need to express milk for the occasional supplementary feed. Hand expression involves applying gentle pressure to the milk reservoirs under the areola behind the nipple to get the milk out.

First wash your hands. then use both hands to massage the breast from the chest wall toward the areola. Use quite a bit of pressure to encourage the milk down towards the reservoirs and go all around the breast.

Place the fingers of one hand underneath the breast and the thumb on top at the edge of the areola where you can feel the lumpy reservoirs. The nipple lies in between your thumb and fingers. Press back towards your chest and then roll your fingers and thumbs over the reservoirs to press the milk out.

Avoid squeezing or pressing too hard as the breast tissue can bruise easily. Go all around the areola repeating this action rhythmically with each hand in turn. Collect the milk into a cup or glass. The first time you express milk you are not likely to get very much but with practise the amount you get is likely to increase.

Using a breast pump

Some women find hand expression very difficult and get on better with a breast pump. There are a variety of breast pumps available which include hand pumps and electric or battery operated varieties that are reasonably priced.

The best fully automatic electric pumps are expensive to buy and can be rented for less money than a day's formula milk would cost. They are worth having if you need to express a lot of milk. Directions for using and cleaning breast pumps come with the manufacturers instructions.

Pumping both breasts takes about 15 - 20 minutes. The key to successful pumping is to encourage the natural let down reflex first and to imitate the rhythm of a baby's sucking.

Remember that the release of breast milk is hormonal, so find a private time when you can relax and trigger the let down by stimulating the nipples or massaging the breasts.

Leaning forward and shaking the breasts also helps to release the milk flow. You can repeat this ritual a few times throughout the pumping session and change breasts a few times in one session.

Storing expressed milk

You can store milk in special plastic bags, or clean glass or hard plastic containers which have been washed in hot soapy water and rinsed well. There are advantages to each.

Breast milk has anti bacterial properties and can be kept at room temperature for several hours and in the fridge for up to five days. If you intend freezing your milk it will keep in the freezer compartment of your fridge for two weeks, in a separate freezer unit for three months and in a deep freeze for six months or more. Remember that frozen fluids expand so leave a bit of empty space in the container.

When using plastic bags, use those designed for breast milk collection. Before storing, fold the top several times and seal with freezer or masking tape.

Place smaller bags in a larger bag to help protect against punctures. Mark the date on each container Freeze your milk in two ounce to four ounce portions.

Smaller amounts thaw quicker, and you will waste less milk if your baby consumes less than you anticipated. You may continue to add small amounts of cooled breast milk to the same container throughout the day. Chill milk in the refrigerator until evening. Then, freeze in appropriate amounts.

You may also add to already frozen milk. First refrigerate all freshly expressed milk until it's cold, and then add to the frozen milk. The newly added milk must be of a lesser amount than the already frozen milk.

Fresh milk may be stored in the refrigerator for 5-7 days at 39F. Frozen milk may be stored in the back of the freezer portion of a refrigerator-freezer for up to six months. Frozen milk may be stored in a -20C deep freezer for up to 12 months.

Place milk in refrigerator the night before you're going to use it. Refrigerator defrosting takes 12 hours.

Or, thaw the milk by standing the container in a pan of previously heated warm water. Don't use hot water, as this can destroy some of the milk's immunological components.

Shake the container before testing the temperature and to homogenise the contents which normally separate in to a creamy and a watery layer. You can keep thawed milk for up to 24 hours in the refrigerator.

Don't warm breast milk directly on the stove, as this can destroy some of its components. There is no point in storing breast milk for a long time. The milk composition changes as the baby grows and milk expressed weeks ago is not suited to this stage of development.

Safety

Never microwave breast milk! Microwaving breast milk can change the milk's composition, and has the potential to burn your baby.

Fat in breast milk will separate and rise to the top. By gently swirling the container, you can mix any fat that may have separated.

Never refreeze thawed breast milk.

Remember that the colour, consistency and smell of your breast milk may vary depending on your diet.

Discard any breast milk you don't use during a feed.

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