Hi everyone my name is ilao and I'm a registered Midwife and childbirth education instructor I practice full scope Midwifery in a busy urban center in Canada I'm also the mom to two lovely children I really enjoy educating parents throughout the prenatal period the birth itself and in the postpartum in today's video we're going to talk about expressing breast milk and storing breast milk and return to work so let's get started if you happen to be self-employed or returning to work early here are six steps to help you transition back to work for step one we're going to increase Supply and build up a stash of expressed breast milk generally this can take a few weeks so it's good to get started early everyone body responds a little bit differently to the pump so don't be discouraged if at first that milk is not piling up in your freezer remember it's always demand Supply baby gets first dibs and we always pump after a feed for step two we're going to introduce a bottle generally it's not advised to introduce a bottle before 3 to four weeks of life to ensure that breastfeeding is really well established and to avoid nipple confusion between the breast and the bottle by the time you get up to four or 6 weeks of life we can start introducing a bottle if we wait a little bit longer than that sometimes babies won't take the bottle and they can be quite particular and fussy ideally you can have a partner give that bottle or a family member and leave the room at that time because baby can smell the milk on you and will often prefer mummy for step three consider storage if you're using child care so for this step if you are using a child care provider make sure that you ask ahead if they have a suitable storage facility for expressed breast milk for step four we want to consider timing of our return to work you could consider starting on a Thursday or a Friday that way you only have a day or two to get through if there's any kinks or bumps to iron out before the weekend then it's a reset before you're back into work the next week for step five you want to feed the baby before you leave for work pump frequently throughout the day and make sure that you're pumping around the same time you would normally feed your baby and then when you return home feed your baby right away again this helps you establish a routine finally for step six it's a good idea to check in with your employer ahead of time before returning to work if you happen to be the first staff member at your institution to pump Express and store breast milk you might just be the Trailblazer and working together with your employer ahead of time you can can find a space that's suitable for this and a place to store that milk on site so checking in and planning ahead is really helpful in this case if you're returning to work after maternity leave it looks a little bit different baby could be anywhere from 12 to 18 months old at this stage have already started the process of self- weening or be drinking from a sippy cup or an open cup and not using bottles at all you may have even introduced other whole milk into baby's diet so that could be cow's milk or goat's milk or just expressed breast milk it can be helpful to bring a pump with you for the first couple of weeks back at work as the breasts can become full and uncomfortable during prolonged absences from your baby and just pumping or hand expressing a little bit to take that pressure away and make you more comfortable you can continue to pump at work and keep that milk aside and bring it home to baby for use the next day as you return to work you can make your breastfeeding relationship whatever it works for you so that could be working full-time breastfeeding pumping at work storing that milk feeding baby before work and after work or even sometimes at night it really just depends on what works for you and your family next up we'll talk about hand expression so Hand expressing is a Technique we use to extract milk from the breast this is done if we need to increase milk supply or sometimes to encourage baby to latch will hand Express a small amount at the start of a feed expressing a little bit of milk after a feed can also be beneficial for healing the sore nipple and areola area sometimes we collect Express breast milk and store it if baby is in the Special Care Nursery if you're interested in hand expression and colostrum harvesting before birth always check in with your care provider there are a few instances where that's not advisable hand expressing is by far the most effective way of extracting colostrum in the first few days of life it's also a great technique to manage issues like mystis and engorgement or block ducts so let's explore the technique we're going to start by having circular motions massaging that breast around to really stimulate the flow of oxytocin you could also consider having baby skinto skin prior to this to help with that oxy to and flow the next step is to cup your hand in a c shape and make sure that the thumb and fingers are well back from the areola next you're going to push those fingers back into the chest wall compress and release rotate a little bit around compress squeeze release and you're going to keep squeezing rhythmically as long as there's milk flow when it slows down move to a new area there is duct work all the way back towards the arm underneath the arm around the breast so you want to work all the way around to ensure you're compressing all of the ducts after hand compression is complete you could consider applying a cool washcloth just to help with a little bit of the discomfort let's take a minute to talk about pumping mums pump for lots of different reasons one of those might be to increase your milk supply so remember we always go back to demand and Supply the more you ask your body to make milk the more milk you'll make another reason might be because you're returning to work or you might be separated from your baby for a prolonged period of time baby could be in the Special Care Nursery or sometime times you're just going out for the night or maybe going for brunch with friends if you're choosing a breast pump make sure that you do your research families sometimes find a double electric the most efficient and what I mean by that is a pump that plugs into the wall and that pumps both breasts at the same time a great tip is to take an old sports bra cut two small openings for the fanges and that way you have a handsfree pumping setup some insurance companies will also cover the cost of a pump so be sure to ask just in case some moms may choose not to pump at all and that's absolutely fine just do what works best for you if you are considering pumping and expressing breast milk let's chat about safe storage and handling breast milk can be stored in special sterile containers or milk storage bags make sure that your only storing small quantities at a time and that you're not overfilling those bags you want to be able to thaw them out and use them in the amounts that baby would feed in a single session make sure you put the date and time on the bags or container and that you rotate them so the newest bags go at the back of the freezer or fridge and the older ones come to the front you can com Bine milk for multiple pumping sessions but you always have to remember cold milk adds to cold milk so pump put that milk into the fridge with your next pumping session put that milk into the fridge also when they cool down to the same temperature you can combine them in one container remember always add cold to cold when you store milk in the fridge or the freezer it separates out and the cream Rises to the top that's absolutely natural and normal it doesn't mean the milk has gone bad when you warm the milk back up you can gently run it under warm running water or in a warm water bath and swirl it to reconstitute the elements don't shake that milk very vigorously or you can destroy some of the components in the milk never heat milk in hot water or in the microwave because doing so can cause hot spots that can burn baby's tongue in general milk can stay out at room temperature for about 4 hours you can store breast milk in the fridge for approximately 4 days and in the freezer for around 6 months just make sure you're tucking it to the back of the freezer where the temperature is most stable and not in the door the temperature is a little bit more inconsistent there if you have breast milk stored in the freezer you can thaw it out overnight in the refrigerator or you can place it in a warm bowl of water to help it thaw out more quickly once that milk has thawed out it needs to be used within 24 hours anything left over after has to be discarded never refreeze thaw milk that brings us to the end of this video I hope you enjoyed all of the tips we've given you today and please be sure to check out the others in this series take care and we'll see you again soon