Difference between revisions of "Health-and-Nutrition/C2/Hand-expression-of-breastmilk/English-timed"
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| Welcome to the '''Spoken Tutorial''' on '''Hand expression of breastmilk'''. | | Welcome to the '''Spoken Tutorial''' on '''Hand expression of breastmilk'''. | ||
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|how to express breastmilk by hand and | |how to express breastmilk by hand and | ||
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|to check whether the baby has fed from one breast completely before offering the other breast, | |to check whether the baby has fed from one breast completely before offering the other breast, | ||
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− | |She should wash the chosen container | + | |She should wash the chosen container in soap and water. |
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|The container should never be dried with a used cloth such as a used kitchen cloth. | |The container should never be dried with a used cloth such as a used kitchen cloth. | ||
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|She should work down both sides of the spine at the same time from the neck to the shoulder blades. | |She should work down both sides of the spine at the same time from the neck to the shoulder blades. | ||
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|Then she should re-position her fingers to express milk from other parts of the breast. | |Then she should re-position her fingers to express milk from other parts of the breast. | ||
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− | |Safe storage of breastmilk | + | |Safe storage of breastmilk and feeding stored breastmilk to the baby are explained in another tutorial. |
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|If the purpose is to relieve symptoms such as engorgement or leaking of breastmilk at work: | |If the purpose is to relieve symptoms such as engorgement or leaking of breastmilk at work: | ||
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− | |This brings us to the end of this tutorial | + | |This brings us to the end of this tutorial. |
+ | Thank you for joining. | ||
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Latest revision as of 13:24, 6 March 2020
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00:00 | Welcome to the Spoken Tutorial on Hand expression of breastmilk. |
00:06 | In this tutorial, we will learn- benefits of expressing breastmilk, |
00:12 | how to express breastmilk by hand and |
00:15 | how often should a mother express breastmilk. |
00:20 | Breastmilk expression is useful- to relieve breast engorgement, |
00:25 | to treat nipple soreness and dry skin on the dark area around the nipple, |
00:31 | to feed a baby if mother’s sore nipple is extremely painful while latching, |
00:38 | to increase or maintain mother’s breastmilk supply, |
00:42 | to keep breastmilk available for a baby when the mother goes out or to work, |
00:49 | to help a baby to attach to a full breast by softening the dark area around the nipple; |
00:57 | to check whether the baby has fed from one breast completely before offering the other breast, |
01:05 | to make nutritious complementary food for a baby by using breastmilk instead of water or cow’s milk, |
01:14 | and, to help in feeding milk to - premature babies, |
01:18 | sick babies, |
01:20 | babies with poor muscle tone, |
01:22 | babies with cleft lip and/or palate and |
01:27 | babies who have difficulty in latching deeply to the breast. |
01:32 | Now, let’s learn how to express breastmilk. |
01:37 | The most recommended way for a mother to express breastmilk is by using her hand. |
01:44 | Because this method causes less discomfort to the dark area around the nipple. |
01:51 | Also, this method needs no appliance. So the mother can do it anywhere and at any time. |
02:00 | Expressing breastmilk by hand is a learned skill and will improve with practice. |
02:08 | It is easy to hand express breast milk when the breasts are soft. |
02:13 | Therefore, a mother should learn this skill on the first or second day after delivery. |
02:21 | Before expressing breastmilk, mother should have a steel or glass container ready to collect the expressed milk. |
02:29 | She should choose a cup, glass, jug or jar with a wide mouth. |
02:36 | She should wash the chosen container in soap and water. |
02:41 | After that, she should either keep the container in boiling water or pour boiling water into the container and leave it for a few minutes. |
02:52 | Then, she should either air dry the container completely or wipe it dry with an unused clean cloth. |
03:01 | The container should never be dried with a used cloth such as a used kitchen cloth. |
03:10 | After the clean container is dried completely, next step is to release breastmilk from the breast. |
03:17 | To help her milk flow, the mother should feel relaxed and emotionally connected to her baby. |
03:26 | Mother can try the following:
She can sit quietly and privately or with a supportive friend. |
03:34 | Some mothers can express easily in a group of other mothers who are also expressing breastmilk. |
03:41 | She can hold her baby on her lap with skin-to-skin contact. |
03:46 | Or she can look at her baby or hear her baby’s voice. |
03:53 | Sometimes even looking at a photograph of her baby or smelling her baby’s clothing helps. |
04:00 | She can take a warm soothing drink, but the drink should not be coffee, strong tea, alcohol or any stimulant. |
04:12 | She can also warm her breasts to help her milk flow. |
04:17 | To warm her breasts, she can apply a cloth soaked in hot water to her breasts or have a warm water bath. |
04:28 | She can stimulate her nipples and the dark area around them by-
gently pulling or rolling them with her fingers. |
04:38 | She can massage her breasts lightly using circular movements. |
04:44 | Mother can ask a helper to rub her back. |
04:47 | For the back rub, the mother should-
sit down, lean forward, |
04:53 | fold her arms on a table in front of her and
rest her head on her arms. |
05:01 | Her breasts should be unclothed and hanging loose. |
05:07 | The helper should rub down both sides of the mother's spine. |
05:12 | She should use her closed fist with her thumbs pointing forward. |
05:17 | She should press firmly, making small circular movements with her thumbs. |
05:24 | She should work down both sides of the spine at the same time from the neck to the shoulder blades. |
05:34 | She should do this for two or three minutes. |
05:38 | All these steps will help in releasing the breastmilk. |
05:43 | This release of breastmilk is called Oxytocin reflex or let down reflex. |
05:51 | After the Oxytocin reflex begins, the mother must wash and dry her hands thoroughly. |
05:59 | Then, the mother should sit comfortably. |
06:04 | She should lean forward slightly. |
06:07 | She should hold the container near her breast. |
06:11 | Now, she should place her thumb and fingers on the breast in a C shape hold from the side. |
06:20 | She can use either hand for holding either breast. And, she can switch to the other hand when the first one tires. |
06:29 | While holding the breast, her thumb should be on the upper part of the breast. |
06:35 | And her fingers should be placed opposite to the thumb on the lower part of the breast. |
06:42 | Her thumb, nipple and fingers should always be in a straight line. |
06:48 | And, the nipple should be in the middle of the thumb and the index finger. |
06:54 | There should be a distance of 2 fingers between-
the nipple and her thumb and the nipple and her fingers. |
07:04 | If the fingers are too close to the nipple, the milk may not flow for long. |
07:10 | Mother will release more milk when she compresses the milk ducts beneath the dark area around the nipple. |
07:19 | In this picture, the mother is holding her right breast correctly with her right hand. |
07:27 | Now, she should press the breast slightly inwards towards the chest wall by applying steady pressure. |
07:36 | Then, without moving the hand gently compress the breast between the thumb and the fingers. |
07:44 | And then release the pressure on the breast. |
07:48 | The mother should repeat these 3 steps-
Press back, Compress, And release. |
07:56 | The first step of pressing back towards the chest wall is an important step. |
08:02 | Pressing only towards the nipple will give very little milk. |
08:07 | But when the breast is pressed back, milk from the dense breast tissue is released. |
08:15 | But, avoid pressing too far back because that can block the milk-ducts. |
08:23 | When the mother starts expressing breastmilk by hand, very few drops of milk may come out at first. |
08:30 | As the let down reflex starts, milk starts to drip out. |
08:36 | In the first few attempts, it is common for the milk to drip out or come slowly. |
08:42 | Later, breastmilk may flow in streams. As with breastfeeding, expressing breastmilk is a skill that comes with practice. |
08:53 | Colostrum, the first milk after birth, may only come in drops but is enough for the newborn. |
09:01 | The thick, often yellow, milk has enormous protective benefits for the baby. |
09:08 | The mother should repeat the 3 steps until the flow of milk slows down to a drip again. |
09:15 | Then she should re-position her fingers to express milk from other parts of the breast. |
09:23 | She can feel for where the breast seems fuller and compress those areas. |
09:30 | She should express milk from one breast for at least 3 to 5 minutes until the milk flow slows down. |
09:38 | Then she should express milk from the other breast in the same way from all the areas. |
09:45 | And then, again express milk from both breasts a second time. |
09:51 | Expressing breastmilk from both breasts adequately takes 20 to 30 minutes. |
09:57 | It may take more time, especially in the first few days. As in those days, only a little milk may be produced. |
10:07 | It is important not to try to express in a shorter time. |
10:12 | Remember, expressing breastmilk by hand should not hurt. If it hurts, the technique is wrong. |
10:21 | Breast tissue is delicate. |
10:24 | Avoid rubbing, sliding or pulling the fingers along the skin, towards the nipple.
This can cause breast soreness. |
10:36 | Avoid tightening or stretching the skin over the dark area around the nipple. |
10:42 | Also, avoid squeezing or pulling the nipple. |
10:46 | Pressing or pulling the nipple cannot express enough milk. |
10:51 | It is the same as the baby sucking only the nipple. |
10:57 | After expressing breastmilk, the mother should cover the container with a clean cloth or plate. |
11:04 | Then, she should store her breast milk safely for later use. |
11:09 | Safe storage of breastmilk and feeding stored breastmilk to the baby are explained in another tutorial. |
11:19 | Let’s now discuss how often a mother should express milk. |
11:24 | If the purpose is to initiate and maintain breast milk production
Or to feed a low birth weight baby or sick newborn baby, then- |
11:35 | she should express milk as soon as possible after delivery. |
11:40 | She may only express a few drops of Colostrum at first. |
11:45 | This helps breastmilk production to begin. |
11:48 | It acts similar to a baby suckling soon after delivery. |
11:54 | The mother should express as much as she can and as often as her baby would breastfeed. |
12:02 | This should be at least every 2 to 3 hours, including during the night. |
12:08 | If there are long intervals between expressions, she may not be able to produce enough milk. |
12:16 | Next, if the purpose is to build up mother’s milk supply and if it seems to be decreasing after a few weeks: |
12:25 | she should express breastmilk every 1 to 2 hours immediately after breastfeeding the baby and |
12:33 | if the baby is expected to sleep for more than 3 hours, then she can express in between feeds. |
12:42 | If the purpose is to relieve symptoms such as engorgement or leaking of breastmilk at work:
the mother should express only as much as is necessary. |
12:53 | If the purpose is to keep nipple skin healthy:
the mother should express a small drop of breastmilk to rub on her nipple. |
13:02 | She should do this after a bath and after breastfeeding. |
13:07 | If the purpose is to keep milk for her baby while the mother is out at work: |
13:14 | the mother should express milk while at work to help keep up the supply. |
13:20 | And, the mother should express breastmilk before going to work and leave it for the carer to give to the baby. |
13:29 | For doing this - mother can plan few weeks ahead if she has a fridge. |
13:34 | She can express extra milk and store it for later use. |
13:39 | Mother can express even after the baby has breastfed. |
13:44 | Mother should leave about 60 to 90 milliliters of milk for each feed. |
13:51 | More breastmilk can be given as per baby’s need while mother is away. |
13:57 | Remember- the more frequent hand expression is used, the easier it becomes to express milk, the faster the milk releases. |
14:07 | And, the more milk mother will make. |
14:11 | This brings us to the end of this tutorial.
Thank you for joining. |