What is the Milk Bank?

The Milk Bank consists of the extraction and conservation of breast milk to later offer it to your baby in a bottle when you cannot breastfeed them.

It is a practical solution for mothers who work and want to maintain exclusive breastfeeding. These reserves are also useful for times when mom is away, for example, if she goes on a trip, or as an additional ingredient for baby food, at 6 months when complementary feeding is introduced.

HOW TO CREATE YOUR MILK BANK

How do you start a milk bank?

A breast pump to start your milk bank is preferable, although you can also do manual extractions; in this section, we will review both options.

The extractions should be done between breastfeeding sessions; it should begin four weeks after the baby is born; this is when breastfeeding is properly established, without being hindered by external causes (unless there is a specific reason, indicated by your doctor).

The recommended times to express milk are:

- In the morning. This is when production peaks.

- Between feedings. Approximately one hour before or after breastfeeding your baby.

- During feedings. While you have your baby on one breast, you can pump the other breast. We do not recommend this until you have been pumping for two weeks, as it may feel uncomfortable to have double stimulation.

Won't I run out of milk for my baby?

No. Remember that breastfeeding obeys a simple rule:

The more suction, the more production.

Many moms fall into the trap of believing that they are not producing enough milk based on the amount of milk they express, and that is a mistake. First, no device comes close to the level of extraction your baby's mouth has, nor does it combine the magic of the biochemical processes of communication established with your body or other beautiful stimuli designed by Mother Nature to generate milk production.

To mention a few examples, your baby's saliva "communicates" with your body to change the composition of the milk that is generated, according to its requirements, or a baby's cry can trigger the let-down response, even if it is not your own baby.

The breast pump is a stimulation, not as powerful as your baby, but a stimulation nonetheless that demands more milk, and your body "registers" it to increase production and meet the need.

It is also important to note that the production obeys certain adaptation and learning times, usually many women refer to between a week to two weeks to see the results of increased production once they start with the extractions.

How do I start extractions?

Considering the date on which you want to have a small bank assembled, start at least 20 days before to ensure that your body has time to increase production.

Remember also that you should not panic if the first few times, you extract little or nothing.

Hygiene and Cleanliness. Wash your hands before extracting. Considering the model of pump you have purchased and containers, check the instructions for cleaning them. Nipples do not need to be cleaned prior to expression.
Massage. Especially on the first few occasions, a massage helps to relax and promote milk let-down. Do it in a circular motion around the entire breast.

Extraction. We recommend that you perform 15-minute extractions for each breast, taking into account the moments mentioned above.

If you do not have that much time to be extracting, it is preferable that you do several short extractions, rather than a few long ones. This is usually more effective because of the effect it has on prolactin.

Labeling. Once the milk has been expressed, identify it with the exact date.

Which extractor do you recommend?

In reality, there are no better brands/models than others, only those that are best suited for a particular mom. Our recommendation is that, if you are looking to bank because you are going back to work, you should prefer a double electric model, so that each expression is done on both breasts at the same time and in a relatively short time than if it were a manual pump.

A breast pump usually has several parts on which the success of the expression also depends, for example, the size of the cups, which should be as close to the size of your breast as possible. Take the time to research these details.

Breast pumping requires patience and learning, and all along the way, routine will be your best ally to achieve the best results.

How can I make a manual extraction?

Hand expression is also possible, although it will probably take longer to express milk compared to pumping. It may also be a convenient choice if depending on your baby (for example, if your baby has just been born and the baby cannot drink directly from your breast).

Place your hand on your breast and massage
Place your fingers in a c-shape, the area to be squeezed is about 3 cm from the base of the nipple, so the movement itself is not centered on the nipple, but around it.
The movement will be to squeeze inwards (towards your thorax) and then compress the breast with your fingers, while moving them outwards.
The movement is done in a rhythmic and deep way, not superficial where you just slide your fingers, or rough where you stretch/crush/rub the breast, as you could hurt yourself.

Manual removal can take approximately 20 to 30 minutes, alternating the breasts.

Here is a video with a very clear explanation of how to perform the manual extraction

How can I increase the amount of milk I express?

There are some tips you can do to increase milk volume:

Pump while breastfeeding, from the breast that is free. This way, your body registers that it needs to increase its production by feeling a double stimulation.
Although we recommend pumping in the morning, it is important to observe your body and record the times when you produce the most milk. Remember that every body reacts differently.
There is a technique called "Power Pumping" that has proven to be effective in increasing the volume of breast pumping. This technique seeks to replicate what happens in a growth spurt or crisis (see our blog "Mom is not a pacifier, nor is the milk running out"), where the volume of production is increased.

The technique consists of performing cycles of extraction-pause-extraction, as we indicate below, so that your body, based on the extra stimulation, increases production:*POST POWER PUMPING*

If your breast pump is a single one

i. Extract 10 min. from one breast and 10 min. from the other breast.

ii. Rest 5 min.

Total Time: 1 Hr.

If your breast pump is a double pump, repeat the following cycle placing both breasts at the same time:

i. Extract both breasts for 20 min.

ii. Rest 10 min.

iii. Pump both breasts for 10 min.

iv. Rest 10 min.

v. Extract both breasts for 10 min.

Total Time: 1 Hr.

Cycle 1 or 2 times a day for 3 or 4 days and you will see the increase in production.

MILK BANK STORAGE

How do I store the milk I express?

It is important that when you express milk, you label it with the date/time of expression. Breast milk can be handled in different ways, so that it can be consumed either immediately or reserved as part of a milk bank. It all depends on what you want to use it for.

Some general rules:

- Always wash your hands before expressing and handling the milk, as well as keeping the pump and containers where you will store the milk clean.

- For the containers where you will store the milk, there are many available in the market, or you can use plastic (food) or glass containers, but make sure they have plastic lids and not metal, because these can contaminate the milk if they rust. We do not recommend using urine collection bottles.

- Always offer your baby the freshest milk possible, and reserve milk from your bank for emergencies.

- Label your pumpings with date/time.

- Do not thaw milk in the microwave and avoid it for heating milk*. Ideally, you should heat water in a saucepan and, once off the heat, place the container with the expressed milk in a water bath, but with the water not on direct heat.

- The milk that comes into contact with your baby's saliva is milk that must be consumed. If there are leftovers, they cannot be reused, refrigerated or frozen again because of the risk of bacterial proliferation, and can only be consumed within the following hour.

Once I express milk, how do I handle or reserve it?

When you first express your milk, you can opt for several storage options, considering the estimated time of consumption:

- Immediate consumption. At a maximum ambient temperature of 25°C, it has a maximum shelf life of 6 hrs.

- Consumption during the day. Refrigerate it, at a temperature of 0 to 4° has a maximum shelf life of 5 days.

- Consumption on another day. It depends on how many days you plan to use it. Suppose you plan to use it within the week (considering 5 days max.), you can keep it in the refrigerator, if it is for a longer period of time, consider these guidelines:

o Freezer in a refrigerator. Maximum shelf life of approx. 2 weeks. This is due to the constant opening and closing of the refrigerator.

o Freezer separate from refrigerator. Max. shelf life of approx. 6 months. Opens less than an integrated freezer, but still you can only use it once.

o Exclusive freezer. Max. life of approx. 12 months. This is a separate freezer, without a refrigerator, exclusively for breast milk.

The decision to freeze the milk leads you specifically to handle it as part of your bank for long-term storage.

How should I thaw breast milk?

- If you need to use milk from your bank (frozen milk), try to thaw the oldest milk, this way your bank will be kept "fresh".

- Do not thaw the milk at room temperature, because of the risk of bacterial proliferation, it is advisable to thaw it as described above in a bathwater style. If you are not going to thaw it immediately, try to maintain the cold chain, that is, from the freezer to the refrigerator and from the refrigerator it can be transported in a cooler with ice until it can be heated. In this chain, storage times are managed as follows:

o Milk from freezer to refrigerator: 24 hrs.

o Milk from refrigerator to cooler with ice: 4 hrs.

o Milk from freezer to refrigerator with ice: 24 hrs.

- All frozen milk that has been thawed may not be refrozen under any circumstances.

How do you know if the consistency and taste of the milk is right?

- During the process of milk preservation, it is normal to see a creamy layer on top and water underneath. It is enough to shake the milk a little to re-integrate it. It does not mean that it is spoiled.

- It is possible that your thawed milk smells strange, some women report a sour, rancid or soapy smell. This is due to the change in lipid structure from the freezing/thawing process. It does not mean it is no good, if handled within the correct time parameters, it is good for consumption.

- Your baby may not accept bottle-fed breast milk at first, and this is normal. Again, if you have followed the recommendations for handling and storing breast milk, it is probably not an issue of the milk spoiling, but rather the fact that it is preferred to drink "straight from the source" rather than from a bottle.

o If this is the case, seek support from a lactation consultant to find the best way for your baby to breastfeed even if you are not around.

Final recommendations.

- When freezing milk, try to place it as far back and away from the door as possible.

- Remember to constantly clean your breast pump, as well as the attachments. Breast milk contains fat that if not cleaned immediately sticks to the components and makes subsequent cleaning difficult. In addition, proper cleaning ensures that you avoid the proliferation of bacteria that pass into the breast milk.

- You can put together several daily extractions, provided that when you put them together they are both at the same temperature, otherwise there may be an imbalance in the composition. If you have milk in the refrigerator and you have just pumped, first put the freshly pumped milk in the refrigerator and then mix it with the milk you had previously.

- There is no bottle or nipple on the market that is "the best" for breastfeeding. Ergonomically, when your nipple is sucked by your baby, it sticks to the baby's palate and stretches to reach the deep part of their mouth, this happens because of the texture and material of the nipple, which has not been replicated by any bottle or nipple. As these are made of semi-rigid plastic, they fit flat in the mouth and do not achieve this position.

Having said that, you will probably invest a bit until you find the bottle that fits your baby.

*Microwaving is not recommended, because if used improperly it can destroy most of the living cells contained in breast milk, even if it does not alter its nutritional value. Most importantly, studies have shown that microwaves heat baby's milk and formula unevenly. This results in "hot spots" that can scald a baby's mouth and throat