Get the baby used to taking a bottle, spoon or cup. Begin to express your milk, once your milk supply is properly established, at about 8 weeks. You can put any milk that you have expressed in the fridge or freezer until you need it. Expressed breast milk will keep:

• 6 hours at room temperature
• 24 hours in the fridge
• 7 days in the freezer compartment
• 3 months in a freezer unit.

You can store the expressed milk in any container or bottle, even ice cube trays – all of which must be sterilised (steam, sterilising tablets and water), or boiled (for 5 minutes, items fully emmersed) and kept scrupulously clean. There are also freezer bags especially designed for freezing breast milk.

Try catching the milk that drips on the non- feeding side whilst baby is feeding off the other one. You’ll be surprised how much you can catch in what’s called a Woolwich nipple shell (they will need sterilising too). The milk you acquire can then be added to your stock and used as and when.

Buy a pump! Go to a chemist or a supplier that has a selection of pumps. Have a look at them, handle them. How easy are they to use? Does using the pump numb your hand after 20 seconds? Look at the price. Some of the electric ones are very expensive but you could hire. The hand operated ones are cheaper and may get better results. They are also more convenient for work. (See information section for stockist’s details)

If buying a pump is an expense too far, why not have a bash at expressing the milk by hand. Start off by gently massaging the breast from the top towards the nipple moving over the whole breast (not forgetting the area underneath). Use small circular movements. Apply hot flannels before you start to help the milk to flow (although this may not be easy at work). Then carefully place the fingers of one hand below the nipple on the margin where the areola meets the skin of the breast. Your thumb is placed above the nipple in the same way. You should be able to feel the lactiferous sinuses (temporary storage spaces for the milk; it’s these baby squeezes when feeding) like soft beads.

With your fingers in the correct position push backwards towards your ribs. The action then is a rolling and squeezing of your fingers and thumb together. You have to be gentle so as not to bruise the delicate breast tissue inside and avoid rubbing the skin, as the friction will make the area sore. It may take a little while to get the milk to flow but keep squeezing as described and eventually milk will appear. Work one breast then the other. Keep working each breast in turn until the milk stops flowing. Catch the drips and squirts in a sterile bowl and then transfer to a sterile container ready for the fridge. Just a quick word – there is a knack to this. 

Be patient and relaxed and work methodically. Rotate the finger position around the nipple (to get all the stores of milk from the ducts), push into the ribs and roll the fingers. You may also have to repeat the massage to encourage the milk to flow again.

Where are you going to express at work? Is there a room-apart from the loo?! Can it be locked for some privacy? Is there anywhere to store the milk because it will need refrigeration? As a last resort, waste the milk- at least you are still stimulating your breasts to produce milk.

It will take much longer to initiate the let down reflex whilst at work because of the obvious stresses and strains. More importantly, however, is that your baby is a far more efficient milk extractor than a pump will ever be. The sight and touch of your baby also helps the milk to flow. When expressing at work take a picture, a toy or blanket - anything that brings your baby closer to you. You need to think beautiful thoughts whilst you express, so think of your baby and try and relax.

Breastfeeding mums have legal protection under the Management of Health and Safety at Work Regulations, 1999. This states that employers have to ensure that working conditions allow a woman to continue to feed her baby and applies until the baby is 12 months old. It may be possible to negotiate shorter shifts or be given regular breaks to express milk. If you work with hazardous substances that could enter your breast milk the Management of Health and Safety at Work Regulations covers this too. The Health and Safety Executive (HSE) or your occupational nurse will be able to tell you if you aren’t certain how a particular substances will affect you. To contact the HSE see references below or Information Slot.

Before returning to work, discuss the possibilities with your boss. Inform him in writing that you intend to continue to breastfeed. Get your GP or health visitor in on the act. A letter from either of them outlining the health risks to your baby if you stop breastfeeding would be helpful. It’s a matter of convincing your boss that keeping baby well means less sick days off for you and that, in turn, will be beneficial to him. Give the boss some idea how long you intend to breastfeed, just so that he understands that the special arrangements will be temporary.

If you work in the public sector you have extra protection: The Pregnant Workers Directive, 1992. This puts emphasis on a mother’s right to breastfeed her baby. It is not up to you to persuade your boss that your baby’s health may suffer if you are unable to breastfeed her. If your work badly affects your breastfeeding, your public sector employer must make temporary changes to your working conditions &/or hours to ease things for you, or provide you with alternative work. Your boss has to preserve the activity of breastfeeding by law.

Explain to your colleagues what you intend to do so that they understand why you disappear for a while periodically.

Read as much as you can about expressing. Support groups such as the La Leche league, The National Childbirth Trust and The Maternity Alliance all have useful booklets giving lots of sensible information on this subject. (See information section for address and telephone number details.)

Make sure that the whole experience will leave you feeling better rather than worse. Maybe expressing doesn't appeal. Why not try partial breastfeeding i.e. feed morning, evening and nights and give formula when you are not there. Unfortunately, this tends to reduce your milk supply, which means that on your days off you would have to continue to feed formula milk. Whatever you decide, do what makes you feel happiest.

Expressing for babies that are unable to feed.

A short note for mums whose babies may be unwell and end up on the Special Care Baby Unit or whose babies have a problem that means breastfeeding is difficult. Some of the above info. will be useful but there are a few differences. As soon as possible after the birth start using the breast pump. It should be used at least every four hours (preferably every three hours) and around the clock if you have the energy, as prolactin levels (the hormone responsible for milk production) need to be kept high for a good milk supply. Express as early as you can in the morning and as late as you can in the evening so that the frequency of expression mimics the feeding pattern of the baby as closely as possible. If you are able to, hold your baby and even put her to the breast. She may not be able to suckle but just holding her there will help you to make milk and it will make the two of you feel better. Don’t panic if the amount of milk you express initially is small. As long as you persevere the amount will increase and as they say "every little helps". Baby will benefit from the protection your milk affords her from infection and you will benefit by knowing you are doing your best.

References.

Management of Health and Safety at Work Regulations, 1999. Pages 31-33: Pregnant Workers. Obtainable from the Health and Safety Executive, Infoline 08701 545500.

The Pregnant Workers Directive. Council Directive 92/85/EEC of 19^th October 1992.