Anyatej dekantálás: mire való és hogyan történik?

In order not to disrupt the natural process of lactation after the birth of a child, and, on the contrary, to promote normal breastfeeding and avoid problems with the mammary glands, you should know when it is necessary to decant breast milk, as well as - how to do it correctly. [1]

What is milk decanting done for?

When explaining how to properly put the baby to the breast, care for the mammary glands during lactation, when and how to decant milk from them, a certified breastfeeding counselor - aka milk decanting specialist - should clearly define the fundamental purpose of this manipulation in each case, taking into account the possible complications of lactation.

They can be avoided if the child is breastfed not by "schedule", but as needed (as they say, how much he requires), because the stimulation of lactopoiesis or lactogenesis, that is, the secretion of milk, occurs reflexively - when the baby actively suckles.

The sensory receptors of the nipple and areola stimulated by suckling initiate nerve impulses to the brain, which causes an increase in the synthesis of the hormones prolactin and oxytocin. The first is responsible for the secretion of breast milk in the mammary glands, and the role of the second hormone is the contraction of the myoepithelial cells of their tissues, leading to the release of milk from the alveoli into the milk ducts. This is what experts call endocrine control of lactation.

During the first week of the postpartum period, the mother's body produces breast milk automatically - at the peak of prolactin synthesis, but after a certain time its level drops, and the process of milk production goes into a "supply-demand" mode, i.e. The control of lactopoiesis becomes autocrine, depending on the frequency and degree of emptying of the mammary glands (which after feeding should become soft until the next "portion" of milk arrives). Thus, the simplest and most effective way to support breast milk production - without decanting - is to breastfeed frequently at all times of the day.

But if there is not enough milk to meet the baby's needs, as evidenced by insufficient weight gain, decreased urination and darker-colored urine, breast milk is decanted after or between feedings. For more information see. - Insufficient milk secretion: how to increase lactation?

But if it is impossible to breastfeed directly due to respiratory distress syndrome and weakness of the sucking reflex in prematurity, perinatal pathologies of the baby, etc., as well as for health reasons of the mother or in case of temporary separation from the child, regular decanting (at least five or six times a day) is not possible. And it is recommended to start it as early as six hours after delivery.

It is necessary to decant breast milk by hand in case of milk stagnation and severe gland engorgement; decanting in lactostasis, which is observed in case of excess milk, which at first the baby is simply unable to suckle; in blockage of the ducts of the mammary glands.

In women with hyperlactation (often accompanied by dilated milk ducts) or with an increased oxytocin reflex, too much milk comes out of the breast quickly, which leads to the baby choking and swallowing air during feeding, causing colic. In order to slow down the flow of milk, it is recommended to decant a little milk before feeding, and also to decant the excess milk a little at a time (no more than three times a day) in order to relieve your own condition.

In most cases, the first decanting of milk is due to the fact that at the beginning of lactogenesis there is breast engorgement. It is recommended to start decanting only when the milk, as it is commonly said, "came up", and this usually happens on the second or third day after childbirth, but in first-time mothers it is possible and a little later. And if there is no milk when decanting during the first three days after delivery, it means that its full secretion has not yet begun, as the process of transformation of acinar epithelium of mammary glands from presecretory to secretory state has not yet been completed. At this time, the newborn sucks the dense protein secretion of the mammary glands stimulating its immune system - colostrum (colostrum). In addition, milk does not flow when a woman does not decant it correctly, in particular, strongly squeezes the nipple. [2]

Rules for milk decanting

There are rules of milk decanting, explaining how to perform this manipulation, so as not to traumatize the mammary glands.

Methods of milk decanting: manual and using milk decanting devices - breast pumps.

How is proper hand milk decanting into a bottle or other container, and how to increase milk by decanting?

When there is enough milk and you just need to decant the excessive residue to avoid stagnation, that is one situation, and three to five minutes is enough to make the mammary gland soft after feeding.

Another thing is when you need more milk to feed a premature baby without putting it directly to the breast. Then the question arises how to induce milk flow during decanting and, in general, how to increase milk during decanting so that it is really enough for the newborn.

Lactation consultants recommend taking a moderately warm shower on the breast area before lactation, placing a warm compress on the same area for five minutes and then giving a light massage for a few minutes while decanting breast milk, for more information see - Breast massage while lactating.

What follows is as follows:

• with one hand to support your chest from underneath;
• place the thumb of the other hand above the nipple (on the border of its areola);
• put the index finger at the same distance from the nipple, but on the opposite side, i.e. From below - opposite the thumb (the shape of the position of the fingers is similar to the letter "C");
• then you should press the gland with your fingers towards the chest wall (in no case until pain) and let go, without removing your fingers, without sliding them on the skin, without touching the nipple, but gently squeezing them towards each other behind the nipple for a couple of seconds and letting go.

How should the milk come out when decanting? This rhythmic movement will cause drops of milk to come out of the nipple first, and then it may come out in streams. If the mother is milky, the milk comes out in streams under pressure, which makes the breast milk foam when decanting.

If drops do not appear, it is necessary to move the fingers slightly (in a circle around the areola), and when the milk stops flowing, the fingers are brought to another part of the breast and repeat the described actions.

Another question with which lactating women turn to doctors is how long after decanting the milk arrives. If during feeding it arrives in a quarter of an hour, after decanting - in 40-60 minutes.

How much milk should I have when decanting?

The amount of milk decanted after the next breastfeeding is individual and depends on the total volume of its secretion, as well as the appetite of the baby. According to pediatricians, most newborns in the first month of life consumes 30-60 ml of breast milk at one feeding, and as they grow, the volume of one feeding reaches 90-120 ml (with a daily intake of up to 700-900 ml).

If a mother has to decant both breasts five or six times a day for 20 minutes to ensure feeding without putting the baby to the breast, then the milk requirement for one feeding, which is every two hours, should be assumed.

When it seems to a woman that there is little milk when decanting, it is worth focusing on the above data, and not panic about the insufficient amount of milk. Because excessive anxiety and stress negatively affect lactation. And complaints that milk is lost after decanting are actually caused by negative emotions and stress, which releases adrenaline into the blood, which is an antagonist of prolactin.

It should also be borne in mind that milk production is higher in the morning than in the afternoon and evening, and fatigue and irrational nutrition of the mother reduce milk secretion.

In addition, the influence of the so-called lactation crises, when milk secretion decreases for a few days when the child is three weeks to one and a half months old, can also be affected, and such declines can be repeated at intervals of about one and a half months between three and eight months. [3]

Pumping breast milk with a breast pump

The better your mammary glands are emptied, the faster new milk is produced, and in some cases, breast pumps can help.

The simplest of these is a decanting pear (with a glass cover and reservoir).

There are also types of piston-action breast pumps, but more often used manual mechanical breast pumps of pump type: Canpol babies, (Manual Breast Pump) Avent Philips), Lovi, Baby Team, Mamivac Easy, Chicco Natural Feeling, Tommee Tippee and others. Many models come with special jars for decanting milk and bottles with feeding nipples.

To solve more serious problems with breast milk feeding or if you need to create a supply of breast milk, there is the Medela Mini Electric milk decanting machine and the Medela Swing electronic biphasic machine (with the effect of imitating suckling).

How to use them is specified in the instructions provided. [4]

Storing milk after decanting

An equally important question is where to put the milk after decanting? According to breastfeeding counselors, if the baby is satiated without finishing the next portion, the leftovers should simply be poured out, and if the excess is intact, it should be stored for supplemental feeding in case of need or as a safety net.

Where, how and how long to store milk after decanting?

Milk can be stored at room temperature after decanting: at +25°C - no longer than 5 hours, at lower temperatures (+20°C) - up to 10 hours.

But it is much more rational to store milk after decanting in the refrigerator, as its shelf life increases to two or three days. And if it is frozen, up to six months.

How do I freeze breast milk after decanting?

Use plastic containers with a lid or hermetically sealed sterile bags to store the decanted milk for freezing. Each serving of milk should be labeled with the date it was decanted.

Milk can be stored for three months in a normal freezer, but twice as long in a lip freezer (at -18°C). Once a portion of milk has been thawed, it should be fed the same day.

Can milk from different decantings be mixed? You can, but only the portions obtained within 24 hours, which should be kept in the refrigerator for an hour beforehand.

How to warm breast milk after decanting? Before feeding the baby with decanted milk, it is warmed to body temperature by placing the bottle in a container of warm water. [5]

Problems with decanting

When the temperature rises after milk decanting, it may be due to milk flow or irritation of the nipple and areola, which leads to the release of oxytocin and the oxytocin reflex. In addition, thirst and headache may occur.

But the pain in the breast during and after decanting appears when this manipulation is performed incorrectly (too strong squeezing of the breast) or in cases of development of lactation mastitis.

If the milk outflow is impaired, it may partially coagulate in the milky ducts, and then there are clots of milk when decanting.

Yellow milk when you pump can mean that it is more fatty back milk. It is also easy for pigments from food or medicines (for example, the yellow dye in the coating of vitamin pills and tablets) to get into the milk. In general, the normal color of breast milk is slightly bluish or yellowish. [6]

Pink milk during decanting can be if a capillary in the nipple has burst or if the mother has eaten beets the day before. Also pink or brownish color gives blood in the milk when decanting, which can get into it their burst capillary glandular tissue gland or damage (cracks) nipples. This does not affect the nutritional properties of the milk and is not harmful to the baby.