Hand expression is a useful technique, and what’s more it’s convenient and free! It’s a handy way to relieve engorgement. You can use it to stimulate milk production if you need to increase your supply, and to provide milk for your baby. You can also combine hand expressing with pumping – read more about pumping here.
Hand expression is often used for antenatal expression of colostrum – read more here.
Hand expression is simple to learn and gets easier with practice. Follow these steps:
- Wash your hands.
- You can use any clean container you like to collect your milk, colostrum can be expressed into a small (5ml) container or even onto a teaspoon if you want to feed it to your baby immediately.
- Relax and get comfortable: your milk will flow more easily if you are warm and comfortable.
- Privacy can help: try the breathing exercises you learnt for use during labour; visualise flowing milk.
- It can be easier to get your milk flowing if your baby is nearby – if he is not try thinking about him, or looking at a photo or recording of him.
- Many moms find that keeping a piece of clothing that smells of their baby close-by helps – this may be especially helpful if you’re separated from your baby, for example if your baby is in special care (NICU).
- Take some deep breaths and drop your shoulders.
- Gently massage your breasts with your hands and fingertips to stimulate your milk ejection reflex (MER or ‘let-down’) – this is the key to effective expressing.
- Bending forward with your breasts suspended means gravity can help milk flow.
The following technique – press, compress, release – is described in The Womanly Art of Breastfeeding:
- Hold your breast with your fingers and thumb cupped around your breast in a C shape, near but not touching your areola.
Then: - PRESS your fingers and thumb back towards your chest.
- COMPRESS your breast between your fingers and thumb, moving them slightly towards your nipple without lifting them from your breast.
- RELEASE without moving your hand from your breast.
- REPEAT, moving your hand to a different place around your breast after every few compressions or whenever milk flow stops, so that you compress all of your milk ducts. Releasing and repeating rhythmically helps to mimic the action of a baby breastfeeding.
- For most moms it’s a process of trial and error – experiment to find what works best for you: when you get a spray of milk from at least one nipple pore (instead of drops or a dribble), you’ve found what works for you.
- Allow time at first: the whole process may take 20 or 30 minutes, you can always stop and start again later if you need to. Frequent short sessions are usually more effective than infrequent, longer expressing sessions.
- Hand expression should feel comfortable. If it’s not adjust what you’re doing until it feels ok.
This video has a good demonstration of hand expression of breastmilk.
LLL offers local support in over 80 countries: see if you have a local group by searching here.
The Power of Hand Expression
Pumping article
LLLGB Hand Expression of Breastmilk
LLL USA, Working and Breastfeeding: My Experience with Hand Expression