Hand expressing breast milk is a skill that is probably as old as humanity itself. Sadly, it is a skill that many have forgotten. And I can just hear you ask: why on earth would anyone need to know how to hand express when we have access to breast pumps? Well, there are a few good reasons:
- Your hands are always with you, they can’t break down and you can’t forget bits of them at home. You only have to go to work without some vital piece of your breast pump once to see why this is important!
- Hand expressing can’t be interrupted by power failures or flat batteries
- When your breasts are engorged or you have a blocked duct, hand expressing often gives a lot more relief than pumping
- If you know how to hand express, your hands can always get a bit more milk out after you’ve finished pumping.
Personally, I love hand-expressing. The only reason I even own a pump is so that I can have my hands free to read a book while I express; I actually find hand expressing to be faster and to yield more milk than the pump. All in all, it is a very valuable skill to learn.
How to hand express
There’s a certain skill to hand expressing effectively; if you take the time to learn to do it right, you’ll be able to express a lot more in a shorter time. This technique that I teach is the most effective way I’ve found to do it: I have seen moms maintain a great milk supply for weeks and even months at a time using only this hand expressing technique.
Step 1: Get the setting right
In order to express effectively, it is very important that you must be relaxed and comfortable. Find a peaceful spot where you won’t be interrupted and sit comfortably. Make sure that it’s not too cold – I’ve found that nothing stops the milk flow faster than shivering. As you get comfortable with hand expressing the setting matters less, but in the beginning any physical or emotional discomfort can make it very difficult to get good milk flow.
Step 2: Wake up your breasts
Before you jump right in and start expressing, you want to get your breasts ready to give a good flow of milk. My preferred method it to massage the breast, but other women also find that stroking the breast or gently stimulating the nipple help. Putting a warm compress (like a warm wet facecloth or a beanbag) on the breast also helps the milk to flow more easily.
It also helps if you can be near your baby, or look at his picture or smell a piece of his clothes. Take a few photos and videos of baby on your cellphone to look at while you express!
Step 3: Get into position
Next, you need to position your hands on the breast in the right place. Hand expressing is not like milking a cow: your fingers don’t slide over the breast; they stay in one place. Start at the nipple and move back towards your chest, and feel for the area where the milk ducts begin: it’s where the breast changes texture and starts to feel a bit lumpy. It’s usually around the edges of the areola (that brown area around the nipple), but it can be more to the front or back. You want to position your hand with the fingers there, so that the breast is between your thumb and forefinger. Once your fingers are in position, you may find that pushing your hand into your breast, back toward your chest, helps you to get a better grip.
Step 4: Squeeze-release
With the breast held between the thumb and forefinger, compress or squeeze your thumb and forefinger together, and then release. Repeat this squeeze-release movement until the milk starts to flow well: in the beginning you may only get milk dripping out, but as you get better at it you should get sprays of milk. (Here’s a tip: use a wide-necked cup to catch the milk; those sprays can go all over the place!). If you do not get much out, experiment with moving your hands closer to or further away from the nipple.
Experiment to find what rhythm works well for you. Usually, the first instinct is to squeeze slowly and for a long time until the last drop of milk stops before releasing and squeezing again. However, I often find that you get more milk more quickly by expressing with a quick rhythm, squeezing and releasing about once a second. Play around until you find what works for you.
You may find that as you squeeze, your fingers naturally roll forward (as if you are making a fingerprint). That is fine. Just make sure you don’t slide your fingers over the skin of your breast – all you will achieve by doing that is to get friction burns on your breasts (ouch!)
Step 5: Repeat
As the breast gets empty and the milk flow stops, you can rotate your hands so that you empty all the parts of the breast. When one breast gives no more, change to the other breast. You can also stop to massage the breast at intervals. I will usually go back and forth between both breasts several times, massaging before I express each time, to get a very good amount of milk out in a single session.
Good luck, and please comment below if you have any tips or ticks to make the process easier and more effective.