How do you hand express your milk?

I am looking for help on hand expressing my milk. I tried a pump but it did not work as well. Can you help?


Debbi Donovan

Debbi Donovan is a Board Certified Lactation Consultant, as well as a retired La Leche League Leader. For more than a decade, Debbi... Read more

There are several benefits to hand-expression of breastmilk. You are able to express your milk, basically at any time, and with no special equipment. When you know how to hand-express, you don't have to worry about being caught without your pump in tow. There is no clean-up of parts, as is necessary when relying on a pump. Many moms respond better to touch (rather than plastic pump parts), and find their milk ejection reflex to be enhanced. And, it's free!

Hand expression is really quite easy, but, as with all new skills, it does require some practice. If possible, find a warm, comfortable and private place to express your milk. Allow yourself about 20 to 30 minutes if you will be expressing in place of a feeding. Have a clean container available to catch the milk in. Wash your hands, and allow yourself to get comfortable. You might find that listening to music or a relaxation tape (even at work, with a head-set) will be of help. Use imagery, if you find it relaxing, picturing details of your baby -- his smell, his warmth, his soft skin ...

Place your hand, thumb above, and about one inch back from your areola, with other fingers cupping under your breast. Using thumb and forefinger, press gently into the chest wall. Continue to press and then release. Find a rhythm that is comfortable for you, and mirrors the suckling of your baby. Rotate your hand around the areola, which will encourage your milk to flow, and assure that milk is expressed from all parts of your breast. If after a minute or two of hand expression, you are not able to express any milk, try a slightly different location. All women are not identically built. Your lactiferous sinuses may be a bit farther back or a little closer to your nipple -- experiment to find the location you are able to best access your milk.

Express each breast until the flow slows down -- about five minutes. Then switch to the other side. You will probably be going back and forth between breasts several times during each session. Warmth and massage can be relaxing and aid in your milk ejection reflex. Hand expression should not hurt! If it does, you may be pressing too hard.

I encourage you to take a look at Manual Expression of Breastmilk: Marmet Technique. Chele Marmet, a Lactation Consultant and director of the Lactation Institute in Encino, California has developed this special technique, that consists of alternating milk expression with massage, stroking and shaking of the breasts. It is very effective, and the illustrations may prove to be very helpful as you learn this new and very useful skill.

With breastpumps becoming so popular over the past several years, many people have forgotten the time-honored skill of hand-expression. I had the pleasure not too long ago of meeting three midwives from Sweden. They informed me that in Sweden, where almost all women start out nursing their babies, breastpumps were the exception, rather than the rule. They were surprised how much we, in the United States, focused on the use of breastpumps. In Sweden, all moms are taught hand expression following the birth of their baby. I think my Swedish friends made a great point. We often turn to the most technologically advanced items, when simpler methods would work just as well, or even better in many cases. My best wishes in mothering!

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