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What is Hand Expression?  

Hand Expression is using only your hands to remove milk from your breasts. It’s a useful technique that is simple to learn and gets easier with practice. Expressing breastmilk with your hands can relieve engorgement, prevent clogged ducts and stimulate milk production. In the early days, hand expression is more effective than using a breast pump. Hand expression and compression before, during, and after breast pumping has been shown to draw more milk than just the pump alone.  

When to Use Hand Expression  

Colostrum, or “golden milk” produced in the early days postpartum, is thicker and more nutrient dense than traditional breastmilk. In these first days after you deliver your baby, hand expression to collect colostrum is more effective than using a breast pump. Loaded with powerful antibodies and antioxidants, colostrum can be hand expressed into a spoon or medicine small cup and fed directly to your baby.   

To relieve engorgement, combine hand expression with gravity for a simple and efficient way to gently drain the breast. Place a large bowl or basin on a flat surface and use hand expression to massage and express your breastmilk into the container. Gravity will aid in allowing the breastmilk to draw out of the breast naturally. Many mothers use this technique in the early days postpartum and beyond.  

How to use your hands to express breastmilk  

For this hand expression explanation and technique, it’s best to think of your breast as a clock. You will gently move your fingers around the dial and repeatedly express your breastmilk with your hands. Many mothers report finding a “sweet spot” when hand expressing or an area the milk flow is the fastest. The sweet spot can be found anywhere on the breast tissue, near or on the areola.   

To Start   

Wash your hands and gather a clean wide base container like a cup or bowl to collect your expressed breastmilk. Next, find a quiet relaxing spot, sit up straight and lean forward slightly to allow gravity to assist.   

Step 1  

Use two fingers to gently massage around each of your breasts in a circular motion. Start at the top of your breast and move your hand toward the nipple. This will begin to stimulate your milk ejection reflex or “let down.”   

Step 2  

Cup your breast with your hand in a “C,” positioning your thumb and index finger (thumb 12 and index 6). Your fingers should be 1-2 inches away from the nipple.   

Step 3  

Apply inward pressure and push very gently back towards the chest wall while keeping all of your fingers cupped around the breast.   

Step 4  

Compress your fingers together and slide them forward, under, and away from the areola.   

Step 5  

Release the pressure but keep your hands on your breast.   

Step 6  

Move your hand to cup your breast in a “C” under the breast, positioning your thumb and index finger on the breast dial (9 and 6).   

Step 7  

Continue to move your fingers around the breast dial quickly, finding your rhythm. Press, compress, and release.   

Step 8  

Repeat and alternate hand expression for each breast.   

After hand expression is complete, your breasts should feel soft. On average, hand expression can take 20 to 30 minutes. Be patient while learning to hand express, especially in the early days. It’s normal to see only drops of colostrum. Every drop of milk is liquid gold and the best food you can provide for your baby. Over time with practice, hand expression becomes easier to do and is a practical way to prevent and treat common breastfeeding challenges.   

Every breastfeeding mom should know how to hand express milk from their breasts. Hand expression should not be painful. If you are experiencing discomfort, you may be pressing too hard on the breast, nipple, or areola.

Connect with a Storkpump IBCLC (International Board Certified Lactation Consultant) at askanIBCLC@adapthealth.com

Source  

Alibhai, K. M., Murphy, M. S., Dunn, S., Keely, E., O’Meara, P., Anderson, J., & El-Chaâr, D. (2022). Evaluation of a breastmilk hand expression toolkit: The M.I.L.K Survey Study. International Breastfeeding Journal, 17(1). https://doi.org/10.1186/s13006-021-00448-3

H;, D. G. G. (n.d.). The effect of uterine and nipple stimulation on induction with oxytocin and the labor process. Worldviews on evidence-based nursing. Retrieved July 18, 2022, from https://pubmed.ncbi.nlm.nih.gov/26444882/

Morton J; Hall JY; Wong RJ; Thairu L; Benitz WE; Rhine WD; (n.d.). Combining hand techniques with electric pumping increases milk production in mothers of preterm infants. Journal of perinatology: official journal of the California Perinatal Association.