Hand expression

Hand expression is exactly what it sounds like: using your hands, rather than a pump, to move milk out of your breast.

It’s the tool we come back to over and over in consults, because it solves so many different problems with nothing but your own two hands:

• It prevents and relieves engorgement
• It helps your baby latch
• It encourages a letdown and gets the milk flowing
• It removes milk you can then give to your baby

That last one matters more than people expect in the early days. A sleepy baby who can’t stay awake at the breast can still get your milk — you just need a way to get it out. And in the first days, when there’s colostrum rather than volume, hands work better than a pump does.

How to hand express

Give yourself a few minutes somewhere comfortable the first time. This is a skill, and it feels awkward before it feels easy.

1. Wash your hands and massage your breasts. A warm towel across your breasts first helps the milk flow more easily.
2. Place your fingers about an inch back from your nipple, lined up with the nipple — thumb above, fingers below.
3. Press back toward your chest.
4. Gently squeeze your breast.
5. Relax your fingers, keeping them in the same spot, and repeat — press, squeeze, relax, in a rhythm.
6. Rotate your fingers around the breast and repeat, so you reach more of the milk ducts.

One thing worth knowing: switching back and forth between breasts brings more milk than staying on one side until it stops.

If nothing comes out on your first try, you haven’t done it wrong. Drops before streams is normal, and most mothers get noticeably better at this within a day or two of practice.

Watch it done

Hand position is much easier to see than to read about. Global Health Media’s video is the one we point families to:

How to Express Breastmilk — Global Health Media