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How to do Hand Expression of Breast Milk

Monday, February 15, 2021

Hand expression is a valuable skill for breastfeeding moms. It takes a little practice but once learned, you may prefer it over using a pump. It is simple, no equipment required!

Watch this video, then scroll down to learn more.

Hand expression can be useful:

  • to collect colostrum in pregnancy (please discuss with your healthcare provider first). Learn more here.
  • to express a drop of milk onto the nipple to entice your baby to feed.
  • to soften your  breast if you are overly full. (There is another simple way to soften the breast. See below to learn more.)
  • to express milk for later use. Learn how  to safely store breast milk in this post.
  • to relieve breast fullness or to obtain milk when you are separated from your baby.
  • in combination with pumping to increase your milk supply. At the breast, baby uses both suction and compression to obtain milk. Pumping works by suction only; hand expression works by compression. Combining the two will more effectively stimulate your milk supply.

How to hand express:

1.  Wash your hands with soap and warm water.

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2.  Stimulate your letdown by massaging, stroking your breasts or rolling your nipple.

3.  Place your thumb and first finger on either side of the nipple about 1½ inches (4 cm) from the base of the nipple.

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4.  Push your thumb and finger straight back toward the chest wall.

5.  Roll your thumb toward the nipple like you are making a thumbprint. Try to avoid sliding your fingers along your skin as you may become sore.

6.  Continue this motion, rotating your hand position around the breast to express milk from all areas.

7.  Some women will need to have their fingers closer or farther from the base of the nipple, depending on the anatomy of their breast. It may take a bit to discover the best position for your fingers to obtain milk.

8.  If you are collecting the milk you express by hand, you will want to express into a wide mouth container. Your milk may flow from more than one pore at a time, creating a spray.

Pregnant? Download our free ebook 5 Crucial Ways to Prepare for Breastfeeding.

Moving swelling away from the nipple and areola

If you are having difficulty latching in the early days due to fullness, softening the brown area around the nipple (areola) with counter pressure can make latching easier. You do not need to soften the whole breast, just the area where the baby is going to latch.

  • Imagine where the baby’s lips will be when feeding; this will determine the placement for your thumb and first finger. For example, if you will be feeding in the football position, your baby’s lips will be horizontal across your breast. If you feed in a cross cradle position, your baby’s lips will be in a vertical position on your breast.
  • Push straight back towards the chest wall and count to 10. This will temporarily move the swelling away from the nipple.
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  • Expand the area you are softening by moving your fingers slightly to each side and repeating the process until just the area where the baby latches is softened.

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References and More Information:

  1. American Academy of Pediatrics. “Hand Expressing Milk” HealthyChildren.org,  21 Nov. 2015. https://www.healthychildren.org/English/ages-stages/baby/breastfeeding/Pages/Hand-Expressing-Milk.aspx
  2. Healthy Families B.C. “Get Started on Expressing Breastmilk.” HealthyFamiliesBC.ca, 10 Aug. 2013, www.healthyfamiliesbc.ca/home/articles/get-started-expressing-breastmilk.
  3. La Leche League GB, “Antenatal Expression of Colostrum.” La Leche League GB, 8 Apr. 2016, www.laleche.org.uk/antenatal-expression-of-colostrum/.
  4. Morton, J. et al. “Combining Hand Techniques with Electric Pumping Increases Milk Production in Mothers of Preterm Infants.” Morton, J, et al.  Journal of Perinatology : Official Journal of the California Perinatal Association, U.S. National Library of Medicine, Nov. 2009, www.ncbi.nlm.nih.gov/pubmed/19571815.
  5. Stanford Medicine, Newborn Nursery. “Hand Expression of Breast Milk.” Newborn Nursery, 2019, https://med.stanford.edu/newborns/professional-education/breastfeeding/abcs-of-breastfeeding/hand-expression-of-breast-milk.html
  6. Stanford Medicine, Newborn Nursery. “Hand Expressing Milk.” Newborn Nursery, 2019, https://med.stanford.edu/newborns/professional-education/breastfeeding/hand-expressing-milk.html
  7. Stanford Medicine, Newborn Nursery. “Maximizing Milk Production.” Newborn Nursery, 2019, https://med.stanford.edu/newborns/professional-education/breastfeeding/maximizing-milk-production.html
  8. Unicef UK, “Hand Expression” Unicef.org.uk. The Baby Friendly Initiative. https://www.unicef.org.uk/babyfriendly/baby-friendly-resources/breastfeeding-resources/hand-expression-video/

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