How to Hand Express Breastmilk (When You Should & Why You’d Want To)

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Knowing how to hand express breastmilk is a must for breastfeeding parents. This post explains how to do it and when it’s better to hand express than use a breast pump.

Every breastfeeding parent should know how to hand express breastmilk. But with modern breast pumps easily available, hand expression has become something of a lost art.

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Knowing how to hand express breastmilk is a must for breastfeeding parents. Sometimes it's more effective than pumping! Here's how to do it.

Hand expressing breastmilk might seem like it would be tedious and maybe even unnecessary, but there are times when it can actually be more effective than a breast pump.

WHEN SHOULD YOU hand express breastmilk?

  • Your breasts are full and you don’t have access to baby or a breast pump. Perhaps you’re away from baby and you forgot to bring a pump with you, or you don’t have a way to power one. Either way, sitting with full breasts can be extremely uncomfortable. Allowing the breasts to stay full for long stretches of time can also put you at increased risk for clogged ducts, mastitis, and low milk supply. It’s important to regularly remove milk from your breasts.
All of this milk was collected via hand expression by a breastfeeding parent struggling with oversupply. Eventually, her supply regulated and she no longer needed to hand express to feel comfortable.
  • You are struggling with oversupply. Oversupply is often a vicious cycle: When you make a lot of milk, your breasts can feel uncomfortably full, and you’re at increased risk for clogged ducts and mastitis if that milk stays in your breast too long. But if you drain your breasts, your body gets a signal to keep making more milk, leaving you uncomfortably full once again. Instead of keeping clogs and mastitis at bay by pumping, you should try hand expressing milk to comfort instead. Hand expression is a different type of breast stimulation that allows you to remove just enough milk to get comfortable without triggering even more milk production.
  • You are trying to express colostrum (early milk). It’s usually easier and more effective to “squeeze” colostrum out of the breast using manual breast compressions than to rely on the suction of a pump. Furthermore, it’s normal for colostrum to come out only drops at a time, and those precious drops can sometimes get lost in the crevices of your pump parts:
There are a number of crevices in pump parts where drops of colostrum can get stuck. Since colostrum only comes out drops at a time, every drop matters!
There are a number of crevices in pump parts where drops of colostrum can get stuck. Since colostrum only comes out drops at a time, every drop matters!

Pro-Tip: If you are expressing colostrum after birth to supplement a baby who is breastfeeding, hand expression is usually the best way to maximize your milk output. If you are expressing colostrum after birth for a baby who isn’t able to breastfeed at all (i.e. expressing for a missed feed), try pumping for about 20 minutes after you’ve finished hand expressing. Hand expression will optimize your milk output, and pumping after will provide your breast the extra stimulation your baby isn’t yet able to provide.

  • You aren’t very responsive to a breast pump. Some breastfeeding parents aren’t very responsive to a breast pump. Their baby can remove milk just fine, but the pump just doesn’t get much milk out. Sometimes this can happen if you have very stretchy, “elastic” nipples, or if you’re using the wrong breast shield size (Pumpin’ Pals inserts or BeauGen pump inserts might help with this). If you find you’re not very responsive to a breast pump but you need to express milk, hand expression is the way to go.

How to Hand Express Breastmilk:

Step 1. Begin by grabbing a clean collection container (a cup or empty bottle works), and washing your hands. Then massage the breasts for a minute or two. Consider expressing after a warm bath or shower (applying gentle heat to the breasts can help).

(The following images depicting hand expression technique are reproduced with kind permission from Off to a Good Start: All You Need to Know About Breastfeeding © Public Health Scotland 2020)

Breast massage before hand expressing breastmilk (step 1)
© Public Health Scotland 2020

Step 2. Position the pads of your thumb and fingers just behind the areola (the darker skin around your nipple), with your thumb on top of the nipple and your fingers below. You’ll be making a “C” shape around your nipple with your hand.

Hand expressing breastmilk step 2
© Public Health Scotland 2020

Step 3. Gently press your breast towards to chest wall to put pressure on the milk ducts.

Compressing the breast (step 3)
© Public Health Scotland 2020

Step 4. Compress your breast between your fingers and thumb to help the milk flow towards the nipple. 

Releasing breast compression (step 4)
© Public Health Scotland 2020

Step 5. Release compression and repeat steps 3 and 4 rhythmically. 

Step 6. When milk stops flowing, rotate your hand. If you think of the face of your nipple like a clock, your fingers were at 12 and 6. Rotate your your hand so that your fingers are at 1 and 7, 2 and 8, and so on. 

Rotating around the breast while hand expressing (step 5)
© Public Health Scotland 2020

HAND EXPRESSION IS A Learned Skill

If hand expressing isn’t very easy or effective at first, don’t get discouraged. Hand expression is a learned skill: You get better at it with time and practice. And your body starts to become more responsive to it over time as well!

If you need help with hand expression, reach out to an International Board Certified Lactation Consultant (IBCLC) in your area who comes highly recommended. Or if you’re in the hospital after birth, ask if there is an IBCLC on staff who can assist you.

Boost Your Milk Supply & Keep It Up

Our FREE guide will give you 5 simple, proven tips to boost your milk supply and increase your pump output. Get results in as little as just a couple days!

If you enjoyed this post, be sure to check out our digital library of helpful resources that quickly teach how to avoid common breastfeeding problems and give you the peace of mind and confidence you need to meet your breastfeeding goals.

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