Hand Expressing - La Leche League International

Hand expression is a useful technique, and what’s more it’s convenient and free! If your baby can’t nurse or isn’t with you, expressing not only keeps him fed, it keeps milk production going. It’s a handy way to relieve engorgement. You can use it to stimulate milk production if you need to increase your supply, and to provide milk for your baby. Read about increasing your milk supply here INCREASING BREASTMILK SUPPLY – La Leche League International. You can also combine hand expressing with pumping – read more about pumping here.  Even if you usually use a pump, a pump failure or power outage isn’t a disaster with hand expressing as your backup. Hand expression is often used for antenatal expression of colostrum by mothers who have diabetes or expect to be separated from their babies after birth read more here. In the early days, if your breasts feel full and engorged, you can express a bit to soften them, making it easier for your baby to latch. Hand expression is simple to learn and gets easier with practice. Follow these steps: You can use any clean container you like to collect your milk, colostrum can be expressed into a small (five ml) container or even onto a teaspoon if you want to feed it to your baby immediately. Relax and get comfortable: your milk will flow more easily if you are warm and comfortable. Try the breathing exercises you may have learnt for use during labour. It can be easier to get your milk flowing if your baby is nearby. If she is not, try thinking about her, or looking at a photo or video recording of her. You may find that keeping a piece of clothing that smells of your baby close-by helps – this may be especially helpful if you’re separated from your baby, for example if your baby is in a Newborn Intensive Care Unit (NICU). Take some deep breaths and drop your shoulders. Gently massage your breasts with your hands and fingertips to stimulate your milk ejection reflex (MER or ‘let-down’) – this is the key to effective expressing. Bending forward with your breasts suspended means gravity can help milk flow. The following technique is described in The Art of Breastfeeding¹: First, gently massage your breast. You might also tug or roll your nipple. You might also use a warm cloth or warm water on your breasts as part of your preparation. Hold your breast with your fingers and thumb cupped around your breast in a C shape, an inch (2 to 3 cm) or so back from your nipple. COMPRESS your breast between your fingers and thumb, moving them towards each other. Don’t drag your fingers or thumb across the skin of your breast – the friction can make you sore. You may find it helpful to push your hand back towards your ribs just before you compress your breast. RELEASE the pressure without moving your hand from your breast. REPEAT, moving your hand to a different place around your breast after every few compressions or whenever milk flow stops, so that you compress all of your milk ducts. Releasing and repeating rhythmically helps to mimic the action of a baby breastfeeding. Move to the other breast, repeating all of the above steps. Learning to hand express is often a process of trial and error – experiment to find what works best for you. When you hand express during pregnancy, amounts are usually tiny, from nothing at all to a few drops. How much you get now does not predict how much you’ll get after birth! From the first few days after birth, when you get a spray of milk from at least one nipple pore (instead of drops or a dribble), you’ve found what works for you. Hand expression should feel comfortable. If it’s not, adjust what you’re doing until it feels okay. Allow time! Frequent, short sessions are usually more effective than infrequent, longer expressing sessions. See resources listed below for further information. LLL offers local support in over 80 countries: see if you have a local group by searching here. Information on online sources of support may be found here. https://llli.org/breastfeeding-info/online-support/ ¹La Leche League International, The Art of Breastfeeding (Ballantine Books, 2024), 398-402. Resources:The Power of Hand ExpressionPumping articleLLLGB Hand Expression of BreastmilkLLL USA, Working and Breastfeeding: My Experience with Hand ExpressionBreast Pumps vs Hand Expression – Do you need to own a pump? | La Leche League Canada Videos with good demonstrations of hand expression of breastmilk: https://firstdroplets.com by Dr. Jane MortonExpressing the First Milk – Small Baby Series by Global Health Media Project Hand expression video – Baby Friendly Initiative