Hand expression is a simple, effective method of removing breast milk using only your hands. This technique is often more effective than a breast pump for collecting the thick, concentrated colostrum immediately after birth. It is a valuable skill for stimulating milk supply, especially in the first few days postpartum, and can increase overall output when used alongside pumping. Hand expression is also useful for addressing common issues like breast engorgement by softening the tissue, which makes it easier for a baby to latch. Since it requires no equipment, it provides a convenient way to remove milk anytime or anywhere.
Preparing for Hand Expression
Creating a calm environment is important because oxytocin is needed to trigger the milk ejection reflex, or “let-down.” Relaxation techniques like taking deep breaths or gentle stretching can help. Leaning slightly forward allows gravity to assist the milk flow into your collection container. If your baby is not nearby, looking at a picture of them or thinking about them can help stimulate the let-down reflex.
Before beginning, wash your hands thoroughly with soap and water to maintain hygiene. Ensure your collection container is clean, such as a food-grade cup, bottle, or syringe, preferably one with a wide opening to catch droplets.
Gently massage the breast with your fingertips, using light, circular motions from the chest wall toward the areola. Warm compresses or a gentle shake of the breast can also encourage milk to begin flowing from the ducts.
Step-by-Step Guide to Hand Expression
Once your breast is stimulated, position your hand to form a “C-hold.” Place your thumb above the nipple and your index finger below it, about one to two inches back from the base of the nipple. This placement should be behind the areola, where the milk ducts are located, and not on the nipple itself.
Next, push your thumb and finger straight back toward your chest wall, applying pressure toward the ribcage. While maintaining the inward pressure, gently compress your thumb and fingers together. After a brief compression, release the pressure and repeat the entire motion in a rhythmic pattern: push back, compress, and release. Avoid sliding your fingers over the skin, as this can cause irritation and is less effective.
As the flow of milk slows down, rotate your thumb and finger position around the areola, similar to the hands of a clock. This ensures you are expressing milk from all the ducts. If you feel discomfort, adjust the placement of your fingers, as hand expression should not cause pain.
Safe Handling and Maximizing Flow
To maximize the amount of milk expressed, switch back and forth between breasts when the milk flow slows on one side. Alternating sides stimulates multiple milk ejection reflexes, increasing your overall yield. If you are expressing milk for a full feeding, aim for a total session time of 20 to 30 minutes, switching sides multiple times throughout.
Freshly expressed milk can remain at room temperature (77°F or colder) for up to four hours, but it is best to use or store it sooner. For longer storage, refrigerate the milk for up to four days or freeze it for six to twelve months in the back of the unit where temperatures are most stable.
Milk should be stored in clean, food-grade containers or specialized breast milk storage bags, avoiding general household plastic bags. Labeling each container with the date of expression is necessary to ensure you are using the oldest milk first. If you are adding freshly expressed milk to a refrigerated or frozen container, you must first cool the new milk thoroughly to prevent thawing the already stored milk.