Hand expression (HE) is the technique of using one’s own hands to remove milk from the breast, offering an alternative to using a mechanical pump. Hand expression is a simple, no-equipment method that can be immediately useful. Learning this skill is beneficial for new parents, especially in the first few days after giving birth or during unexpected situations. This technique can help stimulate milk flow and provide sustenance for the baby when other methods are unavailable.
When Hand Expression is Most Useful
Hand expression is particularly valuable during the initial postpartum period, especially when collecting colostrum, the first milk produced. Colostrum is thick and small in volume; studies suggest that hand expression may be more effective than pumping at removing this concentrated, early milk. Collecting colostrum in small syringes ensures that every drop of this antibody-rich substance is saved for the newborn.
This method is also highly effective for managing sudden breast fullness or discomfort, known as engorgement. Removing a small amount of milk by hand can soften the areola, making it easier for a baby to latch. Targeted pressure can also be used to help clear a blocked milk duct or alleviate symptoms associated with mastitis.
The technique requires no electricity or special tools, making it an excellent choice for emergencies or when a pump is not accessible. Combining hand expression with a pumping session can help drain the breast more fully, which may lead to an increase in overall milk production. Even after the milk flow from a pump has stopped, hand expression can often remove residual milk, ensuring better breast drainage.
Mastering the Hand Expression Technique
A successful hand expression session begins with proper preparation to encourage the milk ejection reflex, often called the let-down reflex. Start by washing hands thoroughly with soap and water to maintain hygiene. Finding a comfortable, relaxed position and gently massaging the breast can help stimulate the hormones necessary for milk release.
Light massage, gentle stroking, or applying a warm compress before starting can encourage milk flow. Looking at a picture of the baby or focusing on their scent can also trigger the release of oxytocin, the hormone responsible for the let-down. Prepare a clean, wide-mouthed container or a small syringe, especially for colostrum, to catch the milk.
To begin the technique, place the thumb above the nipple and the fingers below the nipple, forming a “C” shape. This position should be about one to two inches behind the areola, where the milk ducts are located. The exact spot will vary slightly, so some trial and error may be necessary to find the most effective position.
Next, press the fingers and thumb backward into the breast tissue, toward the chest wall. Avoid squeezing the nipple directly, as this can cause pain or damage. The movement should press the milk forward from the milk ducts toward the nipple.
Maintain the pressure and then gently compress the thumb and fingers together, using a slight rolling motion toward the nipple to express the milk. This action mimics the way a baby’s mouth compresses the ducts during a feed. Release the pressure, and then repeat the motion in a rhythmic pattern: press back, compress, and release.
Continue this rhythmic pattern until the flow of milk slows to a drip. Reposition the thumb and fingers around the areola to drain milk from different sections of the breast. Expressing from multiple positions ensures the entire breast is drained efficiently. Once the flow significantly slows, switch to the other breast and repeat the process. Hand expression should not cause pain; if it does, the technique needs adjustment.
Safe Storage Guidelines for Expressed Milk
Once the milk has been collected, proper storage is necessary to preserve its nutritional quality and safety. Always use containers specifically designed for human milk storage, such as BPA-free hard plastic, food-grade glass, or specialized breast milk storage bags. Containers should be sealed with tight-fitting lids and never filled completely, as milk expands when frozen.
Each container must be clearly labeled with the date the milk was expressed, ensuring the oldest milk is used first. Freshly expressed milk can be kept at room temperature (77°F or 25°C or colder) for a maximum of four hours. If it will not be used within that time, the milk should be moved to a refrigerator or freezer immediately.
In the refrigerator, milk is best stored toward the back, where the temperature is most consistently cool, and can be safely kept for up to four days. For longer storage, freezing the milk right away is recommended to preserve its quality. Stored in a standard freezer with a separate door, milk is acceptable for up to nine months, though six months is often considered best.
For optimal long-term storage, a deep freezer maintains the coldest temperature and allows for storage for up to 12 months. It is helpful to freeze milk in small quantities (two to four ounces) to minimize waste. Once frozen milk is thawed in the refrigerator, it must be used within 24 hours and should never be refrozen.