Tips for hand expressing milk adapted from Working and breastfeeding made simple.

Nancy Mohrbacher looks at the burning issues facing working women who want to continue breastfeeding when they return to work, including how to deal with the challenges of:

  • Milk production
  • Maternity leave
  • Pumping and breast pumps (in depth)
  • Flexible job options
  • Child care
  • Milk storage and handling
  • Work-life balance and more.

 Expressing milk by hand

Hand expression can be a useful way to:

  • Relieve breast fullness
  • Boost milk production
  • Provide milk for your baby.

Prep

  • Wash your hands
  • Take a wide-mouthed container to collect your milk
  • Find a comfortable and private room
  • Relax as this enhances milk flow.

Method
This is based in part on the World Health Organization technique.

Before expressing, gently massage your breasts with any or all of the following:

  • your hands and fingertips
  • a soft baby brush
  • a warm towel

Sit up and lean slightly forward, so gravity helps the milk flow.

With your thumb on top of the breast and fingers below, both about 1.5 inches (4cm) from the base of the nipple, apply steady pressure several times into the breast toward the chest wall. Some mothers find it helps to curl their hand and use just the tips of their fingers and thumb.

If no milk comes, shift finger and thumb either closer to or farther from the nipple and compress again a few times. Repeat, moving finger and thumb until you feel slightly firmer breast tissue and gentle pressure yields milk. Find your “sweet spot” (the area on your breast where milk flows fastest when it is compressed). After finding it, in future, start directly with your fingers in this area.

Apply steady pressure on areas of milk in the breast by pressing fingers toward the chest wall, not toward the nipple.

While applying inward pressure on the breast, compress thumb and finger pads together (pushing in, not pulling out toward the nipple). Find a good rhythm of press—compress—relax, like a baby’s suckling rhythm.

Switch breasts every few minutes (5 or 6 times in total at each expression) while rotating finger position around the breast.

After expressing, all areas of the breast should feel soft. This process usually takes about 20 to 30 minutes.

Hand expression should be comfortable. If it’s not, you may be compressing too hard, sliding your fingers along the skin, or squeezing the nipple. If you feel discomfort, review the instructions and adjust your technique. Find the method that works best for you.

The following two video demonstrations may help:

and

click for this one from Stanford Medicine.

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