The Low-Tech Approach: Hand Expression
Expressing milk by hand works very well for some women. It’s a handy skill to have when:
- You are caught somewhere with full breasts and you don’t have your baby or a breastpump, you’ll be able to relieve breast fullness and avoid problems with engorgement.
- You do not need to express milk regularly.
- Your breasts are more responsive to the skin-to-skin feeling of hand expression than to plastic pump parts.
- Position your hand on your breast, with the thumb above and fingers underneath, about an inch to an inch-and-a-half behind the nipple. If your breast were a clock, your thumb would be at 12 o’clock and your fingers at 6 o’clock. Don’t cup your breast in your hand. Instead, your thumb and fingers should be directly across the nipple from each other.
- Press your thumb and fingers directly back into the breast tissue, towards the wall of your chest. Don’t move them further apart. Just press straight back into the breast.
- Roll your fingers and thumb forward to squeeze milk out of the milk sinuses, which are located under the areola behind the nipple. Don’t slide the thumb or fingers along the skin–this will quickly make you sore.
- Repeat this sequence–position, press, roll–until the milk flow ceases. Then move your hand so that the thumb and fingers are positioned at 11 and 5 o’clock and do it again. Use both hands to work your way around one breast, then switch to the other side until you have emptied all of the milk sinuses. As soon as you see milk squirting from your nipple, you know you are compressing the underlying milk sinuses. (This position is also where baby’s gums should be during efficient latch-on.)
- The trick to hand expression is discovering where to position your fingers. Experiment until you find the right spot. Having someone show you how is very helpful, too.
- Combining hand-expression with breast massage can be a very effective way to stimulate the milk-ejection reflex. Massage first, then express. Massage again, and repeat the hand- expressing routine.
“When I relaxed, I could pump more milk. A friend who’s a dairy farmer told me that cows yield less milk when they’re in a bad mood or if milked by a stranger.”
When you hand-express, milk sprays out in all directions.
- If you’re expressing just to make your breasts more comfortable, you can lean over a sink or express into a towel.
- If you want to save the milk, you’ll need something in which to collect it. Some mothers manage to aim the nipple directly into a baby bottle. Or, try a container with a wider mouth, like a coffee cup or a small jar. As the cup fills up, transfer the milk to a storage container.
- The Medela company makes a special funnel for hand-expression that collects the milk and channels it down into a standard baby bottle.