Breastfeeding is supposed to be natural, right? Between all the pump parts, bottle parts, nursing covers, nursing pillows, nipple shields, and nipple creams you’ve amassed you may have started to question how “natural” this process really is.
It can feel like your baby’s whole nursery is filled with just breastfeeding equipment! How could anything natural require so much stuff?
In the United States, many parents are shocked to learn that they already have a great breastfeeding “pump” in their own hands. Literally!
While it can take a little while to get comfortable using your hands to express breast milk, there are many benefits to mastering hand expression even if you don’t use it all the time.
Intrigued? If you’re interested in learning more about hand expression, how to do it, and some tips for success, read on to get the lowdown on letdown.
Hand expression is using your hands to massage breast milk out of your breasts. Similar to a pump or your baby’s mouth, with hand expression your hand will act as a form of pressure and stimulation.
The goal: activating your milk ejection reflex and getting your breasts to let down lots of breast milk!
Step 1: Wash your hands and make sure any containers you intend to use for collection are clean.
Step 2: Find a comfortable place to express and try to relax. (Don’t be scared to dim the lights and cuddle up in a blanket.)
Before starting, it can help to visualize milk flowing or look at a picture of your little one if they’re not near. (For even more suggestions about how to get your breast milk flowing check out the tips section at the end of this article!)
Step 3: Hold your breast with your fingers and thumb around the breast in a “C” shape. Your fingers should be near, but not touching your areola. Lean forward with your breasts dangling towards the container that will be collecting expressed milk.
Step 4: Press your fingers and thumb back, towards your chest.
Step 5: Gently squeeze to compress your breast between your fingers and thumb. Slide your fingers towards your nipple without lifting off the breast.
Step 6: Release the compression without moving your hand from the breast.
Step 7: Repeat! Move your hand to a different part of the breast every few compressions or if you notice milk has stopped flowing when you apply pressure to a section. Make sure to compress all of your milk ducts to fully drain the breast. Try to release and compress rhythmically, like how a baby would apply pressure during a feed.
Feeling game to give it a try? Make sure to give yourself plenty of time to test it out. While hand expressing usually takes about 20 to 30 minutes once you’ve had some practice, the first few times typically take much longer as you get used to the hand motions involved.
Also, if you learn best through audiovisual presentations, check out this video. Remember practice makes perfect — or at least progress!
Since hand expression does involve some work (especially compared to some hands-free pumping options!), you may wonder when and why people do it. There are many reasons people choose to hand express. These include:
- Collecting colostrum when a baby needs to be in the NICU. Hand expression can actually result in more colostrum being preserved for feeding the baby than with pumping!
- Relieving engorgement and plugged ducts.
- Expressing milk when there isn’t access to a pump. Some people do not enjoy pumping and will choose to hand express over using a pump even when one is available.
- In combination with pumping or nursing to increase the breast milk supply. (You can see a video of this in action here.)
Hand expressing may seem like a lot of work, but it also offers plenty of benefits:
- Hand expression is always available — no need for an outlet or pump!
- You won’t have to worry about parts that break or need cleaning, because you don’t need tools!
- It’s free. With all the expenses in raising a child, free probably sounds pretty great.
- You can get out milk that you might not have been able to express using your pump. Believe it or not, your hand can actually be more effective than a pump. Many breastfeeding parents choose to hand express after feeding their baby and pumping to ensure that they have drained all the milk out of their breasts.
- Hand expression can help with clogged ducts. While you may not be able to get a pump or your baby to put pressure on just the right part of your breast to drain milk that’s stuck, you have more control over where pressure is applied when you use your hand. You also have greater control over the amount of pressure that is being applied to your breast during hand expression.
- Many breast or chestfeeding parents find hand expression empowering, according to the La Leche League, and for some this is an opportunity to get to know their breasts better.
Hand expressing sound good to you? There are a few things you’ll want to consider — especially during the first few times you try to hand express:
- Hand expression should not hurt. If you have any questions or think you might be doing something wrong, make sure to check in with a lactation consultant or attend a lactation support group.
- It takes practice to be efficient at hand expressing. In the beginning hand expression can be very time-consuming as you work with your breasts to figure out how best to release the milk. This won’t last forever, but you should make sure to give yourself plenty of time in the beginning, so that you don’t feel rushed or have any time pressure.
- Stress can affect your results. Remember to take a deep breath and visualize happy/calm things while you hand express. If stress from work or other situations is weighing on you, taking a second to meditate or watch a funny video can help to get you in the right head space.
- You may not express a lot at first. Before your milk volume increases (typically 3 to 5 days after giving birth), you won’t see a lot of milk being expressed. It’s still important to spend time touching your breasts, trying to hand express, and being skin-to-skin with your baby. Doing this will help to ensure that you have a healthy milk supply in the future. Don’t give up on hand expression if it seems like you’re not expressing any milk during this time.
- Use a warm compress on your chest region before expressing to help to get more milk out. (You can also try taking a warm shower or drinking a warm drink before hand expressing.)
- Look at a picture of your baby or listen to a video of them giggling while you hand express to help increase letdown and greater milk production if your little one is not nearby. (A baby blanket that smells like your baby can also be sniffed to trigger letdown and get those loving feelings flowing.)
- Visualize breast milk coming easily out of your breasts. Thinking about it can help to trigger the hormones and reflexes that you’ll need. Before beginning to hand express take a deep breath and relax your shoulders.
- Use gravity to your advantage. Make sure to lean forward and let your breasts dangle as you hand express.
- Create an environment that’s peaceful. Consider playing relaxing music, finding a very private space, and keeping the room sparsely lit while you hand express.
- Consider that good nutrition, plenty of fluids, and as much rest as possible are all helpful for producing sufficient breast milk. In order to take care of your baby, you also need to make sure to take care of yourself! Don’t be scared to ask for help.
Baby product advertisements can make it seem like you need a million supplies to breastfeed. While you may want to invest in a breastfeeding pillow and pump, you already have everything you need to hand express.
It can take a little time to master the art of pushing back, compressing, and releasing in a good rhythm to really get your breast milk flowing, but the reward of having a free, always accessible way of draining your breast milk is well worth it.
If you find you’re struggling with hand expression, have a clogged duct, or are worried that something else is wrong, it can be useful to speak with a lactation consultant or attend a local breastfeeding support group. There are also hotlines you can call to get support at all hours of the day.