Everything You Need to Know about Hand Expression
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If you are separated from your baby or your baby is not feeding well, you may need to begin expressing your milk. While there are a few different ways to accomplish this, research shows hand expression to be the most effective initially and have the best long-term outcomes. But let’s be real, some moms are not comfortable with this. This is the first time they’ve ever touched their breasts this much and they’re sort of weirded out. Read below to see why it’s helpful if you’re down for it.
What is hand expression?
It is using the massage and compression of your hands, with or without assistance from a partner, to express breastmilk. The only gadgets involved are something in which to collect the milk.
Why use hand expression?
- massage and compression are more effective at emptying the breast than suction alone (like a pump provides)
- more effective at removing the colostrum which has a thick, honey-like consistency
- requires no equipment (except a cup or a spoon to collect the milk)
- can be done anywhere
- big boost to a mother’s confidence since she is able to see the drops and know her body is producing colostrum (this often doesn’t happen when a mom first starts using the electric pump, which can be discouraging)
How is hand expression done?
- begin with clean hands and a clean container to collect the milk
- gently massage both breasts all over
- sitting upright or leaning forward can let gravity assist you
- with your hand in the shape of a “C”, place your fingers and thumb just behind your areola
- press back towards your chest
- compress your breast
- gently move fingers towards nipple
- do this all over the breast in various locations to compress all milk ducts
- you can do one breast at a time or go back and forth between the breasts for about 10 minutes
- you might not see colostrum or milk right away, it will take practice to learn what is effective
When to hand express:
- as soon as possible, preferably within an hour of delivery, if separated from baby
- by 12 hours of age if baby has not fed
- for any missed feeding after 12 hours of age
- prenatally, if no risk for preterm labor, starting in your last 2-3 weeks of pregnancy (This is helpful if you anticipate blood sugar issues. Read more here.)
How often to hand express:
- for any missed feedings OR
- as if the baby were feeding, at least every 3 hours around the clock for about 10 minutes
Other ways to express milk:
- Double electric hospital grade pump
- Double electric personal use pump
- Single electric pump
- Manual pump
My experience with hand expression:
As I’ve said in other places, I was not in the medical field and was super skeptical of all of the staff when I had my first baby. I had a few things stacked against me: I was a teenager, my baby was big (9lbs, 11oz), I delivered via c/s, I was a know-it-all. My baby went to the nursery for breathing issues initially, and I was vigilant about telling every nurse that he was not to be fed unless I was breastfeeding him. Once he finally came out to my room, I was terrified they would take him back to the nursery. He was very sleepy (normal), so to keep the monkey off my back, I asked for a syringe and I started hand expressing and feeding him any colostrum I could collect. I did this for a day or two. I didn’t tell the nurses that I was doing it. I just told them he nursed well. Maybe it was my maternal instinct? I don’t know. But either way, he finally perked up and started nursing well, the hand expression was temporary, and I was able to avoid having to supplement or having him go back to the nursery.