The benefits of hand expressing…

Hand expressing is a really useful skill to learn as it allows you to take care of your breasts and prevent potential problems like blocked ducts or engorgment, Sally Tedstone, Midwife and Infant Feeding Specialist provides her tips


What are the benefits of hand expressing breastmilk over pumping?
Hand expressing is great because it can be done anywhere, without the need for special equipment and allows you to target specific areas of the breast such as a lumpy area which could be a blocked duct which, if left could lead to mastitis. It is also gentler than pumping if you are suffering with sore nipples or engorged breasts. If you need to express when your baby is only a few days old hand expressing is usually much easier and your milk will be thick and sticky and every drop is precious.
Before you start wash your hands with hot water and soap.

Stimulating a let-down response to get milk flowing
If you are away from your baby, you can encourage your milk to flow by gently massaging your breasts and stimulating them in a way which feels nice. Focus on finding pleasant sensations to help activate milk flow. Being relaxed and warm is a good way to get your milk flowing so the bath or shower can be a good place to try for the first time.

How to hand express
The next step is simply to express. Make a C shape with your thumb and forefinger and find a the right spot for you. This is usually, about 2 cm back from base of your nipple, where, if you squeeze your thumb and forefinger towards each other a drop of milk comes out. Keep up a steady rhythm of compress and release after a while your milk will start to flow. If it doesn’t then your fingers are probably not in quite the right spot, so move them a bit, usually a bit further back from the nipple. Don’t pinch or drag your fingers across your skin as this will hurt . Once the milk flow slows down a bit then you can move your fingers. If you think of a clock face, you may have started with our thumb at 12o’clock and your finger at 6 0’clock, when you move you can move your fingers to about 10 and 2 and so on until you have expressed the whole of your breast, then swap to the other side.

If you have a lumpy area and are trying to relieve this then place your C shape in the bit of the clock where your lumpy bit is.
Place the C of your fingers on your breast and gently bring the thumb and forefinger together, not in a hard pinch but a gentle squeeze and build up a steady rhythm. If it is working you will see, firstly If there is an area of the breast where it feels particularly engorged, hard, lumpy or different in texture this can be a good place to start. drops and then squirts of milk emitting from the nipple which you can catch in a clean pot or bottle.

What if it is not working?
If it does not work at first, do not worry, instead try a slightly different hand formation, change of rhythm or position to express from until it works for you. Keeping relaxed is really helpful. Don’t put pressure on yourself to get it perfectly first time as this will only make it harder.

Top tips

1. As with breastfeeding, expressing is a skill which takes practice and it is a good idea to get the hang of breastfeeding before attempting to express milk by hand.

2. How can get the milk flowing? It is much easier to express milk if the hormones which summon your milk are flowing. This is easy if you have just been feeding your baby or are spending time with them, as this closeness helps your milk to flow well. If you are not with your baby and need to hand express you can look at a photo of your baby to help stimulate your bonding hormone oxytocin, which gets your let down reflex started.

3. Hand first then pump. Even if you are going to use a pump to express you can start with hand expressing which some mums find a better way to get started.

4. Hand express to improve latch. If you have very engorged and hard breasts it can help to hand express to just expel some milk so the nipple area softens up making it easier for your baby to take a big mouthful of breast and then feed and empty the breast themselves more efficiently.