Hand expressing might seem a bit old-fashioned when there are so many breast pumps available on the market these days.

There are times, though, when using your hands to collect breast milk beats the best of modern technology.

In the first hours and days after your baby is born, colostrum is incredibly important for babies.

You can read more about this in BellyBelly’s article Colostrum – 5 Important Ways It Helps Your Baby.

If your baby is unable to breastfeed directly after birth, expressing your colostrum will avoid the need for early formula supplementation. It will also kickstart milk production, which will begin the transition to mature breast milk.

The low volume and fat-rich colostrum is difficult to collect with a breast pump. Hand expressing, however, allows you to collect every precious drop in a small cup or even directly in a syringe.

Understanding how and why to hand express your breast milk is valuable knowledge for any breastfeeding mother.

Hand expressing breast milk

Here are 4 steps to expressing milk by hand:

#1. Don’t underestimate the results

One study involving mothers of full term babies found that expressing milk by hand in the first three days after birth, rather than using a breast pump to express milk, appeared to improve eventual breastfeeding rates at two months.

Other research by Jane Morton MD, has found when mothers of preterm infants use hand expression in combination with a pump to express breast milk, the average daily volumes of breast milk increased by 135 ml, compared with mothers who used just a breast pump to express milk.

Remember, your newborn has a tiny belly on the first day of life; it’s about the size of a marble. It makes perfect sense that you are only able to express very small quantities of breast milk by hand for feeding your baby in the early days. It’s the right amount for newborns’ little bellies.

#2. Press, compress, release… repeat

Here are simple steps to follow when using hand expression to express breast milk:

Place your fingers and thumb on either side of your nipple, roughly at the edge of your hand in a ‘C’ hold
Imagine a line running from your thumb, across the nipple to your second finger
Press back into the breast tissue, towards your chest
Compress your fingers and thumb towards each other, ‘sandwiching’ the breast tissue between them
Release the pressure, without moving your hand away
Repeat, repositioning your fingers and thumb ‘around the clock’ as you work on different parts of the breast.

Some mothers find that applying a warm compress to the breasts, prior to beginning hand expression, helps the milk flow.

Important note:

When you are compressing the breast, it’s important to note that your fingers and thumb should be at either side of the base of the nipple. Remember, hand expression should not hurt. If you find it painful, it could be because you’re applying too much pressure.

Going gently helps to make the experience comfortable and avoids damage to the delicate milk ducts close to the nipple.

#3. Find your rhythm

With practice, you will begin to work out which parts of your breast respond best and how long to maintain the compression. You’ll eventually develop a technique involving your hands and your milk flow.

When the flow eases on one side, switch to the other breast and work backwards and forwards between them.

Once both sides slow down, take a break for a few minutes and then begin the process again.

Colostrum will ooze or weep from the nipple, especially in the first day or so. As your milk begins to change, you might see droplets or, occasionally, even sprays.

Once lactation is established, you can expect more of a flow – either dripping or spraying – as you express.

Find out more about how hand expressing works by watching this video.

#4. Drop by drop

To begin with, the amount of expressed milk can be measured in drops. Gradually, you will see the volume increasing. At this stage, you could move from collecting the drops in a syringe to collecting the milk in a small clean container. Eventually, you might even hand express directly into a bottle.

In these early days, how much you express isn’t as important as how often you express. If your baby is not latching well or not breastfeeding effectively, hand expression lets your body know you still want to establish a full breast milk supply. Hand expression helps you get off to a great start.

Hand expressing can also help relieve engorgement in the early days postpartum.

For more tips on relieving engorgement you can read BellyBelly’s article Engorgement – Relief For Breast Engorgement.

For information about expressing milk with a breast pump, you can read our article This Technique Can Double the Amount of Milk You Express!

Colostrum harvesting during pregnancy

Did you know that you don’t have to wait until your baby has been born to begin practising hand expression?

‘Antenatal expression’ is the term used for expressing colostrum during pregnancy.

Here are a few reasons a mother might chose to do this:

It makes sure the baby’s first feed will be colostrum, even if the mother and baby are separated after birth
It means there’s a back up supply if the baby is not feeding effectively from birth and supplementation with extra milk is required
The mother might be having an elective c-section and is aware that the medications used in surgery could affect her baby’s sucking skills immediately after the baby is born
If the baby is know to have a congenital condition during pregnancy, which could affect breastfeeding after birth
If the mother has risk factors such as high blood pressure or gestational diabetes
It’s useful practice for expressing breast milk by hand before the baby arrives.

You can read more about this in BellyBelly’s article Expressing Colostrum During Pregnancy.