Hand Expressing: How to Guide
- Victoria Lamb
- Sep 23, 2024
- 4 min read
Hand-expressing is the act of manually removing milk, or colostrum, from your breasts by hand. The UNICEF UK Baby Friendly Initiative considers it to be a useful skill that should be taught to all lactating parents.
It can be used in a variety of circumstances, including (but not limited to):
Antenatal colostrum harvesting
Expressing colostrum to tempt sleepy newborns (taste and smell are powerful senses!)
Expressing for comfort when engorged
Expressing colostrum and/or milk if you're separated from your baby, such as if they are in the neonatal unit
Collecting milk to be stored and used to feed via a bottle or SNS (Supplementary Nursing System).
Benefits of Hand-Expressing:
Convenience - you can do it anywhere, anytime
You only need your hands (and something to collect the milk in, if you want to)
Stimulates the breast, promoting more milk production
Excellent way of getting the oxytocin flowing!
Step-by-Step Guide:
If you're doing this for the first time, make sure you're warm, comfortable and relaxed.
Sitting in your favourite comfy chair, listening to some calming music or even laying in a warm bath can be excellent ways of relaxing yourself in preparation for hand-expressing. See further down for more relaxations and oxytocin promoting ideas!
Wash and dry your hands thoroughly before starting.
This reduces any potential contamination to the milk and your breasts.
Start by gently stroking and massaging the breast for at least a few minutes. The aim of the game with this is to increase oxytocin production, which is the hormone that helps milk flow and can stimulate a let-down.
You can use any technique you feel comfortable with, such as rolling the breast, kneeding, using nipple stimulation or light pressure all around the breast, whatever works for you.
Next, make a "C" shape with your forefinger and thumb.
Similar to how you would if you were demonstrating how big or small something is with your fingers! 🤏🏽
Place your thumb and forefinger on the breast, starting at the nipple (on the areola).
Sort of like you're trying to pinch your own nipple, except don't pinch!
Slowly walk your forefinger and thumb backwards (outwards) on the breast, applying light pressure, until you find an area that feels slightly bumpy and different to what you've already felt closer towards the nipple.
This area is usually around 2-3cm back from the nipple but it will vary between individuals.
Once you've comfortably found this area, push back towards your chest wall.
Press down with your thumb and forefinger, using a comfortable pressure, until you feel some resistance. If you experience any pain, stop and adjust your grip before trying again.
Whilst pressing down, compress (squeeze) your thumb and forefinger together for a few seconds, then release, then press down and compress again, repeating in a rhythm.
With any luck, some milk (or colostrum) should come out! Early on, you might only get a few drops at a time. Doing this rhythmically helps to simulate a baby feeding,
Once milk stops flowing from that area, you can rotate your thumb and forefinger and repeat on a different area of the breast.
You can go in whichever direction that works for you, but going clockwise might help you work systematically.
If you can't get any more milk out of that breast, move on to the other side and repeat!
You can keep going for as long as you're comfortable for. If you're just starting out, you could try doing a few minutes on each side and working your way up to longer sessions as you gain more confidence and experience.
If you're wanting to collect what you express, you can express directly into a bottle (for milk), a sterilised spoon or a syringe (for colostrum).
Don't feel disheartenened if you don't get much (or anything) the first time. Hand-expressing is a skill that can take some practice and it's normal that you might need to try a few times before getting the hang of it.
This video from UNICEF UK is a great video reference to use alongside these written steps.
As stated earlier, hand-expressing works best when you're warm, calm and relaxed.
Ideas for Relaxation and Encouraging Oxytocin:
Get some privacy
If other people being around makes you feel nervous or tense, try and find somewhere you can be alone (or ask others to leave!)
Keep your baby close (if they're already here).
If you can't have them nearby, smelling their clothes or looking at pictures of them can be really helpful. If you're doing this antenatally, stroking your bump or thinking about your baby works really well.
Breathing techniques
Those breathing techniques used during labour can be really great at helping you stay calm and relaxed
Have a bath
Laying in a lovely, warm bath can be an amazing way of getting into that relaxed state. If you're not much of a bath person, you could try doing it in the shower, but it would be much harder to collect anything you express without also collecting water (not recommended) so it's best suited to expressing for comfort rather than collection.
If you need, or want, any assistance with learning how to hand-express, make sure to reach out to a skilled lactation specialist such as IBCLC, Infant Feeding Coach, Breastfeeding Counsellor or Peer-Supporter.
