Hand Expression (Hand Milking)

Hand expression is a valuable skill for any breastfeeding parent. It requires no equipment, can be done anywhere, and many find it more comfortable than using a pump.

When to Use Hand Expression

Hand expression is useful in many situations:

• During pregnancy (from week 37 onwards) to collect colostrum if your baby may need supplements after birth
• After delivery when your baby isn't nursing effectively or frequently enough to stimulate milk production
• For relief from engorgement, sore breasts, or oversupply
• When separated from your baby and experiencing breast fullness
• To increase supply when combined with pumping or nursing
• For convenience when a pump isn't available or practical

Many parents prefer hand expression over pumping because of its simplicity and the direct control it provides.

Basic Technique

Preparation

1. Wash your hands thoroughly
2. Warm your hands if they're cold
3. Get comfortable in a relaxed position
4. Have water or another drink nearby
5. Prepare a clean container to collect milk

Stimulating Letdown

Before expressing, encourage your milk to flow:

• Gently massage your breasts in circular motions
• Apply warm compresses if helpful
• Look at your baby or a photo of them
• Think about your baby or listen to recordings of them
• Allow adequate time—stress and rushing can inhibit letdown

Expression Technique

1. Position your fingers: Place your thumb and two fingers approximately 2-3 cm (about 1 inch) behind the nipple, forming a "C" shape with thumb on top and fingers below

2. Press back: Push your fingers straight back toward your rib cage

3. Compress: Squeeze your thumb and fingers together, pressing toward each other

4. Release: Relax the pressure completely before repeating

5. Repeat rhythmically: Establish a press-compress-release rhythm similar to a baby's sucking pattern

6. Rotate position: Move your fingers around the areola to express from all areas of the breast

Important Tips

• Avoid sliding your fingers across the skin—this can cause friction and soreness
• Don't squeeze the nipple—this can be painful and doesn't effectively express milk
• Wipe fingers if they become wet and slippery
• Be patient—it may take a few minutes for milk to flow
• Expression should not hurt—adjust your technique if you feel pain

What to Expect

Colostrum (Early Milk)

When expressing colostrum in the first days after birth:

• Expect small amounts—drops rather than streams
• Colostrum is thick and often yellow or orange in color
• These small quantities are normal and perfectly suited to your newborn's tiny stomach
• Colostrum is highly concentrated with antibodies and nutrients

Mature Milk

Once your milk has transitioned:

• You may see streams or sprays of milk
• Volume varies depending on time since last feed and individual factors
• Milk may appear thin and bluish, or thicker and more yellow

Duration and Frequency

How long to express depends on your goal:

• For relief: Express just until comfortable (may be just a few minutes)
• To maintain supply: Express for 15-20 minutes per breast
• To increase supply: Express more frequently, even if yield is small

Combining with Other Methods

Hand expression works well alongside:

• Pumping: Hand expression after pumping can help fully empty the breast
• Nursing: Express before nursing to soften an engorged breast, or after to fully drain
• Hands-on pumping: Massage and compress while pumping to increase output

Storing Expressed Milk

Follow safe milk storage guidelines:

• Use clean containers designed for breast milk storage
• Label with date and time
• Refrigerate or freeze promptly if not using immediately
• Follow recommended storage times for your situation

Frequently Asked Questions

How often should I practice before birth?

If you choose to express colostrum during pregnancy (after week 37), once or twice daily is typically sufficient. Always consult your healthcare provider first, especially if you have a high-risk pregnancy.

Why isn't any milk coming out?

It can take practice. Ensure you're relaxed, try different finger positions, and give yourself time. If you consistently have difficulty, consult a lactation specialist.

Is hand expression as effective as pumping?

For many people, yes. Some find they can express more by hand than with a pump, particularly in the early days with colostrum. The best method is the one that works for you.

Track Your Expressing Sessions with Pumpe

Whether you're hand expressing or using a pump, keeping track of your sessions helps you understand your body's patterns and maintain your supply. Pumpe is designed specifically for parents who express milk regularly.

With Pumpe, you can:

• Log each expressing session including duration and volume
• Track your milk output to see trends over time
• Monitor your pumping schedule to maintain consistent supply
• Build and manage your milk stash with inventory tracking

If you're combining hand expression with pumping or nursing, Pumpe helps you see the complete picture of your milk production journey.

Download Pumpe on the App Store

References and Further Reading

• Ammehjelpen: Hand Expression (Norwegian) — Detailed guide on hand milking technique
• Ammehjelpen: Hand Expression Before Birth — Information on prenatal colostrum collection
• Ammehjelpen: Milk Storage — Guidelines for storing expressed milk

This content is for informational purposes only and does not replace professional medical advice. Consult your healthcare provider for personalized guidance.