Babies Breastfeeding Pumping & Storing How to Hand Express Breast Milk Step-by-Step Instructions By Donna Murray, RN, BSN Donna Murray, RN, BSN Facebook Twitter Donna Murray, RN, BSN has a Bachelor of Science in Nursing from Rutgers University and is a current member of Sigma Theta Tau, the Nursing Honor Society. Learn about our editorial process Updated on September 20, 2022 Medically reviewed by Rebecca Agi, MS, IBCLC Medically reviewed by Rebecca Agi, MS, IBCLC Rebecca Agi, MS, IBCLC is a board-certified lactation consultant and founder of Best Milk LA, a lactation consulting service. She is a nationally recognized lactation expert, who's been featured in several media outlets. Learn about our Medical Review Board Print Verywell / Mira Norian Table of Contents View All Table of Contents How to Hand Express Milk Step 5 When It's Helpful Pros and Cons The hand expression of breast milk, also called manual expression, is a technique where you use your hands instead of your baby or a breast pump to get the breast milk out of your breasts. This skill is fairly simple to learn and is a good technique to know and practice when you begin breastfeeding so that you’ll be ready if and when you need it. Read on to find out how to hand express breast milk including when it is most helpful. How to Hand Express Milk Expressing breast milk by hand is a skill that may take time and a little practice to learn how to do it properly. You can follow these steps to express breast milk by hand. Remember to have a storage bottle, cup, or bowl ready to catch the expressing milk. Here are the step-by-step instructions for hand expressing breast milk. Step 1 Wash your hands with soap and water. Step 2 Get into a comfortable position and try to relax. Step 3 Place a warm towel on your breasts or gently massage your breasts for a few minutes before you begin to help get the breast milk flowing. Step 4 Use a photo of your baby. Your baby could also be nearby; if not, that’s when it’s helpful to have a photo, a sound recording of your child making sounds, or a blanket with your baby's scent, or try other relaxation techniques like music to help stimulate your let-down reflex. Verywell / Mira Norian Step 5 Position your hand on your breast in the C-hold. That is, place your thumb on the top of your breast and your fingers underneath your breast so that your hand is in the shape of a C. Your thumb and your fingers should be 1 to 2 inches behind your nipple. Step 6 Hold a clean collection cup or breast milk storage bottle under your breast with your other hand so that your nipple is directly above it. Verywell / Mira Norian Step 7 Begin to gently push your breast back toward your body with your thumb and fingers. Step 8 Bring your thumb and fingers together. Then, use a rolling motion as you move your hand forward toward your original starting position. The gentle rolling motion will move the breast milk out of the milk ducts. Use firm but gentle pressure as your breast tissue is sensitive and can be bruised or damaged if you are too rough. Verywell / Mira Norian Step 9 Lean forward a little bit to collect the breast milk that should be dripping or spraying out of your nipple. Be careful to get the breast milk into your collection container without any of the milk touching your hands first. Step 10 Repeat steps 7 and 8 at a steady, rhythmic pace until there isn't any more breast milk coming out or until you have alleviated the fullness of engorgement. If you intend to completely drain your breasts, rotate your hand to another position around the nipple (C, U, backward C, upside-down U) to express from all areas of the breast and begin the process again. Step 11 Switch breasts when the flow of breast milk stops. Verywell / Mira Norian Step 12 Give your baby the milk you expressed right away or seal it in a breast milk collection bag or container and store it to use at a later time. How Long Can Breast Milk Stay Out? When Hand Expression Is Helpful You may wonder why anyone would want to express their breast milk by hand when they could use a breast pump. While many people who breastfeed use a breast pump, especially if they need to pump very often, hand expression is still a valuable skill to learn. This technique comes in handy when: A source of electricity is not available, your pump stops working, or it needs new batteries. Another option in these situations is to use a hand-powered pump. Your breasts are engorged and hard right before breastfeeding, so you may express a little bit of breast milk to soften them and make it easier for your baby to latch on. Your breasts become full and uncomfortable while you're away from your baby, and you don't have your breast pump with you. You're collecting colostrum for your preemie or newborn and since there's only a small amount, you want to get as much as you can without losing any in the pump parts or tubing. Breastfeeding Questions and Answers Pros and Cons of Hand Expression There are multiple benefits and drawbacks to hand expression—and some people feel more or less comfortable and efficient with the technique compared with pumping. Pros Natural and cost effective No equipment needed Quiet and readily available Can be more comfortable and effective than a breast pump Cons Requires practice Time consuming Doesn't work for everyone Pros There are multiple reasons to learn hand expression and many people find it helpful. Some positives include that some people do not like the feeling or sound of using a machine to pump their breasts. Also, hand expression is always available. It's free and no equipment is required other than a collection container. Plus, if you express breast milk by hand before and after using a breast pump you may get more breast milk than if you only pump. Learning how to use hand expression can help you become more comfortable with your breasts and more aware of what's normal and not normal. Plus, it could help you notice any changes in your breasts that may need attention. Cons However, even though it's a useful skill, there are a few downsides to hand expression as well. One con is that it takes practice to become good at expressing your breast milk by hand, so you'll have to invest a little time into learning to use the technique and getting comfortable with it. Using a breast pump may be quicker and more efficient for you. Additionally, some people just have trouble with hand expression and can't get much or any breast milk to express. A Word From Verywell When you're in the hospital after the birth of your baby, ask your nurse or the hospital's lactation specialist to teach you how to hand express your breast milk. If you want to learn the technique, or you have any questions after you leave the hospital, you can contact your doctor, a lactation consultant, or a local breastfeeding group for support. 7 Tips to Make Breast Pumping Easier 4 Sources Verywell Family uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Mohd Shukri NH, Wells JCK, Fewtrell M. The effectiveness of interventions using relaxation therapy to improve breastfeeding outcomes: A systematic review. Matern Child Nutr. 2018;14(2):e12563. doi:10.1111/mcn.12563 Altuntaş N, Ünsal A. Which hand position in breastfeeding is better for milk intake: Palmar grasp or scissor grasp? A pilot study. Breastfeed Med. 2019;14(9):662-665. doi:10.1089/bfm.2019.0126 University of Michigan Health System. Hand expression technique. Stanford Medicine. Hand expression of breastmilk. Additional Reading Lawrence RA, Lawrence RM. Breastfeeding A Guide For The Medical Profession, Seventh Edition. Elsevier. Ohyama M, Watabe H, Hayasaka Y. Manual expression and electric breast pumping in the first 48 h after delivery. Pediatr Int. 2010;52(1):39-43. doi:10.1111/j.1442-200X.2009.02910.x Riordan J, Wambach K. Breastfeeding and Human Lactation, Fourth Edition. Jones and Bartlett Learning. By Donna Murray, RN, BSN Donna Murray, RN, BSN has a Bachelor of Science in Nursing from Rutgers University and is a current member of Sigma Theta Tau, the Honor Society of Nursing. 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