How to Hand Express Breast Milk

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 pretty easy 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.

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.

How to Hand Express

Expressing breast milk by hand is a skill. Just like any other skill, it may take time to learn how to do it properly. Practice the technique to become get the best results. You can follow these steps to express breast milk by hand. Remember to have a storage bottle, cup, or bowl ready.

1. Wash your hands with soap and water.
2. Get into a comfortable position and try to relax. You can 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.
3. 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.
4. 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.
5. 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.
6. Begin to gently push your breast back toward your body with your thumb and fingers.
7. 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.
8. 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.
9. Repeat steps 6 and 7 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.
10. Switch breasts when the flow of breast milk stops.
11. 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.

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

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.