Babies Breastfeeding Pumping & Storing How to Hand Express Breast Milk By 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 Donna Murray, RN, BSN Reviewed by Reviewed by Rebecca Agi, MS, IBCLC on May 05, 2020 Rebecca Agi, MS, IBCLC is a board-certified lactation consultant and founder of Best Milk LA, a lactation consulting service. Learn about our Review Board Rebecca Agi, MS, IBCLC Updated on May 05, 2020 Print VOISIN/Getty Images Table of Contents View All Table of Contents Why Hand Expression Is Useful How to Express by Hand Pros and Cons Where to Find More Information 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. Why Hand Expression Is Useful You may wonder why anyone would want to express their breast milk by hand when they could use a breast pump. While most women will 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: Your breasts become full and uncomfortable while you're away from your baby, and you don't have your breast pump with you.A source of electricity is not available, your pump stops working, or it needs new batteries.Your breasts are engorged and hard right before breastfeeding, so you express a little bit of breast milk to soften them and make it easier for your baby to latch on.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 Express by Hand Expressing breast milk by hand is a skill. Just like any other skill, you have to learn how to do it and practice it to become good at it and get the best results. You can follow these steps to express breast milk by hand. Wash your hands with soap and water.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.Use a picture of your baby, a recording of your child making sounds, a blanket with your baby's smell, or other relaxation techniques like music to help stimulate your let-down reflex.Take your hand and position it 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.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.Begin to gently push your breast back toward your body with your thumb and fingers.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.Try to be gentle. Your breast tissue is sensitive and you can bruise it or damage it if you squeeze, pull, rub, or slide your fingers over your breast.Lean forward a little bit to collect the breast milk that should be dripping or spraying out of your breast. Be careful to get the breast milk into your collection container without any of the milk touching your hands first.Repeat steps 6 and 7 at a steady, rhythmic pace until there isn't any more breast milk coming out of your breast, or until you have alleviated the fullness of engorgement.Switch breasts when the flow of breast milk stops. When you switch breasts, rotate your hand to another position around the nipple (C, U, backward C, upside-down U) and begin the process again. These different positions help to drain the breast milk from all the areas of your breast.Give 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 Pros Natural and cost effective No equipment needed Quiet and readily available More comfortable and effective Cons Requires practice Time consuming Doesn't work for everyone There are many positive reasons to learn hand expression: It's natural.It doesn't cost anything.Other than a collection container, it doesn't require any equipment.It's quiet.It's always available.If you express breast milk by hand before and after using a breast pump you may get just as much if not 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 need attention. However, even though it's a useful skill, there are a few downsides to hand expression as well: 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.Some women just have trouble with hand expression and can't get any breast milk. Where to Find More Information 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. Was this page helpful? Thanks for your feedback! Track your baby’s most exciting moments with our milestone checklist. Get it free when you sign up for our newsletter. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article 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. Updated 2015. Stanford Medicine. Hand expression of breastmilk. Additional Reading Lawrence RA, Lawrence RM. Breastfeeding A Guide For The Medical Profession, Seventh Edition. Elsevier; 2011. 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; 2014.