Hands-On Pumping to Increase Milk Supply

Nursing mother using automatic breast pump

Asawin_Klabma / Getty Images 

Hands-on pumping is a breast massage technique that can increase the amount of breast milk you pump during each pumping session. Because hands-on pumping helps you to drain the breast more fully each time you pump, it helps increase your milk supply and helps you provide more of the fatty hindmilk that will help your baby grow.

Hands-on pumping helps mothers who may be struggling with volume produce more milk at each pumping session. If you have a baby in the Neonatal Intensive Care, have had a premature baby, or need to pump, this technique of combining pumping hand expression and breast massage (“hands-on pumping”) has been shown to increase milk volume by 48%.

With hands-on pumping, a breastfeeding person uses their hands to assist in milk removal while pumping (instead of relying on a breast pump alone).

Breast massage and hand expression combined with pumping will not only help maximize the amount of milk you will pump with each session but will also increase your milk supply overall. 

Using Hands-On Pumping

When using hands-on pumping to increase milk supply, you'll massage both breasts before you pump and during your pumping sessions. Here's a pumping routine that you can use:

  1. Start with the right equipment. Use a fully electric, hospital-grade pump with a double pumping kit. Wear a bra that holds the flanges in place while you pump to free up your hands to massage your breasts.
  2. Massage your breasts before pumping. Massage both breasts using small circles in a spiral pattern (similar to a self-breast exam), paying extra attention to the outer margins of the breast. Stroke the breasts from the outer margins toward the nipples. Use a light touch to help you relax and to help stimulate your let down.
  3. Pump both breasts until the milk starts to subside, usually about 5 to 7 minutes. Adjust the suction to the highest level that is comfortable for you (make sure it does not hurt!)
  4. Repeat the massage process. Pump each breast while massaging it. Pay special attention to areas where you feel lumps (these are full milk ducts). Using medium pressure, stroke your breast from the outer margin in toward the pump to empty the ducts.
  5. Continue until your milk production subsides again (usually about 3 to 5 minutes). Hand-express into the pump flanges. The last milk (hindmilk) is the richest milk that you produce.

Maximizing Your Milk Production

Here are some other ways you can increase and maximize your milk production while your baby is in the NICU.

  • Continue to pump regularly. Eight times in 24 hours in ideal to maintain your milk supply. Remember it’s supply and demand. 
  • If you are pumping in place of a full feeding, pump for 15 minutes—even if the milk stops flowing. The pumping stimulates the breasts to maintain your milk supply. 
  • If you are separated from your baby, it’s important to begin expressing your milk within the first six hours after giving birth.
  • Spend as much time as you can close to your baby. Holding your baby skin-to-skin will not only help you and your baby bond but will help your body to produce prolactin and oxytocin, which helps to increase your milk supply.
  • Try listening to music. Music has been shown to increase the amount of milk expressed in the NICU.
2 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.
  1. University of Wisconsin Hospitals and Clinics Authority. Hands-on pumping helps mothers make more milk. 2020.

  2. Stuebe AM, Grewen K, Meltzer-brody S. Association between maternal mood and oxytocin response to breastfeeding. J Womens Health (Larchmt). 2013;22(4):352-61. doi:10.1089/jwh.2012.3768

By Cheryl Bird, RN, BSN
Cheryl Bird, RN, BSN, is a registered nurse in a tertiary level neonatal intensive care unit at Mary Washington Hospital in Fredericksburg, Virginia.