Why express by hand?
- It can be used to help the baby attach to the breast
- It can help to prevent or relieve engorgement
- It is particularly useful for milk in very small quantities, e.g. colostrum
- It can be used to help clear blocked ducts
- It can be more effective than a pump
- It’s free! No equipment needed.
How to hand express
1. Roll your nipple between your finder and thumb to make it stand out. Make a C-shape with your thumb and either your index or middle finger, and cup your breast.
Feel back from the end of the nipple to where the breast tissue feels different, about 2-3cm from the nipple. You may feel a change in the breast tissue at this point, sometimes it feels ‘knobbly’, sometimes slightly firmer. You are now touching the skin above the dense, milk-making tissue. This is where you should place your finger and thumb to express your breastmilk.
2. Holding your finder and thumb in this C-shape, press back towards your rib cage.
This brings your finger and thumb back into the dense, milk-making tissue, away from the ducts near the nipple.
3. Bring your finder and thumb together, so that they press into the milk-making tissue, and milk will begin to appear in droplets.
Use a sterile cup or bowl to collect it, and try to build up a rhythm. Try not to slide your finger over the skin, as this will hurt and it will be more difficult to express milk. When the flow slows down, move your finger and thumb around the breast and express from the other side, and you can keep changing breasts until the milk slows or stops.
Practice makes perfect!
If you are doing this when your milk supply is not yet established, you may need to repeat these 3 actiions a few times to get the colostrum to flow and you may get 1-10mls (up to 2 teaspoons full). You can keep moving your finder and thumb around or use the other hand to take milk from all around the breast, but the technique should remain the same each time. If your milk supply is established, the milk may spray out in several different directions.
If you are not able to breastfeed your baby directly, you need to start expressing as soon as possible after the birth, preferably within 6 hours. Keep doing it at least 8 times in every 24 hours, including at least once at night, until your baby is feeding properly.