Erica McClannahan, RN, BSN, IBCLC

One of the most important things that I teach new parents during every single one of my consultations is hand expression.  Hand expression refers to the manual removal of colostrum/milk using your hands rather than directly latching your baby or using a pump. This skill is particularly important during the first few days postpartum, but it is also a crucial tool to utilize in late pregnancy and throughout your lactation journey. This kind of deep ductal tissue stimulation is an amazingly effective way to support milk onset, get the milk flowing, and relieve the pressure of very full breasts. 

How Do You Hand Express?

This physical skill takes some practice- everyone’s breasts are a little different and respond differently.  The best thing to do is practice, get comfortable with your body, and learn how it responds to different kinds of stimulation.  Try to think of it as applying compression to the firm tissue deep in the breast- so you aren’t milking just your nipple.  This is my favorite video that demonstrates the best technique.  If you are hand expressing for colostrum, I suggest using a small cup and a syringe to collect and save your liquid gold.  If you are yielding higher volumes, you can express directly into a bottle or a haakaa collection device.  You can either offer your expressed milk to your baby or save it in the refrigerator or freezer.  Check out the storage guidelines for breastmilk here. 

When Should You Hand Express?

Hand expression can be started in late pregnancy (37+ weeks) as long as you are cleared by your provider to do so.  Breast stimulation can jump-start labor since it releases the hormone oxytocin, which also causes contractions.  Starting the breast stimulation process in late pregnancy is a great way to create a mini stockpile of colostrum to use in the first days after your baby is born and also jump-starts the process of bringing your milk in.  In my experience, women who hand express during pregnancy have milk onset much sooner than those who don’t and have much more plentiful colostrum. If you do collect colostrum in pregnancy, bring it with you (in frozen syringes) when you deliver your baby since the best time to utilize it is in the first few days postpartum!  

Once your baby is born and learning how to breastfeed, hand expression is a powerful way to draw out colostrum to entice your baby to latch or offer them nourishment when they are sleepy post-birth or are not ready/able to latch themselves.  This kind of deep tissue stimulation in the breasts helps support milk onset and bring your mature milk in faster, which is great for you and your baby!  

Hand expression is also the perfect way to relieve pressure and get the milk flowing in very full, engorged breasts.  Some women find it much more effective than a breast pump during those times!  I recommend that some form of manual compression is used with every feeding- it can be utilized before, after, or even during a feeding to help get the milk flowing, especially in the firm, lumpy areas of the breast.  

Why Is It Important?

Hand expression is one of the most important tools to have in your toolkit because of its effectiveness at bringing in your milk, building a strong supply, relieving engorgement, and is something that requires no equipment or cost.  If you are ever stuck in a situation where you don’t have access to a pump and your baby isn’t available to latch, this is a way to remove milk and protect your supply and breasts from issues like mastitis.  In my professional opinion, hand expression is the most beneficial thing you can do for your lactation journey on a day-to-day basis!

Give this a try, and reach out to us for support as needed! Happy expressing!