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Hand expressing

Hand expressing


Using your hands to express your breast milk often takes a little while to master. Some women find that hand expressing their milk comes naturally, others find it an awkward and slow process. Many women find it is initially frustrating and tedious, but after being shown the proper technique and practising, they eventually get the knack. Being able to hand express is a useful skill to have. However, if you are finding hand expressing frustrating, tiring or unproductive, you may wish to try using a breast pump. A breast pump may also be a better option if you are needing to express for every feed, or you may choose to hand express at some times, and use a breast pump at others.

The advantages of hand expressing are:

  • It costs nothing.
  • It is convenient, no breast pumps to prepare, or sterilise.
  • It can be done anywhere, any time.
  • It can be used to express small amounts of milk to relieve overfull breasts (for comfort) or to gently rub milk onto sore nipples.
  • It involves skin to skin contact, which stimulates a greater milk production and helps to trigger a let-down reflex.

The following explains how to hand express breast milk. However, if you are finding the process difficult, ask your caregiver, or early childhood nurse to go through it with you, to make sure you are using the correct technique. (Be aware that not all women are able to hand express their breast milk, even when using the correct technique).

You will need to have a sterilised container to express your milk into. This may be a large bowl (that has been boiled in water), held between your knees, placed on your lap, or on a table at a comfortable height. Or it can be a sterilised plastic container. (You may want to try expressing small amounts of milk in the shower, or bath, or into a clean nappy or hand towel, a few times until you get the hang of it.) To hand express you need to:

  • Wash your hands.
  • Find a place that is quiet and private (if possible). Make yourself comfortable. You may want to implement some techniques to help you relax, or stimulate a let-down. This may involve playing some relaxing music, taking some deep breaths, placing a warm compress on the breast, doing a visualisation, and/or looking at a photo of your baby.
  • Sit in a position that is comfortable (or you may choose to stand near a table with the bowl sitting on it). Use pillows to support your back, if sitting. You may need to lean over the bowl you are using to catch the milk.
  • Have a glass of water handy, as expressing milk (as does breastfeeding) naturally triggers your thirst.
  • Try to stimulate a let-down. This can be done by massaging your breast, using gentle, firm, circular motions over the top, side and underneath parts of the breast, usually for a minute or so. Then use the tips of your fingers to lightly stroke the breast repeatedly, from the top of the breast down to the nipple. This may need to be for a few seconds, or up to a minute or so. Once you start to feel a let-down (or your nipples start to drip milk), you can begin expressing. If neither of these signs are noticeable within a few minutes, you can start to hand express anyway, as sometimes just the act of rhythmically compressing the areola will stimulate a let-down.
  • To begin expressing, place the hand you are not expressing with under your breast to support it. Keep the hand well back, clear of the nipple and areola and handle your breast gently. (If your breasts are small, you may not need to support them).
  • Place the thumb of the hand you are going to express with on the top edge of the areola (above the nipple), where the darker skin meets the normal skin of the breast. Place the next two fingers of that hand underneath the nipple, but back from it, so that these fingers also lie on the underside edge of the areola. Even though you will use these fingers to compress this area, they should not really move much from this position.
  • OK, now you are ready to go. Using your thumb and other two fingers, push them back into the breast tissue, and then firmly compress the areola with your thumb and fingers. Release the compression (without taking your fingers off the areola) and repeat the action. Push in and compress. Continue this in a rhythmical cycle, adjusting your fingers slightly if it helps to get a better flow.

NOTE: Avoid compressing (pinching or squeezing) the actual nipple. The nipple is where the milk is released and compressing it will only prevent this (as well as probably hurt and bruise your nipple). The areola (well back from the nipple) needs to be compressed to move the milk out through the nipple. You may want to rotate your fingers to other parts of the areola (say each side of the nipple), or swap hands (or start expressing from the other breast), if the one position becomes tiring or awkward, or the milk flow slows. Never try to force milk out, if it is not coming readily.

Hand expressing breast milk Image 12-45 illustrates where to place your fingers to hand express breast milk.

The milk you expressed into your bowl or container can then be poured into the sterilised bottle or container you intend to keep your breast milk in for storage.


Last revised: Wednesday, 19 December 2012

This article contains general information only and is not intended to replace advice from a qualified health professional.

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