Hand expression of milk

Hand expression of milk - Transcript

In this video I’d like to talk to you about the technique of hand expression. This is a really useful skill to learn, and it’s a way of getting milk out of your breast with your hand only (as opposed to a pump). Now why might you need to hand express? There are a number of circumstances which might warrant this.

One of them is, straight after the birth – maybe two or three days in, many women start to get a little bit engorged, as the milk comes in, that mature milk increases. If you become engorged, where you feel a general congestion going on, then hand expressing your milk will help your baby to latch on better.

You can hand express a little bit that will make your nipple protrude better, and it will also keep you comfortable as well. It could also be that after the birth your baby doesn’t latch on well, and hand expressing your milk is a great way to generate your supply and also be able to give that milk then to your baby, until your baby gets better at doing what he is hard-wired to do.

You may also use the hand expression technique if you have a blocked duct, for instance – this helps, along with massage and warmth. Targeting the area with hand expression can be very useful to get rid of that, and have a look at the related video.

If you are one of these breastfeeding ladies who has a fast let down of milk, once the baby does the fast sucks, you find that the milk lets down very very forcefully, then that can be a problem for your baby, and hand expressing a little bit of milk just before the feed, before latching, can help in that circumstance to reduce that flow, and allow it to be more comfortable for your baby, more manageable.

I would also encourage you to look at the related video regarding antenatal expression of colostrum – that’s about learning to hand express your milk beforehand, so that you can use that milk in particular circumstances.

In the first few hours and days after birth, if you find that your baby isn’t latching on too well or not at all, then hand expression is the best thing to do for those first couple of days ,before you start thinking about a breast pump.

We would encourage you to hand express every two to three hours at that point, and even at night as well. After that it would be important to use a hospital grade double pump if your baby isn’t latching.

So what about the technique itself? It’s really important beforehand to get as relaxed as you can, and this means doing anything that will make you feel relaxed. That can be anything from watching the television, having a hot drink, massaging the breast – and that can be massaging towards the nipple. It can be kneading the breast, all the way around the clock face of the breast. Warmth and massage, a hot bath or shower, or something like that, or warm flannels on your breast – all of those things can help, before you actually do the technique itself.

Another useful thing that you can use, if you are not next to your baby, is a photograph or a blanket that your baby has used. All of these things just help to generate hormones that will help in the process of helping your milk to let down, when you do the technique.

You will also need to use a wide- mouthed container that will collect this milk. I have known breastfeeding mums who have tried to express milk into a bottle, and of course your milk comes out of the nipple in many different directions. It can be quite hard to catch -so something like a jug or a bowl that has been really well cleaned, preferably sterilized, to collect that milk, is adequate.

So what about the technique itself? You’ve got nice and relaxed with all of those particular techniques. Now, you are going to actually do the technique itself. What you are going to do is to cup your breast with one hand, with your other hand you are going to pinch your nipple and work back from the nipple, squeezing until you find an area where the texture feels slightly different.

Some women will say it feels like a row of nodules or dots. I get different women describing it in different ways. Now once you’ve found that area where the texture feels slightly different, you’re going to put your thumb on top of the breast, fingers underneath, and squeeze and release, squeeze and release, squeeze and release, and you keep on doing that – just building up that rhythm.

At first it can be really disconcerting because you will see nothing – it might be that you are doing the squeeze and release for one to two minutes before you see any milk coming out of the breast at all. That’s fine, and it’s normal, so don’t be discouraged at that point, but carry on. Squeeze and release, squeeze and release. Eventually you’re going to see drops. Sometimes women have given up at that point thinking that this can’t possibly be right, because you’re only seeing drops – but keep on going at the same spot.

What you’re not doing is sliding your hands down the breast – you’re literally squeezing and releasing at the same point, the whole way through – eventually you’re going to see milk shooting out of the breast, so squirts of milk. Keep on going – eventually the squirts will subside.

Just to reiterate, you do the squeeze and release action until you eventually see drops. You keep on going until you see squirts. Keep on going again until those squirts have subsided. At that point you can rotate to another area of the breast and repeat that whole sequence. Once again, rotate again.

When you’ve been all the way around the breast, you can then go over to the other side, and start again from that side in the same manner. If you find that the place where you put your thumb and your fingers isn’t causing milk to come out of the breast, no matter how many times you’ve squeezed and released, then you can alter the position, move slightly towards the nipple, slightly further, or further back even, and try again there. Sometimes it can take a little bit of time to find that area.

Some women will also find that they need to press into the chest wall first, and then do the squeeze and release. So it can take a little bit of time to get used to this technique. We know that the more you do it, the more finely tuned it becomes. It becomes more natural over time, basically.

So it’s an excellent skill to learn and very very important, especially in the prevention of blocked ducts – because blocked ducts can lead to mastitis, mastitis can sometimes lead to abscesses, and the more women who can do this technique of hand expression, the better really for preventative care.

Review dates, references & further resources

Review Dates

V1 published June 2017. Next review date: April 2020

References

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