Hand expressing

Unicef recommends that all pregnant women are taught to hand express during pregnancy. It’s a skill you’ll most certainly need, so great to learn early.

WHY HAND EXPRESS?

Harvest breastmilk; this is hand expressing breastmilk in pregnancy and freezing it ready for baby. The early breastmilk called colostrum, is present in the breast from around 26 weeks gestation. Some Mums benefit from collecting colostrum before their baby is born. For example, Mothers with diabetes are encouraged to do this, as these baby’s may struggle to maintain blood sugars, requiring extra milk. Harvesting milk should NEVER be done before 37 weeks as there’s a risk of stimulating contractions. This is not evidence based, but is precautionary. Check with your Midwife first before harvesting milk.

Separation from baby; during complications such as admission to special care baby unit, hand expressing colostrum for your baby can help baby recover more quickly and also stimulates and maintains milk supply.

Baby not latching; in the early hours after birth, hand expressing stimulates your breastmilk encouraging baby to latch. You may also collect your milk in a syringe and feed it to your baby if they’re having difficulties latching.

Reassurance; hand expressing enables you to see your milk is coming out.

Method of expressing; hand expressing is the only way to express until your mature milk comes in on day 3 – 5. After this you may use hand expressing in conjunction with a breast pump to reduce expression time and encourage further let down. Check the expressing and breast pump article.

Soften the breast; when your milk first comes in, breasts can become very engorged making latching more difficult. Hand express milk to soften the area before breastfeeding baby.

Get rid of lumpy breasts or blocked ducts by massaging and hand expressing the affected areas.

HOW TO HAND EXPRESS
Get comfy and sit up straight.
Relax and if you’ve given birth, ideally sit next to your baby or have something that reminds you of baby with you.
Start by massaging the breast stroking downward and squeezing gently all over. This stimulates the hormone Oxytocin which causes the milk ejection reflex.
Using your forefinger and thumb make a C shape and feel for a lumpy texture under the skin. These are your milk ducts. Your finger and thumb should be behind the areola and not on the nipple.
Compress your finger and thumb together, pushing back towards the chest wall to stimulate the milk cells. Avoid sliding your fingers forward. Hold the compression for a few seconds until you notice droplets of milk forming on the nipple.
Once the milk stops flowing, move your hand around to stimulate and compress a new set of milk ducts.
It can take a while to get the milk going and the first time you try, you may only get a few drops or not see anything. Don’t worry this is normal and the stimulation will help for next time. Mastering a good technique and getting into a rhythm can also take time. Get someone to watch and check how you’re going.
Once you see milk, use a sterile syringe or pot to collect it. A Midwife or support worker should provide you with these in hospital. You can also drip the colostrum straight into baby’s mouth.
You might only get a fraction of milk to begin with but after a few attempts you should start seeing more. It can take up to an hour first go but will get easier and quicker each time.

If you need to hand express to maintain or get your milk supply going, you must do it between 8-12 times in 24 hours.