Nursing 101: How to Hand Express Breast Milk

Many moms from our Smart Parenting Village Facebook group who need to express breast milk try to do it by hand before buying a breast pump. Lactation consultants consider hand-expressing breast milk as the safest method. Breast pumps, while they get the job done faster, can be prone to contaminating breast milk if they're not washed, rinsed and dried properly after every use. (Click here to know how to clean your breast pump properly.)

When done right, expressing by hand is also an excellent way to extract colostrum from your breast, and it is the least painful way to relieve engorged breasts. "If you’re not using your pump properly or if you're using an ill-fitted flange, you could cause damage to your breast tissue," lactation counselor Sylvia Malabanan of L.A.T.C.H. said in one of the SmartParenting.com.ph workshops.

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How to express breast milk by hand

The La Leche League International (LLLI) recommends the "Marmet Technique," which has worked for thousands of mothers. It's easy, but it can take some getting used to. Here's a step-by-step guide:

1. Wash your hands. 

Prepare a container like a spoon, cup, bowl, or bottle to catch breast milk. Make sure to lean forward so your precious liquid gold end up on the container and none of it goes to waste. You can ask someone to hold the container for you or use your opposite hand to keep it under the breast you're trying to express milk from.

2. Put warm compress or massage your breasts.

It helps to prepare your breast to help with the milk let down. Either do a breast massage similar to how you would do a breast exam. You can also stroke the breast from the chest wall to the nipple with light tickle-like strokes, or gently give your breast a little shake as you lean forward to help stimulate your milk ducts.

3. Make a cup or a letter "C" using your hand.

Place the thumb and the rest of your fingers just outside your areola. Make sure they align (think of the hands on a clock when it's 12 p.m. and 6 p.m.). Use your left hand if you're expressing your left breast. You can rotate the position of your fingers, but maintain the alignment (e.g., the hands that form 9 p.m. and 3 p.m., 11 p.m. and 5 p.m. on a clock, and so on).

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4. Press back gently onto the chest wall.

Try to get a good handful of breast tissue. Without removing your fingers off your breast, spread your fingers slightly, but don't spread your fingers apart. For large breasts, you may need to lift the breast up a bit first before pressing back gently towards your chest.

5. Gently squeeze your breast outward from our chest.

Use a gentle but firm rolling motion. Repeat the process rhythmically until breast milk starts to come out. Note that it may take a few repetitions. If milk isn't coming out, repeat the massage and rotate your fingers to stimulate a different set of milk ducts. 

Try not to squeeze your nipple, pull forward your nipple or slide your fingers on the breast. Doing so will hurt you and it does not help. The milk ducts that contain the milk are located in the breast tissue and not the nipple. 

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Watch this video below to give you a better idea on how to do hand expression of breast milk.

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