How and Why to Hand Express Milk

Most people who are considering using a pump to collect their breast milk do it because they have a need to store up some milk. They might be going back to work, having a night out, or have a baby in the NICU who is not able to breastfeed yet. Manual hand expression of breast milk is another way to collect your milk that can be simple and also very effective.

Using a pump can be really useful, but it can also be too much in some circumstances. It involves getting the machine out and plugged in and getting it set up with bottles. It can take a significant amount of time and there is also cleaning to do after. Some people also struggle to get any milk out using a pump.

Start Collecting Milk While You’re Pregnant

There are several great reasons to give hand expression a try. To start, a lot of experts are recommending that you try to collect some milk using hand expression before the baby is born!

During pregnancy, your body has been doing the big work of growing a placenta and baby, but did you know that your breasts are also already preparing to feed your baby later!? This is happening in stages throughout pregnancy, and by the third trimester most people have everything ready to feed a baby.

Using hand expression, you might be able to collect small amounts of the first milk called colostrum toward the end of your pregnancy. Colostrum is especially nutritious milk that is made in very small batches. The idea is that you keep a few small servings of colostrum in storage so that if your baby needs supplementation, your own milk is available. This is most commonly necessary if you are diabetic and your baby’s blood sugar levels are unstable at birth or if there are structural issues with the breasts that can make breastfeeding harder at first.

Colostrum can stay good for a week in the fridge, or freeze it if you’ll need to store it longer. It’s a really great idea to draw up a small amount (it might literally be just a teaspoon!) in a syringe and store it in a plastic zip-top bag. That makes it easy for someone to thaw it out and inject it directly into your baby’s mouth if it’s needed. Keep these in a cooler with ice packs when you transport the milk with you later. Once they thaw out they have to be used pretty quickly or thrown out so it’s good to keep them frozen until you know you need them.

It is possible that hand expression can trigger some labor-inducing hormones to start preparing your body for birth, so it’s best to wait until at least 37 weeks when you’re full term to avoid the added risk for premature birth.

Why Express by Hand?

Hand expression can also be handy after your baby is born. Sometimes people have to spend some time away from their babies right after birth. It might be that the baby needs some extra care in the NICU, or sometimes a mother needs a procedure or recovery time that means she can’t be with her baby right away.

If this happens, it’s nice to be able to provide a little milk to send to your baby in the meantime. Hand expression can often be done quickly and easily and provide just enough for the baby’s needs until you’re back together.

In the first couple of days after birth, you only produce a small amount of milk called colostrum. Newborn babies have very small stomachs and only need about a teaspoon at a time anyway, If a hand expression kit is available, it will have everything you need to collect those drops of milk. If not, a lactation consultant may be able to help you find a small plastic medicine cup or spoon to collect the milk and take it to your baby.

Another reason to use hand expression in the first few days especially is that collecting colostrum with a pump can waste precious milk. It’s such a small amount that most of it ends up stuck in the tubes and hoses instead of in the bottle. A lactation consultant might recommend using a pump for about 15 minutes to stimulate the breast and get it ready, then use hand expression to collect the colostrum.

Hand expression is also a great way to relieve engorgement. Engorgement is a fullness in the breasts that many people experience when their milk volume increases. This usually happens on the third or fourth day after your baby is born and can be uncomfortable. The breasts will usually get much bigger and more firm. This fullness can stretch the nipples tighter, making them smaller and flatter in some cases. That can make it harder for a baby to get a good hold on the breast for feeding. Relieving engorgement using hand expression can help you be more comfortable, and make it easier for your baby to get a meal. Here are more tips for relieving engorgement.

Another reason that some people learn to do hand expression is that pumping is very uncomfortable or doesn’t work for them . Some people can get more milk from the breast by hand! Pumps can be a little intimidating and it can be harder to make milk under stress. It’s also important to make sure the pump parts fit each breast correctly so that you can get the most milk for your time. This is sometimes tricky, frustrating, and can lead to pumping failure. Some people find that they can reduce frustration by switching to hand expression, and that makes them much more successful at collecting their milk.

Some people choose to use hand expression over pumping because they have an OVERSUPPLY of milk. Pumping can often make this problem worse because of the extreme amount of stimulation to the breast. Pumping can cause your body to make even more milk. Hand expression is a gentler way to remove milk, and can often be enough to collect milk without creating an oversupply issue.

How to Hand Express

Lactation consultants can show you how to hand express the milk, and I always recommend that you take advantage of any time you get with a lactation consultant to ask about hand expression in addition to any other issues or questions you might have. You can also use this instructional sheet that describes the process of hand expression or watch this hand expression video to see how it’s done.

If you are choosing to collect your breast milk, it’s so important to understand that there are many ways to do this. If you try it and encounter problems, it doesn’t necessarily mean that you don’t have enough milk or that you’ll never be successful. It’s very possible that you just need to try a different way. Consider talking to a lactation consultant for help.