9: The Most Underutilized Tool for Milk Expression

Today we are going to talk about hand expression and I’m going to do my best to describe a visual and tactile experience on a podcast. But it’s that important.

Hand expression is one of the most underutilized tools for lactating mothers in my opinion. Many women find it awkward or get discouraged when they try and it doesn’t “work” immediately. But with a little guidance hand expression can be an amazing tool.

• You have your hands even when you don’t have a pump, or an outlet, or that one missing part that was left at home.

• Hand expression can be great when you need to relieve some pressure but don’t want to whip out the pump.

• When you know how to hand express, not only do your breasts get some additional skin to skin loving but you are more likely to utilize hands on pumping

• Hands on pumping is when you massage and encourage milk flow with your hands, while you are using a pump.

• This typically yields more milk volume and makes pumping more effective. It’s just a great skill to have.

I’m going to describe it to you, but a visual is really helpful on this one. And really, hands on help can expedite the learning curve here as well. But if you’re like me you’ll try it first and then decide if you need help (I don’t recommend that, I just know that’s how I roll.). The steps are super simple:

1.     Warm up your breast with some massage and warm touch (you can even use a warm compress or shower if it feels good to you).

2.     Place your ‘pumping’ hand in a C (or as I like to call it your LEGO hand position- if you have Legos or saw the LEGO movie you’ll know what I mean).

3.     Use your crab hand, and put your hand on your breast- your palm will be on your breast and your thumb and forefinger should be about 1-2 inches away from the nipple. (But they will be on either side of the nipple sort of framing it if you will).

4.     Now here’s where people get messed up, because they start imagining milking a cow. But you are not a cow and you do not have cow utters so now that you’ve imaging that- erase that visual form your mind and go back to your soft palm flattened crab claw. Press back into the chest toward the ribcage, compress your crab claw (in a pinching motion, but do not actually pinch or hurt yourself), then release. Back-compress-release, back compress release, back-compress-release until milk comes.

5.     Milk expression will start slow, but be gentle- you don’t get more milk by injuring yourself or being rough. If you are in the colostrum phase, or new to expressing milk a very small amounts to start is normal.

6.     Once you get going, you’ll make small adjustments, rotate your hand position around the nipple, and get to know how to best work with your breasts.

As always, be sure to use clean hands and catch the milk in a clean food grade safe container. Also leaning forward a bit is a great help. If you practice on breasts that are some-what full it can be a bit easier. And you can also practice in a warm shower just to get the hang of it. Once you get going- watch out for shooting streams which can happen.

If you are struggling, check back in: Were you just emptied out when you tried? Perhaps try at a better time. Did you do the breast massage warm up? Re-start there. Did you get the hand position and the motion right? BACK-COMPRESS-RELEASE. And if you are having a little (or a lot) of trouble, don’t beat yourself or your boobs up- most of us need a little hands on support and a seasoned lactation consultant is likely covered by insurance and available in your area or if not then by telehealth.

Helpful Resources: https://med.stanford.edu/newborns/professional-education/breastfeeding/maximizing-milk-production.html