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Expressing milk by hand works very well for some
women. It's a handy skill to have when:
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You are caught somewhere with full breasts and you don't have your baby
or a breastpump, you'll be able to relieve breast fullness and avoid
problems with engorgement.
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You do not need to express milk regularly.
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Your breasts are more responsive to the skin-to-skin feeling of hand
expression than to plastic pump parts.
6 Easy Steps to Manual
Expression
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Position your hand on your breast, with the thumb above and
fingers underneath, about an inch to an inch-and-a-half behind the nipple.
If your breast were a clock, your thumb would be at 12 o'clock and your
fingers at 6 o'clock. Don't cup your breast in your hand. Instead, your
thumb and fingers should be directly across the nipple from each other.
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Press your thumb and fingers directly back into the breast
tissue, towards the wall of your chest. Don't move
them further apart. Just press straight back into the breast.
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Roll your fingers and thumb forward to squeeze milk out of
the milk sinuses, which are located under the
areola behind the nipple. Don't slide the thumb or fingers along the
skin--this will quickly make you sore.
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Repeat this sequence--position, press, roll--until the milk
flow ceases. Then move your hand so that the thumb and fingers are
positioned at 11 and 5 o'clock and do it again.
Use both hands to work your way around one breast, then switch to the other
side until you have emptied all of the milk sinuses. As soon as you see milk
squirting from your nipple, you know you are compressing the underlying milk
sinuses. (This position is also where baby's gums should be during efficient
latch-on.)
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The trick to hand expression is discovering where to position
your fingers. Experiment until you find the right
spot. Having someone show you how is very helpful, too.
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Combining hand-expression with breast massage can be a very
effective way to stimulate the milk-ejection reflex.
Massage first, then express. Massage again, and repeat the hand- expressing
routine.
How to Collect the Milk
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When you hand-express, milk sprays out in all directions.
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If you're expressing just to make your breasts more comfortable, you can
lean over a sink or express into a towel.
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If you want to save the milk, you'll need something in which to collect
it. Some mothers manage to aim the nipple directly into a baby bottle.
Or, try a container with a wider mouth, like a coffee cup or a small
jar. As the cup fills up, transfer the milk to a storage container.
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The Medela company makes a special funnel for hand-expression that
collects the milk and channels it down into a standard baby bottle.
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