How to Hand Express Breast Milk

Last updated on September 28th, 2021 at 01:55 pm

You just woke up, your breasts are engorged, it’s almost feeding time, and guess what? Murphy’s Law is up to its mischief again! There’s a blackout and you can’t use your breast pump…panic much? Oh yes! This is how I felt when it happened to me. Now is the time to hand express your breast milk.

Since then, I have purchased a backup manual pump, but that was after the fact. I’m also going to get back-up flanges for both pumps too because I just found out that old or defective flanges can be a big reason for a pump not to work. Whatever it is, I want to be prepared. It’s not like you can just run to your corner store for a new pump or parts, especially if you have a crew like mine; with twin toddlers and a singleton, it’s just not going to happen. So, being presented with the situation at hand, I needed to figure out how to manually express milk, STAT!

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Why should you know how to do this too? Even if you have the Mercedes Benz of electric pumps, it’ll be worth nothing if there’s a blackout and the backup battery pack (if you even have one) isn’t charged. Plus, you don’t want to be in a panic when you’re trying to figure out how to do this.

If you still believe this situation doesn’t apply to you, I can tell you that I’ve experienced all kinds of crazy things that caused my machine to be DOA. For example, aside from the blackout, once, my husband lost the flanges when he did the dishes, and at another time, an outlet wasn’t working.  

For you pregnant twin mommas reading this: If your twins are whisked away to the NICU after delivery, you can hand express your colostrum into a cup in the recovery room and have it delivered the NICU. Get that liquid gold to those babies! It’s recommended to nurse or pump for the first time within the first few hours after delivery.

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Another reason to learn how to hand-express milk? If you need to help things along. For example, one of the flanges my pump came with was defective. When I saw that one side wasn’t pumping right, I called the manufacturer and the rep told me I needed to replace the flanges. While I was waiting for my replacement order, I used the machine to start the massaging action while pressing down manually to express the milk, then alternate sides, which helped to keep my supply up. This situation was most likely why I was able to hand-express without the machine when I needed to.

Of course, you can try to let your babies nurse, but there are instances when this isn’t going to work either. Such as, when babies can’t get a good latch, if your breasts are engorged, or if you need to have bottles ready.

So how do you hand-express milk? Here are some simple steps:

Preparation to Hand Express

Be gentle: When possible, take a hot shower to get the milk flowing, especially first thing in the morning and/or if your breasts are engorged. If you can’t, use a warm towel or warm compress.

Wash hands: Always wash hands before any type of feeding, especially for hand-expression, pumping or nursing.

Collection tools: Have clean bottles/containers ready to express into. If hand-expressing soon after birth, you can use a spoon and an oral syringe.

Let gravity help: Sit up and lean forward while expressing milk.

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Massage: Slide your hands from the outer areas of your breast toward the nipple; this helps prepare for ‘let-down’ without having the milk come out. You may feel lumps; this is the milk that has accumulated. But, if there is pain and breasts are not engorged, you may have a clogged duct; try alternating warm/cold compresses for relief. If the pain continues, contact your physician.

3 Steps to Hand Express

• Form a letter C with your thumb and pointer finger. Place hand under breast and position fingers about an inch from the areola (midline).
• While in position, push your hand back towards your chest wall without stretching the skin, squeeze (compress) gently and release.
• Press down and continue this motion, then switch sides. If the milk isn’t coming out, grasp the areola (outer part of the nipple where the dark circle begins) with your thumb above and place one or two fingers below. Push in toward your chest. Gently compress while rolling your fingers toward your nipple (not on the nipple). Rotate your fingers slightly around the areola and repeat the massage to drain the entire breast. Reminder: alternate sides, which simulates the rhythm of nursing.

Collect milk in a clean container. Refrigerate or freeze the milk if you’re not going to use it immediately.  

The La Leche League suggests the Marmet Method of hand expression. I have outlined some of the basics, but you can use this handy guide to assist in methodology: https://goo.gl/qkfFAV

This video does a good job of demonstrating hand expression:

So there you have it! While I hope you’ll never need to manually express your milk during an emergency, such as a blackout or having lost or defective parts; but for whatever the reason, I hope that I’ve provided you with the information needed to get you through it.

One more thing: try not to wait for worst-case-scenarios. Practice hand expression now and then so that if you ever needed to do this, you won’t be stressed and the milk will let down quicker.

Sources:

Manually Expressing Breast Milk: https://www.webmd.com/women/pumping-or-hand-manually-expressing-breast-milk

Getting Started with Breastfeeding Resources: https://med.stanford.edu/newborns/professional-education/breastfeeding.html

“Marmet Method of Hand Expression.” La Leche League of Rochester, La Leche League International, 23 Oct. 2003, lllrochester.weebly.com/.

All content on this Web site, including medical opinion and any other health-related information, is for informational purposes only and should not be considered to be a specific diagnosis or treatment plan for any individual situation. Use of this site and the information contained herein does not create a doctor-patient relationship. Always seek the direct advice of your own doctor in connection with any questions or issues you may have regarding your own health or the health of others.

Lorraine Conforti is a proud mom of twin boys and pet-parent of two cats and a dog. Being both conservative and artistic, she describes herself as “a little bit country and a little bit rock and roll.” She enjoys the arts, music, writing, and had performed in a Blues/Rock band with her Husband for several years. She is also passionate about health and fitness and has held certifications for nutrition and Personal Training, and has earned a BS Degree in Healthcare Management. 

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