Breastfeeding is a natural process and most mothers who want to breastfeed can produce enough milk and successfully nourish their babies at the breast. Hand expression is a tool women have been using for thousands of years to assist with various needs and challenges that can arise during breastfeeding.
Why should I learn how to hand express?
During the early days and weeks of breastfeeding many women experience uncomfortable fullness in their breasts or engorgement as their body shifts from producing colostrum to mature milk. This fullness is caused partly by the increased amount of milk in the breasts, and also by fluids shifting in the body after delivery. Women who received large volumes of IV fluids during and after delivery are likely to experience swelling in their breasts as their bodies regulate and get rid of these extra fluids.
Sometimes this swelling in the breasts can make latching difficult for the baby and removing milk difficult for the mother. Hand expression is more effective than pumping during these early days because the early milk is thicker and more viscous than mature milk. Pumping can cause the swelling to become worse because it draws the swelling down the breast towards the nipples. Hand expression is a more gentle and easy way to remove milk, decrease swelling and make latching easier.
Hand expression is also helpful for mothers who are pumping because particularly at the end of a pumping session the milk is more viscous and hand expression can be a more effective way to remove it. This video from the Stanford Newborn Nursery shows how to combine pumping and hand expression to increase milk supply: https://med.stanford.edu/newborns/professional-education/breastfeeding/maximizing-milk-production.html
Hand expression is an especially important skill for all mothers to be familiar with because it can be used in emergencies to maintain milk supply in case mother and baby are ever separated due to an emergency and access to a pump or electricity to run the pump is not available.
How can I learn to hand express?
There are many methods of hand expression that have been taught throughout the years and throughout the world. Each woman’s body is unique and each woman will have to discover how to remove milk from her own breasts. The only really important thing is to find the way that works best for you. This video produced by Breastfeeding Medicine of Northeast Ohio demonstrates one way to massage the breasts and hand express:
When should I learn to hand express?
Some mothers begin hand expressing before their babies are born if they want to build up a supply of colostrum to feed to the baby in case of hypoglycemia or other reasons that might require supplementation.
Usually hand expressing before delivery is not necessary. You may want to try it to familiarize yourself with your breasts, but too much breast stimulation can cause premature contractions and labor so be sure to ask your doctor first, particularly if you are at risk of delivering early.
Many mothers begin hand expression after their baby is born. This video by the Stanford Newborn Nursery shows how hand expression, combined with spoon feeding small amounts of colostrum to the baby can increase mothers’ milk supply and give babies the the benefit of extra calories:
How can I learn more?
Check out these resources if you would like to learn even more about hand expression:
A La Leche League article about engorgement - http://www.llli.org/faq/engorgement.html
A La Leche League information sheet with instructions on how to hand express - http://www.llli.org/docs/0000000000000001WAB/WAB_Tear_sheet_Toolkit/06_hand_expression.pdf