Hand Expression Tutorial

Have you heard of hand expression, and the many benefits that it can have on your breastfeeding journey?

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First, what is hand expression?

Hand expression is a easy-to-learn technique that breastfeeding mothers can use to:

• Produce denser milk than that from a mechanical or manual breast pump.
• Continue to stimulate the breasts if separated from her baby (for medical reasons, returning to work, or other scenarios)
• Express colostrum prenatally or after birth to establish a robust milk supply.
• Express milk when pump parts are forgotten, damaged, or there is no electricity.

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Hand Expression in Pregnancy

** You must get the all clear from your medical provider before hand expressing during your pregnancy**

Typically, in a healthy, low-risk pregnancy, mothers can begin to hand express colostrum after 37 weeks gestation.

Mothers can collect and store this colostrum to use after their baby's birth. This is a great way to prevent:

• Significant weight loss in the newborn
  • Newborns are expected to lose weight, but no more than 7-10% of birth weight)
  • Supplementing with prenatal colostrum can lessen the amount of weight a baby will lose.
• Jaundice
  • By supplementing with prenatal colostrum, this add to a newborn's intake and help them to have more poopy diapers, which help to will help expel the waste that can contribute to jaundice.
• Formula supplementation
  • Since you are supplementing with your own breastmilk, the likelihood that your baby would need additional supplementation with formula is very low.
  • If you are desiring to exclusively breastfeed, supplementing with prenatally expressed colostrum can help you reach your goal!

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When collecting any expressed colostrum, you can store them in syringes like these from Hakaa.

Make sure to store them in the freezer prior to use, then you can bring them with you to the hospital to use after delivery of your baby.

You may need to check with your hospital or birthing center about their policy, but most will require you to be responsible for keeping the prenatally expressed colostrum cooled and stored in your own cooler bag or mini fridge during your stay in the hospital.

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Hand Expression After Birth

Hand expressing colostrum has similar benefits to hand expressing colostrum prenatally. Hand expressing after birth can decrease the risks of:

• Low Milk Supply
  • Some newborns struggle to fully empty the breasts in the first few days of life, so hand expression can be a useful tool to lay the foundation for a mother's milk supply. ‍
• ‍Significant weight loss in the newborn
  • Newborns are expected to lose weight, but no more than 7-10% of birth weight)
  • Supplementing with colostrum can lessen the amount of weight a baby will lose, especially since milk that is hand expressed is shown to have greater density than milk expressed via a mechanical pump.

• Jaundice
  • By supplementing with colostrum that is hand expressed, this add to a newborn's intake and help them to have more poopy diapers, which help to will help expel the waste that can contribute to jaundice.
• Maternal Risks: engorgement, clogged ducts, and mastitis
  • Once a mother's milk "comes in," (usually between day 3 and day 7 after delivery) her breastmilk is changing from low volume colostrum to higher-volume mature milk.
  • If a mother's breast is not completely emptied each feeding by the baby or a pump, she can be at risk for engorgement, clogged ducts, or mastitis.
  • Hand expression can be used to help a mother fully empty her breasts and keep milk moving, which can prevent discomfort and infection associated with engorgement, clogged ducts, and mastitis.

And of course, using hand expression throughout your breastfeeding journey can be a valuable tool to continue to maintain adequate milk supply.

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How to Hand Express: A Step by Step Guide

1. First, begin by washing your hands
2. Find a comfortable place where you can relax and have privacy
3. Begin with massaging your breast with either your hands, or a warm cloth for a few minutes.
4. Make a "C" shape with your thumb and pointer finger, with your thumb above the areola, and the rest of your fingers below, supporting your breast. Your nipple should be evenly between your thumb and fingers in the C shape.
5. Place a clean container (this can be a syringe, bottle, bowl, or other milk catching device) below your nipple with the opposite hand in order to catch the milk.
6. Gently press your thumb and fingers back towards your chest wall, then compress your breast.
7. Compress and release several times until your see milk flowing ( It may take a few minutes to get milk flowing, especially if expressing colostrum).
8. Continue gently compressing and releasing your breast all around your breast, until you've evenly expressed milk from all around your breast.

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Want to learn more?

Watch our free online tutorial about hand expression by signing up HERE.

Sydney White is a Registered Nurse and Certified Lactation Counselor providing breastfeeding support in San Diego County.

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All links in this post are a part of the Amazon associates program, and are commissionable.

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Resources:

Lauwers, J., & Swisher, A. (2021b). Counseling the nursing mother: A lactation consultant’s guide (7th ed.). Jones & Bartlett Learning.

Walker, M. (2023). Breastfeeding management for the clinician: Using the evidence (5th ed.). Jones & Bartlett Learning.

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Disclaimer: This information provided in this blog article is for educational purposes only and is not intended as medical advice. While we strive to provide accurate and up-to-date information, it is important to consult with your qualified healthcare professional before making any decisions about supplementation or addressing concerns about your baby's weight gain. This information is not a substitute for professional medical consultation, diagnosis, or treatment. Never disregard professional medical advice or delay in seeking it because of something you have read here. For further information, please consult with a pediatric healthcare provider or visit reputable medical sources such as the American Academy of Pediatrics or the World Health Organization

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