Expressing Breast Milk - Push, Press, Roll, Relax...

Expressing breast milk may serve different purposes and there are different ways to do it. Some women prefer pumping; others - hand expression.

Whatever the technique, there are situations when milk has to be extracted out of the breasts completely in some way other than baby sucking.

Visit Breast Pumping section to learn more about pumping. This section is about expressing breast milk by hand.

Hand expression has once been the only method of extracting breast milk from the breasts that breastfeeding mothers knew and trusted. 

Even now with all the advancements and inventions in pumping, hand expression remains a valuable skill to master. Here is when and why it may come in handy:

• Power goes off and you don’t have a battery to operate your pump.

• Pumping doesn’t completely drain your breasts and you need to hand express to remove the remaining milk.

• Your pump goes out of order or you forget to take it with you.

• You experience engorgement, mastitis or any other painful breast condition, and pumping hurts too much.

• Your baby doesn’t nurse after the delivery and you need to extract colostrum to give to him/her. Since it is just a few drops, breast pump may not be able to get them out of your breasts.

• During the first week after the delivery your breasts may get lumpy and engorged as they adjust to holding milk. Hand expression combined with massage and warm compresses helps soften your breasts and get rid of the lumps.

• If your milk ejection reflex (let-down) is slow, hand expressing some milk prior to pumping helps trigger it.

• Hand expression is free and always available.

3 Methods of Hand Expression

Before hand expressing breast milk, gently massage your breast moving from the base towards the nipple.

After you’ve massaged your breasts, start expressing breast milk using one of these methods:

Place your thumb above and your fingers below your nipple just outside of the areola. Push them slightly towards your breast.

Gently press your thumb and fingers together and roll them forwards rhythmically. Then relax your fingers for a moment and repeat the movement.

Expressing breast milk this way takes time to learn, but then is fast and always available.

Do not slide your fingers. They should remain in their spots. Your other hand should be holding a container. When the milk flow stops shift the position of the thumb and fingers clockwise. This ensures that all the ducts get emptied.

Here is this method in brief and easy to remember:

push->press->roll->relax->push->press->roll->relax….

When you are just starting expressing milk, the flow may not be strong and steady. Hand expression and massage opens up all the ducts and you will soon see many tiny flows from the nipple.

Do not compress, pull or rub your nipples and the areola while hand expressing to prevent sore nipples, cracks and bruises.

A cup (or any other container with smooth edges) is pressed against the breast below the nipple just outside of the areola.

Place your thumb above your nipple just outside of the areola.

Gently roll your thumb towards the cup.

Do not slide your thumb. But your rolling movement should be as if pushing the milk from deep in the breast towards the nipple.

Repeat the movement. When the flow stops, move your thumb clockwise.

This method is mostly used when pumping or traditional hand expression is painful due to engorgement or clogged milk duct. Visit Breastfeeding Problems section to read more.

A thoroughly washed wide-neck glass bottle is filled with hot water (pour it in slowly to prevent glass from cracking).

Leave it until the entire bottle warms up.

Pour the water out.

Cool down just a little so that the bottle rim is not too hot.

Apply bottle to the breast around the areola. As the bottle cools down on the breast, the pressure inside the bottle starts pulling milk out of the breast.

The neck of the jar on the picture may be just wide enough for your overfilled and engorged breasts. It has to be wider than the areola to create enough suction and pressure.

You can pick something with slightly narrower opening. Go by the size of your breasts and the areola.

find a glass bottle/jar with neck wide enough to fit areola and some skin around it

fill the bottle/jar with hot water until warms up, pour water out, cool down the rim

apply the bottle/jar to your breast

find a glass bottle/jar with neck wide enough to fit areola and some skin around it

fill the bottle/jar with hot water until warms up, pour water out, cool down the rim

apply the bottle/jar to your breast

let the milk flow

When you apply the bottle/jar to the breast, you will notice how the nipple will look as if being pushed out of the bottle and will slightly flatten. You may need to massage your breast a little to start the milk flow.

Warm the bottle with hot water again and repeat the process. It is time consuming, but it is the least painful way of relieving breast engorgement.

Expressing breast milk by hand takes practice and after a couple of times you'll get better at it.

In fact, some women master it to the degree that they manage to empty the breasts faster than the pump and express more milk.

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