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Tuesday, November 27, 2012

Hand Expressing Your Breast Milk

Introduction

It is easier to learn to express if someone guides you. Please ask for help when you start. This text based guide was set in place to help you learn easily. We also have a selection of hand expression videos available to aid you in successfully expressing your breast milk. If you need help or advice, please don't hesitate to contact us! You can also ask your local Lactation Consultant to guide you as they are usually on site at the hospital guiding new mothers to express their colostrum for their new borns and have a lot of experience hands on (if you prefer) training.

Look for videos of Hand Expression techniques and tips in the Hand Expression category.

How do I hand express?

Before you start, you need a wide-necked container (sterile for a baby under 6 months old), such as a feeding cup, wide-necked bottle, bowl or expressing funnel.

  1.     Wash your hands.
  2.     Sit comfortably, with your back straight, in a chair or on the edge of your bed.
  3.     Create a wide ‘C’ shape with your thumb and either your index or middle finger. Place them directly opposite each other, thumb on top, approximately 2.5-3.5 cm from the base of your nipple. This may be at or near the edge of your areola (the darker skin surrounding the nipple). Your other fingers will help support your breast tissue (see Fig. 1).

  4. First Step In hand Expression
    First Step In hand Expression. Make a "C" at the beginning or slightly before the areola

  5.     Your milk is stored in milk reservoirs under the areola. Press in towards your chest wall (see Fig. 2) and then draw your finger and thumb together, as though they would meet behind the areola, not behind the nipple (see Fig. 3). Some women can feel the milk reservoirs, like small peas, under their fingers. Droplets of colostrum stored in the reservoirs will be pressed out towards the nipple.

  6. Hand Expression - Push into the chest / breast
    Second, push into your breast / chest, supportying the breast with the other fingers

    Hand Expression - Compress Behind the areola
    Third, Gently "roll down" or compress the breast behind the areola

  7.     Release the pressure of your finger and thumb, then repeat the action: press and release, press and release. This should not hurt, and if it does, try to reposition your thumb and finger, and make sure you are not squeezing the nipple itself. Avoid rubbing or sliding your fingers along the skin as this may result in friction damage to the skin. The movement of your fingers should be more of a rolling action.
  8.     Repeat this action until you see drops of colostrum/milk appearing at the nipple. At first no milk may come, but after pressing a few times, milk will start to drip out, and may spurt as your supply becomes better established. Catch the droplets in your container. Be patient, it may take a minute or two for your efforts to be rewarded.
  9.     Press the areola in the same way all around your breast, to make sure milk is expressed from all lobes of the breast. You can use either hand.
  10.     Express one breast for about 5 minutes, or until the flow begins to slow, moving your finger and thumb around to remove milk from all areas of the areola. Express from the second breast in the same way for about 5 minutes. Return to the first breast for another 5 minutes and then finish with another 5 minutes on the second breast again. These timings are approximate; please be guided by your own milk flow and swap sides when the flow slows down. Some women swap sides more frequently. It is important to allow at least 20-30 minutes for preparation and expressing so that milk is removed well enough to stimulate the production of more milk.

Notes About Your Areola

Every woman has different areola sizes. If you have smaller areolas you might wish to go a centimeter or an inch or two past the areola. If you have larger areolas you can try starting an inch or two away from the nipple or you can start at the base of your areola and work your way out. This can be very confusing since areola sizes differ more than you might think.

Areolas, the skin around the nipple, usually darker or lighter than the nipples, is where a lot of the important tissue is for storing your milk are located. Behind the areola and into the breast. Milk doesn't come from the nipple, rather it passes through the nipple. In an ideal latch for a baby the nipple would be close to his/her throat, thus the nipple is more like an "aimer". The areola is a great self guide to where you should compress and manipulate the breast for the best milk ejection.

Hand Expression
Hand Expression of a real breast
Areola sizes range from and inch in diameter, too a 4 or 5 inch diameter. Many women shown in videos and pictures for hand expression ahve the average size areolas, however if yours are smaller or larger it doesn't men you are strange, sick, or deformed. It is simply your body, and the beauty of everyone is their differences. This sizing difference could be confusing, however. Simply use the areola as your base line of comparison for you. Some women with large areola may experience  great milk flow simply beng 2 inches away from the nipple while expressing, others may need to extend their fingers to widest parts of the areola even at a large size to achieve better milk flow from the nipple. If you have smaller areolas, or maybe even "average" going past the areola is also another great way to drain the breast.

Breast Compression & Draining The Breast

Breast compression is similar to the normal compression of the areola in hand expression. Simply wrap both hands around the breast. Get a good firm hold with boths hands, and gently squeeze as you go down your breasts. You would go all the way to the areola like when hand expressing. This will help drain the breast. This may be helpful for women with larger breasts.

Some other basic tips on draining your breasts for hand expression is:
  • A warm water bottle between your breasts
  • Taking a warm / hot shower
  • Compressing the breast
  • Massaging the breasts (like a breast exam)
  • Leaning over and gently shaking or "jiggling" the breasts

More detailed picture of Hand Expression
More detailed picture of Hand Expression

Sources

New Born Baby Hand Expression
Sakura Mahal Hands On
About.com
Medela

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