Why Hand Expression?
- Skin-to-skin contact with hand expression encourages the milk ejection relax (MER) or 'let-down reflex'.
- Mothers usually get more milk using hand expression alone or complied with pumping that using just a pump.
- It requires no special equipment and is always available ,even in emergencies.
- Its convenient and free.
Hand expression is particularly useful if you need to express colosseum during late pregnancy (see this article for more information) or in the first few days after birth. It makes it easy to save every drop of precious colostrum.
If You Use A Pump
Whatever pump you may use, combining pumping with hand expression can help you express more milk more effectively.
- Breast massage and hand expression can be used at the beginning to get your milk flowing.
- Breast massage while pumping increases the amount of milk you can express.
- Continuing to hand express can release milk remaining, even after the pump flow has stopped.
- And if your pump breaks down, or there is no electricity, you alway shave your hands.
Practice Helps
Hand expression is simple to learn and gets easier with practice. You may receive information and a demonstration of hand expression from you midwife. Developing your own routine, starting with relaxation techniques and stimulating milk flow, makes it easier too.
How Breasts Work
When milk is removed more often, your breasts feel soft and comfortable and produce milk faster. When milk is removed infrequently, your breasts may feel full but produce milk more slowly. Frequent milk removal is the key to gaining milk production whether you are breastfeeding or expressing. Expressing stimulates your breasts-though not as effectively as baby- to make and release milk.
Before You Start
Wash your hands. Have a suitable clean container available to collect your milk; colostrum can be expressed into a small (5ml) container or even onto a teaspoon for immediate feeding. Once milk production has increased milk may spray in several directs so a bowl, wide mouthed container or a bottle with a funnel might be more practical.
Relax And Get Comfortable
Milk tends to flow better when you are feeling comfortable, relaxed and arm. Tension or anxiety inhibits milk flow. Relaxation techniques can help increase the amount of milk you can express. The sound of running water may help, or you could practice in the bath or shower.
Seek privacy; try the breathing exercises you earned for use during labor; visualize flowing milk. Have your baby nearby, or thin of him/her. Use photos or recordings of your baby and smell his/her clothing. All these will help stimulate milk flow. Take a few deep breaths, drop you shoulders and please tension with each exhalation. Bending forward with your breast suspended means gravity can help milk flow.
How To Hand Express
One Basic Approach
- Start by encouraging milk flow in both breast.
- Then hand express from each breast until milk flow slows right down. If you need to increase milk production, continue expressing for a couple of minutes after milk flow has stopped.
- Repeat these two steps at least twice more. You will find milk flow slows or stops sooner each time you repeat.
- Most mothers adapt the above approach to suit themselves, so experiment to find what works best for you.
Step by Step
Encouraging milk flow
Stimulating you r milk ejection relax (MER or 'let-down') is key to expressing. It can take a few minutes. You may see drops of colostrum or breastmilk, or even experience a tingling sensation, but many mothers don't see any milk until they start actually expressing. Experiment with the following suggestions to find out what works best for you.
- Massage your breast starting at the top, using a firm circular pressure on one spot. After a few seconds, lift up your fingers to move to the next area on the breast. Spiral around the breast towards the areola and nipple.
- Storke your breast from the top of the breast to the areola and nipple. Light stroking with fingers is one option, or use a soft item with a light tick-like stroke. Continue this stroking motion from the chest wall to the nipple around the whole breast. She your breast gently while leaning forward so gravity can help your ;milk flow.
Hand Position
You can use either or both hands on one breast, or express both breasts at the same time. Hold your hand in the shape of a letter 'C', with your thumb and forefinger behind the base of you ripple, feeling for the change in texture of your breast. Move your fingers closer to, or away from your nipple to find the best place for you.
To Express
Start with the pad of your thong at the top of your breast, and your finger pads below.
How Long Will Hand Expression Take?
Allow plenty of time at first: the whole process may take 20-30 minutes, but you can always stop and start again later if you need to. Frequent short sessions are usually more effective that infrequent longer expressing sessions.
Switching between breasts several times as milk flow slows can help trigger further milk ejection reflexes. The more MERs you stimulate, the more milk you will be able to express and make.
Hand Expression Shouldn't Hurt
Squeezing, pulling and sliding fingers along the skin can cause discomfort, bruising and skin burns. Pain of discomfort inhibit the MER and are signs the something needs adjusting. If your breast feels engorged or tender try warm moist heat immediately before expressing. Start expressing from the most comfortable areas.
Removing milk from areas around a blocked duct can reduce the discomfort, making it easier to express from the tender area later.
Source: https://www.laleche.org.uk/hand-expression-of-breastmilk/ Written by Sue Upston, Karen Butler and mothers of LLLGB
