M.Ed., RD, LDN, CLC, RYT-200
Andie is a Registered Dietitian, Certified Lactation Consultant, and Certified Personal Trainer who thinks of nutrition counseling as equal parts science and sensitivity. She specializes in lactation, sports nutrition, exercise fitness, and weight loss programs.
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When to Hand Express
Before mechanical breast pumps were readily available, nursing mamas would use hand expression to remove milk from the breast. Even if you now have a pump at your disposal, hand expression is still a useful skill to know and learn.
The following scenarios are all appropriate times to hand express:
How to Hand Express – the Marmet Technique
Developed by a mother who needed to express her milk over a long period of time for medical reasons, the Marmet technique mimics the actions of a breastfeeding baby and is the most recommended method of expressing breastmilk by hand.
Keep in mind that milk supply will increase over the early weeks following your baby’s birth and the amount you express will also increase as you get better at hand expressing.
While other methods exist, the Marmet method minimizes the damage to breast tissue, bruising or even skin burns that may result from other techniques – especially if you are hand expressing on a regular basis.
The Marmet technique is considered safe, but if anything feels uncomfortable or painful, you should always reach out to a healthcare provider or lactation specialist.
Videos of hand expression can be found here https://med.stanford.edu/newborns/professional-education/breastfeeding/hand-expressing-milk.html and here https://vimeo.com/65196007.
Wash your hands well and find a clean container to collect expressed milk. Many mothers express milk directly into a bottle or breastmilk storage bag. You may feel more comfortable starting with a cup that has a wider mouth to minimize spills.
Try to find a comfortable space where you feel relaxed – this will help with milk flow. If you are away from your baby, looking at a photo of your little one or even smelling their clothes or blanket can help stimulate milk flow.
You can try sitting or standing (whichever is more comfortable for you), as long as you are in an upright position, slightly leaning forward. This way, gravity is working for you.
Try placing a warm wet towel on your breasts for a few minutes before massaging – many women find the warmth helpful. Then massage your breasts to help stimulate the flow of milk. Start by moving your fingers around your breast, pressing firmly in a circular motion (similar to a breast examination). Be sure to lift your fingers off your breast as you move around the nipple – a sliding motion could cause skin burn. Lightly stroke your breasts from the chest wall to the nipple – continue to do this around the breast. Then, shake your breasts gently while leaning forward so that gravity can help the milk eject.
Express milk in place of a full feeding
Massage and express from each breast about three times using this pattern.
These timeframes are just guidelines. Pay attention to the flow of milk and switch to the opposite breast as the flow slows down. Your own timing and efficiency will improve as you practice the technique.
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