Don’t think you’ll ever need to know how to do hand expression? Think again! While this is a skill that ALL mothers should know, those in the military have even more reason to know how to do it. Even if you plan on using an electric pump, the best laid plans can go wrong. It is always a good idea to know how to hand express your milk for the unexpected TDY, downed aircraft, power outages or missing pump parts. Every pumping mother runs the risk of forgetting her pump at home, or losing pieces (like those little white membranes on the Medela pumps), or having their tubing suddenly develop a pinpoint leak. And some mothers may be stationed in areas prone to natural disasters such as earthquakes, hurricanes or tornados where the loss of power means your pump won’t work anymore (you can and probably will be stuck on base if this happens…away from your baby). But military mothers also face the very real prospect of being sent into the field, far from electricity; or on an unexpected TDY or overnighter at a remote base, far from the local WalMart where you can run in and buy replacement part pieces. Knowing how to do hand expression is very important and may mean the difference between keeping your supply up and remaining comfortable, or losing your supply and being downright miserable.
It should also be noted that a small percentage of mothers can express milk faster by hand than with a pump, something you won’t know until you learn and give it a try!
Recent research has also shown that combining hand expression WITH pumping yields a higher milk volume than just pumping alone. This could be for a variety of reasons, but one of the most valid would be that the breasts respond better to skin-on-skin rather than plastic pump pieces. Another reason to learn hand expression!
Quickie Anatomy Lesson
First things first, you need to understand the basics of your breasts and where the milk collects so you know where your ‘sweet spot’ is for hand expression. Your breasts each have number of milk glands (anywhere from as few as 8 to as many as 20) that are all connected to ducts leading to the nipple. Right behind your nipple is a region where the ducts swell with milk right before and during milk ejection (they used to call it the ‘milk sinus’ until researchers figured out that it disappears when there is no milk in it.) Finding this area that swells during the milk ejection is the key to finding your ‘sweet spot’. This is the same spot that your baby finds with his tongue and presses against to force the milk out. How do you find this ‘sweet spot’ for your self? PRACTICE, PRACTICE, PRACTICE! I suggest practicing in the shower where the water makes your skin slippery and the warmth helps trigger a milk ejection. It’s also easier to clean up the milk once you find the ‘sweet spot’ and milk starts spraying everywhere!
How-to Hand Express
The basic technique hasn’t changed much over the years, and is pretty simple, really. Have a container ready (large-mouth is best) and/or a towel to catch the milk. If you are away on a FTX or TDY with no way to store your milk, you may just be expressing onto the ground or into a sink :
- Massage the breasts gently to encourage the milk-ejection reflex or let-down.
- Place your thumb and index finger on each side of your areola about 1-2 inches back from the nipple. Your hand should form a ‘C’ shape.
- Press back towards the chest wall.
- Compress your fingers together towards the nipple. Do NOT slide or squeeze.
- Repeat all around the breast to empty all the ducts.
- Repeat steps on other breast.
- Express from each breast for 3-5 minutes or until the flow switches from a stream to drops.
- Alternate breasts and express from each breast 2-3 times apiece.
The entire process should take between 20-30 minutes. With more practice you will get faster!
Here are some additional links to videos and photos showing how to perform hand expression: