Breast-Feeding: Breast Massage and Hand Expression

Breast massage and hand expression of your breasts helps your milk to flow. Some women find that hand expression works better than using a breast pump to express milk.

On the second to fifth day after you have your baby, changes in hormones cause your breasts to start making a lot of milk. This is called engorgement. Hand expression helps to get milk flowing when this happens.

Breast Massage

Take a warm shower or bath, or put a warm washcloth on your breasts for 5 to 10 minutes. Heat improves blood flow and helps your milk let-down. Relax. Take deep breaths and think about your baby.

For best results, start by massaging your breast:

• With clean hands, hold your breast in one hand and massage with the other. Using the flat of your fingertips, start at the chest wall and stroke toward your nipple and areola (the dark area around your nipple).
• You may also use a circular motion when you feel a full milk duct.
• Gradually move around the whole breast. This should take about 1 minute.

Hand Expression

• Place your thumb, index, and middle finger in a C shape about 1 to 1 ½ inches away from the nipple. Start at the 3 o’clock and 9 o’clock positions.
• Press in toward the chest wall. Don’t move your fingers, just press back. This opens the ducts.
• Gently press your thumb and fingers together, rolling them forward. The rolling motion expresses the milk from the milk ducts.
• Repeat these motions (press back, press together, and roll) until the milk ducts are empty. Then move your fingers to another position around the nipple and repeat.
• Collect your milk in a clean, wide-mouthed container like a cup or small jar. The milk may spray out in several directions, so be prepared!
• If you lean forward slightly, gravity helps get the milk into the container.
• Switch back and forth between breasts when the milk slows down.
• Experiment with finding the best way to position your fingers until you find the right spots.
• Hand expression will take about the same amount of time as your baby does to nurse. At first, it may take 45 minutes. As you get more practice, expect to spend 20 minutes hand expressing.