Hand Expression to Support Your Breastfeeding Journey

A low milk supply is the most common reason for mothers to stop breastfeeding.  We have learned that what we do (or do not do) in the first 3 days after birth can have a major impact on future milk production potential.  Research found that milk production in pump-dependent mothers of preterm babies depended on the frequency they used hand expression in the first 3 days after birth.   Mothers who used hand expression more than 5 times a day in the first 3 days yet pumped with the same frequency as other study mothers, expressed an average of 955 mls, about a quart a day by 8 weeks. Mothers also found consistent increases in production when they did not rely solely on pump suction alone to remove milk, but used “hands-on pumping”. This technique combines breast massage, compression and hand expression with electric pumping and does not require more time. 

About 50% of mothers will have some difficulty getting their babies to latch on well in the first day. A recent study suggests it is more effective to teach hand expression of milk than pumping in the early days.  At 2 months, mothers assigned to hand expression were more likely to be breastfeeding (96.1%) than mothers assigned to breast pumping (72.7%). (p=0.02)

Another study suggests more milk can be removed with manual expression than with a new, double rental-grade pump in the first 48 hrs post-partum.  Given the feasibility and safety of hand expression, the routine practice in the first several days for infants at risk for suboptimal intake, and/or mothers at risk for suboptimal milk production should be to encourage frequent hand expression in the early days. This provides more stimulation to the breasts than breastfeeding alone and more milk for the baby. And as an added bonus, there is no cost or risk and only potential benefit in this approach!

Tips for hand expression:

1. Like any skill it can takes some practice to learn how to hand express. Watch some videos – we have some here on Sweet Sips Colostrum Spoons
2. Start hand expression at 37 weeks gestation. Order your hand expression kits here.
3. Reach out to a local IBCLC for further in-person instruction if needed. You can use this United States Lactation Consultant Association (USLCA) website to find a lactation consultant near you.