Updated: Jan 12, 2020
by Alissa Pemberton – Midwife & International Board Certified Lactation Consultant| www.suffolkbreastfeeding.com
When we think about expressing the first thing which pops into most mum's minds is a breast pump. Whilst breast pumps are a great tool and most mums will use one at some point in their breastfeeding journey, there is another little magical trick you can have up your sleeve which can be a saviour in so many situations! How to Hand Express - start by washing your hands, and collecting something to express into. If you are expressing whilst pregnant, or in the first day or two you may find expressing straight into a small syringe is most effective. If not use a clean cup/bottle. - using the same hand as breast (if expressing from right breast, use right hand), make a C shape with your thumb and fingers - place your fingers about 1-2cm outside your areola. - press back into your breast (almost as if you were trying to stretch the skin around your nipple) - compress your thumb and fingers together behind your nipple. Your fingers shouldn't slide down your breast. - you can adjust the position of your hand until you find a spot where you see most milk come out. - it may take a few minutes to achieve a letdown, and massaging before your start expressing can help.
When is hand expressing useful? Hand expressing is a great tool to use at a number of different times in your breast feeding journey. In the first few days, before your milk comes in, the colostrum you produce is very thick and very small amounts and therefore gets lost in a breast pump. Many pumps also don't have strong enough suction to extract much colostrum. Hand expressing is the go to during these first few days, and it's a great technique to use if for any reason you are separated from your baby or you're having difficulty latching - you can hand express colostrum into a syringe to feed to your baby. Hand expressing can also be used in conjunction with a breast pump. Hand expressing a small amount of milk prior to using your pump can help to stimulate a letdown. When you notice the milk flow has slow significantly/stopped whilst using your pump, take the pump off and hand express for a few minutes - you can obtain a lot of extra milk by hand expressing, even once the pump is no longer able to. If your baby is having trouble latching you can hand express a small amount of milk onto the nipple to entice them to latch. Did you know you can express before your baby is born? Many mums are surprised to hear you can express colostrum even before your baby is born! Your body starts producing colostrum from around 28 weeks of pregnancy. It's recommended you don't start expressing until 37 weeks, as there is a very small chance with any type of nipple stimulation it can trigger surges in oxytocin (the hormone responsible for contractions during labour) and cause pre-term labour. Using exactly the same technique above, you can express colostrum directly into syringes. Simply label them with the date, place them in a ziplock bag in the freezer and add to your stash as often as you like in the last few weeks of pregnancy. You will find over the time you express your supply with actually increase and by the time your baby is born you might be obtaining twice as much colostrum or more during each hand expressing session as you did when you first started. How often to express in pregnancy? You can express as often as you like. Many mums find once they're on maternity leave and have more time they will express every day or twice a day. Once you get closer to or beyond your due date you might even like to express more frequently or use an electric breast pump to help bring on labour. If I express now, will there still be colostrum for my baby when they're born? YES! Your body produces colostrum in the same way as mature milk - the more you remove the more it produces, so it will replace everything you express during pregnancy. You may even find you have more colostrum available after birth than you otherwise would have!
So why hand express before birth? As a parent, there's rarely a situation where you'll regret being prepared for every eventuality - the same goes for breastfeeding. Whilst many mums will find breastfeeding goes smoothly from day one and they don't need to top up their baby with expressed milk or formula, there are many situations where this might be necessary and it's such a relief as a mum to know you've got a stash of colostrum ready for your baby in those first few days in case there are any difficulties with breastfeeding. If you are unwell and unable to breastfeed, your baby requires special care in the NICU or you are having trouble latching - you don't need to worry about introducing formula unnecessarily because you've got a prepared stash of frozen colostrum waiting!