In the first 3 to 4 days after the birth of your baby, hand expressing your colostrum (your first milk) for a few minutes after each feeding will help you learn how to express milk and give your breasts extra stimulation. Stimulation of your breasts helps your body make milk, which is especially important if your baby is not feeding well. If this is the case, you can give your baby the expressed drops of colostum to encourage her to feed. You can also massage colostrum onto your nipples and let them air dry to help keep them from becoming sore.
Around day 3 or 4 after birth, some women experience breasts that are very full and uncomfortable, also known as engorgement. The breast can be so full that your baby has difficulty latching. You can express a little milk to soften the breast, making it easier for your baby to latch and feed. If your baby is small, preterm, or not feeding well, the expressed milk can be given to your baby using a spoon or cup. Feeding your baby frequently, every 2 to 3 hours in the first few days, helps prevent your breasts from becoming engorged.
How to hand express: Many women find it helps to use warmth, such as a warm wet towel or diaper, before starting to hand express. If your baby is with you, a skin-to-skin cuddle is a great way to ‘apply warmth’ and to help stimulate the let-down of your milk. Next, you want to gently massage your breasts. There are many different ways to do this. Experiment to see what works for you.
To express your milk, start by placing your fingers at the edge of the areola (the coloured area surrounding the nipple) or about 1 and 1/2 inches from the base of the nipple. Press your hand back into your chest wall. Then, gently squeeze your fingers together without sliding your fingers down your breast. As you continue to hand express, drops of milk will start to flow. Press, gently squeeze, and release - repeat several times and then move your finger positioning.
It is important to move your fingers around the areola in a circle to express from different parts of your breast. Switch from one breast to the other every few minutes.
This mother is expressing in the first 24 hours after birth. Many mothers do not get any or just a few drops of colostrum the first few times they try. This is normal. The second mother is able to express more colostrum. Partners can help collect the drops of milk with a spoon. Milk supply will increase over the early weeks. The third mother has an older baby and she has an established milk supply. She expresses into a clean container.
Learning to do hand expression takes practice. Do not be surprised if you do not see anything the first few times you try. It does not mean that you do not have colostrum in the breast – it just takes time to get the sticky colostrum flowing.
Like many mothers, you may find that once you learn to hand express, you can get as much milk, if not more, by hand expressing as you can with a pump. It makes sense to wait until after birth to see what you may need. If there is a temporary problem where you need to pump, a rental pump may be your best choice.