Many women hand express milk to reduce engorgement, prevent let down, and save milk for later use. For some women, hand expression can be a more comfortable alternative to breast pumps. The process can be done anywhere, and without special tools or devices. It has also been shown to help the breasts produce more milk; some women's breasts express milk more easily through skin-to-skin contact than through the use of a plastic pump. If you want to know how to hand express breast milk, see Step 1 to get started. CLICK HERE.


1. Wash your hands. Your hands should be washed before you attempt to hand express breast milk. If you washed your hands with cold water, let them warm up before touching your breasts. Cold hands can cause the process to take longer than warm hands. If it's your first time and you're feeling uncertain, you can also ask for help from a nurse, or even get some help from your partner.


2. Put a cloth moistened with warm water over your breast for 2 minutes. This can help with the expression of milk. Though it's not necessary, it certainly won't hurt the process.


3. Give your breasts a massage. If you want to prime your breasts for hand expression further, you can give your breasts a gentle massage using your hands or a soft towel. Just gently knead and massage the skin around both nipples to help your breasts relax and get ready to produce milk.


4. Sit up and lean forward. This position will make it easier for you to express your milk and to stay comfortable during the process. You won't express as much milk if you're standing or lying down.


5. Position your fingers over the milk reservoirs on your breast. You should position your hands in a "C" above or below your nipple. Here's what you should do:

  • Put your thumb above your nipple. It should rest approximately 1 inch (2.54 cm) above your nipple.
  • Place the first 2 fingers of your hand 1 inch (2.54 cm) below your nipple directly in line with your thumb.
  • Adjust your finger placement for comfort and your breast size.
  • Refrain from cupping your breast in this position


6. Apply pressure inward toward your chest wall. The pressure should be gentle and firm, but should not feel like you are squeezing the breast at all. Avoid tightening or stretching your skin over the areola, because this will make it more difficult to express the milk. Press your thumb and index finger directly back into the breast tissue, into the wall of the chest. Here are some other things to keep in mind:

  • Remember to press back, not out, and to roll your fingers, not slide them.
  • Roll your thumb and fingers forward so that you squeeze the milk out of the milk sinuses, which are found under the areola, under the nipple.
  • Keep fingers together. Spreading your fingers out reduces the effectiveness of the process.
  • Lift larger breasts before applying pressure


7.  Collect the expressed breast milk in a container. If you're expressing just to make your breasts feel more comfortable, you can express the milk into a towel or just express it over a sink. Here are some things that you can do if you do want to save the milk for later use:

  • Use milk bags to collect the expressed milk.
  • Express the milk directly into bottles for later use.
  • Use a funnel to direct the breast milk into your chosen container, if necessary.
  • Use a container with a wider mouth, such as a coffee cup or a small jar. Once the cup is filled, transfer the milk into a storage container.


8.  Repeat the process on the other breast. Change positions slightly on each breast to completely express all milk. Moving back and forth between the breasts will stimulate even more expression of milk.

Until recently hand expression of milk has been an under-utilized skill in our institution. But there are many benefits of knowing how to express milk from the breast without the use of expensive or cumbersome pumps. In this video, Dr. Jane Morton demonstrates how easily hand expression can be taught to mothers.

This material was developed by Jane Morton, MD and produced for educational purposes only.  Reproduction for commercial purposes is prohibited.  Utilization of the materials to improve care of pregnant women and their newborns is encouraged with proper citation of source.