How to hand express breastmilk

hand-expressing-breastmilkThere are many situations when knowing how to hand express breastmilk is a very valuable technique. Perhaps your breastpump quits working or you are unexpectedly separated from your baby.

Stanford University has an excellent video showing how to do hand expression:

Stanford University Hand Expression Video – This video contains a real example of hand expression.

The website of Dr. William Sears has a simple step by step explanation: Hand Expressing Your Milk – The Low-Tech Approach (from

Expressing milk by hand works very well for some women. It’s a handy skill to have when:

  • You are caught somewhere with full breasts and you don’t have your baby or a breastpump, you’ll be able to relieve breast fullness and avoid problems with engorgement.
  • You do not need to express milk regularly.
  • Your breasts are more responsive to the skin-to-skin feeling of hand expression than to plastic pump parts.


  • Position your hand on your breast, with the thumb above and fingers underneath, about an inch to an inch-and-a-half behind the nipple. If your breast were a clock, your thumb would be at 12 o’clock and your fingers at 6 o’clock. Don’t cup your breast in your hand. Instead, your thumb and fingers should be directly across the nipple from each other.
  • Press your thumb and fingers directly back into the breast tissue, towards the wall of your chest. Don’t move them further apart. Just press straight back into the breast.
  • Roll your fingers and thumb forward to squeeze milk out of the milk sinuses, which are located under the areola behind the nipple. Don’t slide the thumb or fingers along the skin–this will quickly make you sore.
  • Repeat this sequence–position, press, roll–until the milk flow ceases. Then move your hand so that the thumb and fingers are positioned at 11 and 5 o’clock and do it again. Use both hands to work your way around one breast, then switch to the other side until you have emptied all of the milk sinuses. As soon as you see milk squirting from your nipple, you know you are compressing the underlying milk sinuses. (This position is also where baby’s gums should be during efficient latch-on.)
  • The trick to hand expression is discovering where to position your fingers. Experiment until you find the right spot. Having someone show you how is very helpful, too.
  • Combining hand-expression with breast massage can be a very effective way to stimulate the milk-ejection reflex. Massage first, then express. Massage again, and repeat the hand- expressing routine.

When moms come in for a lactation consultation with Diane Erdmann RN BSN IBCLC, showing moms how to massage and express their milk is the first thing that is done with every mom before getting baby latched on. To make an appointment for a lactation consultation, call Diane at (402) 707-1696 or contact Diane to set up an appointment.

Still have questions? Don’t hesitate to call or email me anytime with your concerns. I am here to assist you in any way I can.

(402) 707-1696 or contact me.