The One Skill I Want You To Learn before birth
One of the most important things that I teach new mothers during consultations is hand expression. Hand expression refers to manually removing colostrum/milk using your hands rather than directly latching your baby or using a pump. This skill is essential during the first few days postpartum but is also an important tool to utilise in late pregnancy and throughout your lactation journey. Deep ductal tissue stimulation is an amazingly effective way to support milk onset, get your milk flowing, and relieve the pressure of full breasts.
Research has shown that practising hand expression during pregnancy can significantly boost a mother's confidence and preparedness for breastfeeding. Not only does it enhance breastfeeding confidence, but it also extends the duration for which mothers breastfeed. Taking the time to practice hand expression before your baby arrives can be empowering, especially as it allows you to familiarise yourself with the process without the pressure of needing to express milk for your baby immediately.
Studies have revealed that hand expression can be particularly effective in the initial days after giving birth, especially when your colostrum is thick and your breasts are engorged. Unlike pumping, which may result in wasted colostrum sprayed on the sides of the bottle, hand expression ensures that every precious drop is saved. Hand expression can also be used with pumping to increase the caloric content of your milk and facilitate better milk removal.
Beyond its practical benefits, hand expression can also positively impact how we perceive our breasts and their capabilities. It can help alleviate concerns about milk supply, a common worry among breastfeeding mothers. Recent research has shown that our perceptions of milk production often do not align with reality, highlighting the importance of practical skills like hand expression.
Various studies have highlighted the advantages of antenatal hand expressing, such as increased milk volumes after birth, better breastfeeding outcomes, higher colostrum production, and improved confidence in breastfeeding. Whether you collect colostrum or not, practising hand expression during pregnancy can serve as valuable preparation for your baby's arrival.
Hand expression can be started in late pregnancy (36+ weeks) as long as you have no significant risk factors and your health provider clears you.
Incorporating hand expression into your routine post-birth can help support milk supply, provide additional colostrum for your baby if needed, and offer relief during periods of engorgement.
This physical skill takes some practice. Everyone’s breasts are a little different and respond differently. The best thing to do is practice, get comfortable with your body, and learn how it responds to various kinds of stimulation. Try to think of it as applying compression to the firm tissue deep in the breast—so you aren’t milking just your nipple.
If you are hand-expressing for colostrum, I suggest using a small cup and a syringe to collect and save your liquid gold. If you are yielding higher volumes, you can express directly into a bottle or a milk collection device. You can offer your expressed milk to your baby or save it in the refrigerator or freezer to take with you to hospital.
Once your baby is born and learning to breastfeed, hand expression is a powerful way to draw out colostrum to entice your baby to latch or offer them nourishment when they are sleepy post-birth or are not ready/able to latch themselves. This kind of deep tissue stimulation in the breasts helps support milk onset and bring your mature milk in faster, which is excellent for you and your baby!
Lactation consultants can show you how to hand express your milk effectively and efficiently. I always recommend that you take advantage of any time you get with a lactation consultant to ask about hand expression and any other issues or questions you might have on this topic.
Hand expression is one of the most important tools to have in your toolkit because of its effectiveness at bringing in your milk, building a strong supply, and relieving engorgement. It is something that requires no equipment or cost. If you are ever stuck in a situation where you don’t have access to a pump, and your baby isn’t available to latch, this is a way to remove milk and protect your supply and breasts from issues like breast inflammation. In my professional opinion, hand expression is the most beneficial thing you can do for your lactation journey on a day-to-day basis!