The Complete Guide to Hand Expression

What is hand expression?

Hand expression is very simple. It is the process of using your hands to move/express your milk. Put another way…let’s learn how to milk your boobs. Hand expression is often better at moving your early milk, colostrum, than a pump. 

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What is colostrum? 

Colostrum is a nutrient-rich, yellowish fluid that is produced by the mammary glands of mammals, including humans, during late pregnancy and the early postpartum period. 

• It is your first milk and what your baby will drink after they are born. It is essential to your baby’s development 
• supports their immune system, promotes growth and development, and improves their gut health by providing a protective coating to your baby’s gut. 
• Colostrum also provides antibodies that help to protect your baby from infections and to support its overall health.

When does colostrum “come in?”

Your body starts producing colostrum between 16-22 weeks gestation. The exact timing can vary from woman to woman and can be influenced by a number of factors, such as maternal hormones, stress levels, and certain  conditions.

After giving birth, the production of colostrum increases, and over time transition to more mature milk.  Milk production typically starts ramping up 20-40 hours after birth and most mothers notice a big shift around 2-4 days after birth. This is commonly called “milk coming in. '. In reality, your milk production gradually increases over 2-4 days after birth.  This milk is referred to as transitional milk and is a mixture of colostrum and more mature milk. You will make transitional milk from 2-5 days after delivery until up to 2 weeks after delivery. Transitional milk may appear more yellow in color than mature milk. 

Over the next few weeks after your birth, your milk volume will continue to increase until reaching a more steady point around 1 month. Exclusively breastfed babies require about 25-30 ounces per day from around 1 month  of age to 6 months of age. At 6 months, with the introduction of solid food, this requirement slowly and gradually decreases. 

When should I start giving my baby colostrum?

Your baby should be fed colostrum as soon as possible after birth, as it is rich in nutrients and antibodies that are critical for their health and development. You will want to feed your baby regularly and on-demand, rather than on a strict schedule.

Why learn hand expression?

Studies show that using your hands to express milk within the first hour after your birth could increase your milk supply by 130% by 6 six weeks postpartum.  Knowing this skill also allows you to feed your baby your colostrum even if they are struggling to latch. I have had so many moms tell me over the years that knowing how to hand express SAVED their breastfeeding journey. 

When should I start practicing hand expression 

My goal is for you to know how and when to hand express before your birth.  That way you will be able to do it immediately after birth and will know what techniques work best for your body. I recommend starting to practice hand expression around 38 weeks, with provider clearance–plan to ask your provider at 35ish weeks.  Generally, if you are cleared for intercourse, hand expression should be allowed. Hand expression stimulates oxytocin release which is also released during orgasm. 

When should I hand express?

• Do it after a shower - warmth, and relaxation help
• Light massage will boost oxytocin
• Practice for 3-5 minutes, two times a day
• Consider collecting for use during the early breastfeeding days

• Collected colostrum can be used instead of formula for early supplementation, can help entice a sleepy baby, help with low blood sugar for at-risk infants, and can help support infants with jaundice.

What is colostrum harvesting?

It is safe to say colostrum harvesting is having a moment, despite its name. 😉There are a lot of benefits to harvesting or saving your colostrum pre-birth to feed your baby after they are born. Harvesting your own colostrum can be a good option for those who want to provide their newborn with the benefits of colostrum, which includes antibodies and growth factors that help to protect the baby from infections and support its growth and development. It can also be a good option if you are struggling with latching, dealing with a very sleepy baby at the breast or baby with low blood sugar, or other concerns about your baby not effectively moving colostrum at the breast. 

Colostrum can be stored in a clean container in the refrigerator for up to 72 hours, or in the freezer for up to 6 months.

How do I hand express?

1. light massage around the nipple/areola...get acquainted with your breasts and nipples
2. place a finger in a "C" around the nipple
3. compress (push) fingers back toward your chest wall
4. then brings fingers together for a 1-second hold 
5. Relax your fingers and repeat 
6. IT IS NORMAL FOR IT TO TAKE A FEW MINUTES FOR MILK TO FLOW, ALTERNATE WITH LIGHT MASSAGE, AND TRY TO RELAX. 

Hand expression, like latching, will take a little practice, which is one reason it is great to start prior to birth. By starting prior to birth, It gives you a chance to get practice on how to express, how your body responds, and demystifies your nipples prior to the first latch with your baby. In Boob School, we have an entire module on hand expression full of tips and tricks to get the most out of this practice. Plus a bonus guide to give you detailed steps, instructions, and tips to help you get the most out of hand expression.

Common Questions & Answers

Q: "I've tried this and nothing is coming out, is that okay?"

A: It can be completely normal prior to birth and even immediately after birth for you not to be able to express any colostrum, it doesn't mean to stop trying! It is still stimulating your breast tissue and is beneficial. It may also be a sign to troubleshoot a bit. 

Try a slightly different hold on your breast, making sure you are not compressing and rolling your nipple, but are pushing back into your chest wall, trying a slight repositioning of your fingers. 

Try adding in more massage or warmth so much even have success practicing after sex when oxytocin levels are naturally elevated. 

Some moms will have trouble expressing colostrum until the placenta is delivered. The placenta secretes hormones that, “put the breaks on lactation.” Depending on your sensitivity to these hormones in pregnancy you may not see much or any drops until after birth. THIS DOES NOT MEAN YOU WON’T MAKE PLENTY OF BREASTMILK. I recommend continuing to practice. One of the biggest benefits is simply knowing the hand motion so you can use this skill right after birth!

Q: "My provider said there is no benefit to hand expressing prior to delivery, is that true?"

A: This is the bullshit that makes me want to shout from the rooftops, respectfully, your provider is full of it and not informed. Hand expression prior to birth can be HUGELY beneficial, not only is it linked to better feeding outcomes and duration, but it gives you CONFIDENCE with your breasts/nipples and your ability to get things going. Learning all there is to know about breastfeeding and hand expressing after birth, with no prior experience, is a bit like trying to build a car and drive it at the same time.  Hand expression stimulates the same hormones as having an orgasm so if you are cleared for sex hand expression should be safe. 

Q: "I've given this a try and want to collect the colostrum, but don't know what to use. Help!"

A: YAY!!! Look at your badass self go! Collecting colostrum can be hugely beneficial for the early postpartum time! You can collect it in a spoon and then transfer it to a 3 ml syringe, then freeze it. Click here for supplies to collect your colostrum. You can bring your collected colostrum to the hospital with you! 

Hand Expression Masterclass

Want to learn more about the how, when, and why of hand expression? I got you!!!  We have an entire masterclass class in Boob School walking you through the entire process from prenatal practice to using it to help your baby latch.  We also give you a downloadable BONUS PDF with directions and storage guidelines. 

Here are just a few thoughts from moms who have watched my Hand Expression Masterclass...

"Thank you so much for your hand expression masterclass - I could not feel more confident going into my delivery in the next couple weeks"- Katie

"Tears of joy! I just practiced hand expression for the first time and had immediate success! I can't tell you the peace of mind and empowerment it brings me to have this tool in my belt"- Stephanie 

"I took your hand expression class before I had my baby.  We weren't able to latch in the hospital but I was able to hand express to establish my supply while we worked with an IBCLC on latching. We have not needed to supplement at all. I wanted to say thank you because I really think being able to hand express helped set us up for success"-Heather

How to get more help today…

Get access to my Hand Expression Masterclass, TODAY, in Boob School! Get access to 12+ modules, live class recordings, free membership to natural breastfeeding, 11 bonus guides, a private Facebook group, and live weekly support calls! Phew! If that sounds like a lot, it is! I designed Boob School to be as comprehensive as possible aka the breastfeeding class I wish I had and the one I want my baby sister to have for her journey. 

Need more one-to-one support? You can reach out to a team member today, here.  

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Cheering you on, always!!

XOXO
Kelly

Boob School Founder and CEO

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