Hand Expressing Breast Milk: Step-by-Step Guide

Hand expressing breast milk means using your hands, not a pump, to remove milk from your breast. It’s free, it needs no electricity or equipment, and once you’ve learned it, you can do it anywhere.

It’s a skill worth learning even if you plan to pump or nurse. The CDC calls it an important skill for lactating women, especially in an emergency. Here’s how to do it step by step and when it helps most.

When hand expression helps

The CDC and La Leche League International (LLLI) list several situations where hand expression is useful:

• The first days after birth. Colostrum comes in small amounts, and hand expression collects small amounts well. The CDC notes that hand expression encourages milk production early in lactation.
• Engorgement. Releasing a little milk softens a very full breast so your baby can latch more easily. See our guide to engorged breasts for more relief tips.
• When pumping is painful. The CDC says hand expression may be more comfortable for some parents who have pain with a pump.
• No pump available. A power cut, a broken part, an unexpected separation from your baby or a disaster situation.
• Alongside pumping, to get more milk out (see below).
• Before birth, in some cases. LLLI mentions expressing colostrum during pregnancy for mothers with diabetes or who expect to be separated from their baby after birth. Only do this with your provider’s advice (more below).

Stanford Medicine’s newborn nursery, which teaches the technique to new parents, notes that hand expression lets you remove milk without expensive or bulky pumps.

How to hand express, step by step

Get ready

1. Wash your hands with soap and warm water, or use hand sanitizer with at least 60% alcohol, as the CDC advises.
2. Use a clean, wide-mouthed container to catch the milk. For colostrum, a small cup, spoon or syringe works well.
3. Get comfortable and lean forward slightly so gravity helps.
4. Warm and massage your breast. A warm compress, then gentle strokes from the outer breast toward the nipple, helps trigger let-down.

Press, compress, release

The CDC describes the technique in four steps:

1. Make a C shape. Place your thumb above the nipple and your fingers below it, about 1 to 2 inches (2.5 to 5 cm) behind the nipple.
2. Press your fingers and thumb back toward your chest.
3. Compress your fingers and thumb gently together.
4. Release, then repeat in a rhythm: press, compress, release.

At first you may see nothing, then drops, then, once let-down starts, small sprays. Keep a steady rhythm.

Cover the whole breast

• Rotate your fingers around the breast, like the hands of a clock, to express from different areas.
• Switch breasts when the flow slows, then go back. The NHS suggests continuing until the milk drips very slowly or stops.
• Don’t slide your fingers over your skin, and don’t squeeze the nipple itself. The NHS warns this can make your nipples sore.

The CDC is clear on one point: don’t squeeze hard or pull on the nipple. Hand expression should not hurt.

If milk isn’t flowing

• Move your fingers slightly farther back or to a different spot. The NHS suggests shifting your fingers if no drops appear.
• Think about your baby, look at a photo or smell a piece of their clothing.
• Breathe slowly, stretch or ask someone for a gentle back or shoulder massage. The CDC notes tension and anxiety can stop milk flowing well.
• Practice in the shower or another private space.

LLLI reminds you that hand expression is simple to learn and gets easier with practice.

Hand expressing colostrum

Colostrum, your first milk, is thick and comes in small amounts. That’s exactly what your newborn needs. Read more in our guide to colostrum.

• Collect it carefully. LLLI suggests catching colostrum in a small container or directly on a teaspoon to feed your baby right away. A small syringe can draw up drops from the spoon.
• Expect drops, not ounces. A few drops is normal and valuable.
• Early and often helps. In a 2009 Stanford study of mothers of premature babies, those who hand-expressed colostrum at least six times a day in the first three days later produced more milk than those who did it less often, even though both groups pumped equally.

Expressing colostrum before birth

Antenatal colostrum expression is sometimes recommended, for example if you have diabetes or your baby is expected to need extra support after birth. An NHS Greater Glasgow and Clyde guideline says most pregnant women can safely express from 36 to 37 weeks, using hand expression only, and lists situations where it’s not advised, such as a risk of preterm labor, placenta previa or bleeding in pregnancy.

Talk to your doctor or midwife before you start. LLLI notes that amounts before birth range from nothing at all to a few drops, and that what you get doesn’t predict your supply after birth.

Combining hand expression with pumping

You don’t have to choose between your hands and a pump. LLLI says you can combine the two, and many people get more milk this way:

• Before pumping: hand express or massage for a minute or two to start let-down.
• During pumping: massage and compress firm areas of your breast. Stanford researchers taught this approach, often called hands-on pumping, to mothers of premature babies.
• After pumping: hand express for a few minutes to remove extra milk.

If you’re exclusively pumping, this can be especially helpful in the first weeks. If you want a simple tool for occasional sessions, a manual breast pump is another low-cost option.

Storing hand-expressed milk

Cap and label the container with the date. Freshly expressed milk keeps up to 4 hours at room temperature (77°F [25°C] or colder) and up to 4 days in the fridge. Our breast milk storage calculator gives a use-by time for each storage place.

When to call a lactation consultant

Reach out to an IBCLC, a La Leche League Leader or your doctor if:

• Hand expressing hurts, or leaves your nipples or breasts sore or bruised
• You can’t get any milk after several tries in the days after birth
• Your newborn isn’t feeding well and you need to give expressed milk
• You have a painful lump, redness, fever or flu-like symptoms

A lactation consultant can watch your technique and show you small changes that make a big difference. For more on expressing and pumping, visit our pumping guides.