Hand Expression of Colostrum or Breast Milk
How hand expression helps you and your baby?
- More breast milk or colostrum can be expressed out.
- Frequent colostrum removal encourage breast milk to come in sooner.
- Stimulates your breast for better milk flow and supply.
- Encourages milk ejection reflex (MER) or "let down reflex" with skin to skin contact.
- Relieve engorged breasts.
- Supplement more breast milk or colostrum to baby who needs more milk.
It can be done anytime and anywhere. No equipment is required. Just use your hands.
Hand expression makes it easy to collect every drop of precious colostrum prenatally and the first few days after birth.
This video shows you how to use hand expression to extract out more colostrum or breast milk on the first few days after birth.
- Sit up and lean forward (slightly)
- Gentle massage with your fingers or warm towel
- Form a "c" with your thumb and finger pads
- Press back, compress and relax (Release and repeat rhythmically)
- Alternate (switch back and forth between breasts)
- Collect milk in spoon, vial or syringe
Early hand expression increase the later milk production.
How to hand express
- At the start, simulate milk flow in both breasts. It may take a fews minutes of hand expression, to simulate your milk ejection reflex (MER or "let-down") for the colostrum or breast milk to start flowing. Some may experience a tingling sensation.
- On each breast, expressing until the milk flow slow right down. You may continue expressing for a few minutes after the milk flow has stopped to further increase the milk production if needed.
- Repeat the above two steps at least twice more. Each time you repeat, the milk flow slows and stops sooner. More milk ejection reflexes can be trigger by switching the breasts several times as milk flow slows.
How to collect the expressed colostrum or breast milk?
Colostrum can be expressed into a teaspoon or small container (3-5ml) for immediate feeding or storage. Once milk production has increased, a bottle with funnel, a bowl or wide mouth container is more suitable as the milk may spray in several directions.
How much time will hand expressing take?
Frequent short sessions are more effective usually. You may take about 20 or 30 minutes for the whole process.
More milk can be removed as the flow tends to be better when you are feeling relax, warm and comfortable. You could practice in the shower or bath. Use the relaxation techniques, visualise flowing milk, take a few relaxing breathing and drop your shoulder with each exhalation, have your baby nearby, or think of baby (smell your baby's clothing, use your baby's photos or recordings).
Antenatal Expression of Colostrum
Practice hand expression parentally build your confidence, gets familiar with your breasts and how they work.
Is it safe? Yes, a few minutes 3 times in a day is unlikely to trigger labour. Stop immediately if you experience any uterus cramps when expressing.
When to start: around 36 weeks of pregnancy.
How much time: 3 to 5 minutes, just until you have a few drops of colostrum.
How frequent: you can express up to 3 times in a day.
How to store expressed colostrum: Store the syringe at the back of the fridge (coldest area) if you plan to express again that day. After the last expression, seal the syringe in a bag. Label and date it before putting it in the freezer (separate from the raw meat/poultry/seafood) for up to 3 months. Fresh colostrum can be stored safely in the fridge for 48 hours.
Warm and relax helps with the milk flow. You can start by practicing in the shower or bath.
When you start collecting colostrum, express after a warm shower or bath.
Regular simulation and practice will increase the colostrum you can expressed out.
You will be able to express colostrum if needed, including:
- A small amount of colostrum on the nipple encourage baby to feed
- If baby doesn't feed well on the first few days after birth.
- Supplement your own colostrum or breast milk to prevent or treat conditions such as low blood sugar or jaundice.
- Avoid problems with breasts engorgement and mastitis.
Collect colostrum for some special situations, including:
- Planned caesarean or induced birth. If mother and baby are separated, the colostrum is available to feed baby.
- Mothers with diabetes. Colostrum can maintain the baby's glucose levels. Exclusive breastfeeding reduce the risk of a baby developing diabetes later in his life.
- Mothers with breast abnormalities or who have had breast surgery. Stored colostrum will be helpful if the mother encounter problem to establish supply.
- Baby with a cleft lip or palate will be harder to be breastfeed. The breast milk will aid with the healing when the cleft lip is repaired and protect baby from hospital germs.
- Other medical conditions.