BOX 7How to express breast milk by hand

The mother should:

  • Have a clean, dry, wide-necked container for the expressed breast milk;
  • Wash her hands thoroughly;
  • Sit or stand comfortably and hold the container under her nipple and areola;
  • Put her thumb on top of her breast and her first finger on the underside of her breast so that they are opposite each other about 4 cms from the tip of the nipple;
  • Compress and release her breast between her finger and thumb a few times. If milk does not appear, re-position her thumb and finger a little closer or further away from the nipple and compress and release a number of times as before. This should not hurt – if it hurts, the technique is wrong. At first no milk may come, but after compressing a few times, milk starts to drip out. It may flow in streams if the oxytocin reflex is active;
  • Compress and release all the way around her breast, with her finger and thumb the same distance from the nipple;
  • Express each breast until the milk drips slowly;
  • Repeat expressing from each breast 5 to 6 times;
  • Stop expressing when milk drips slowly from the start of compression, and does not flow;
  • Avoid rubbing or sliding her fingers along the skin;
  • Avoid squeezing or pinching the nipple itself.

From: SESSION 4, Management and support of infant feeding in maternity facilities

Cover of Infant and Young Child Feeding
Infant and Young Child Feeding: Model Chapter for Textbooks for Medical Students and Allied Health Professionals.
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