Hand expressing is a skill every breastfeeding mother should learn how to do.  Whether you're stuck somewhere without a pump or you're working out a stubborn clog, nature's original breast pump is always on hand!  Mothers who do not need to express milk regularly may find that expressing milk by hand is the only pump they will need.  Some women find that their breasts are more responsive to the skin-to-skin contact through hand expression than to plastic pump parts, which could help with volume output.

 

How to hand express:

 

1. Making a C shape with your hand, feel back 2-3 cm from nipple with your thumb on top and other fingers underneath.  This will be near but not touching your areola. 
    

2. Press your thumb and fingers directly back towards the wall of your chest.
    

3. Compress your breast between your thumb and fingers, moving them towards your nipple without lifting them. 

4. Release the compression.
    

5. Repeat these steps until milk stops coming out.  Adjust your hand to a different place on your breast.  You can use both hands to work your way around one breast, repeating the above steps until milk stops.  Switch to the other side until you have emptied all of the milk sinuses.
   
   Remember:  Press, compress, release.
    

It can take practice to learn what placement works best for you.  It may take 20-30 minutes for the whole process at first.  Breast massages before and during hand expression can be very effective in stimulating and releasing a letdown.  You can attach a Haaka to the opposite breast in order to catch every ounce of liquid gold that comes out.  Avoid pulling the nipple as it may result in tissue damage.  Hand expression should feel comfortable.  If it is not, adjust your hands until it is. 

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This video is a good visual demonstration for further instruction:

https://med.stanford.edu/newborns/professional-education/breastfeeding/hand-expressing-milk.html