10 Things An Expert Really Wants You To Know About Hand Expression

One of the first things I learned about Francie was her catchphrase, "Go milk yourself." I had absolutely no idea what that meant. In time I learned that she was also a working mom of two, a birth doula, and an International Board Certified Lactation Consultant-in-training. I also learned that "go milk yourself" referred to hand expression: a method by which a lactating parent can express and collect milk using only their hands and a container. Francie is passionate about it, and so I wanted to ask her how to hand express when you're breastfeeding, because while I knew you could sorta squeeze milk out of a lactating breast in a pinch (no pun intended), I didn't know it was a thing.

Now, when I say she's passionate about hand expression, I'm not exaggerating. She describes teaching other parents about this method as "her life's work," and she's not kidding. Her business, TheMilkinMama (and website of the same name) is designed to be a comprehensive hand expression resource for breastfeeding and chestfeeding parents. It has online workshops, videos, and links to other resources. Her team of teachers lead workshops for parents, birth professionals, and anyone else who supports parents who feed their babies with their bodies. Her book on the topic Go Milk Yourself: You Have Power. Express It! is coming out on October 10.

Photo courtesy of Hassan Abdus-Salaam

Yeah: she literally wrote the book on this, you guys.

I was curious. How does hand expression work? Could you really forgo a pump and just, well, milk yourself? A lot of my curiosity about hand expression was rooted in my deep-seated (and well-documented) hatred of pumping. I loathed pumping, largely because it was rare that I could never pump enough to provide sufficient milk for my infant when I was at work. Though I haven't nursed a baby in over a year now, listening to Francie teach others about hand expression and laud it as a viable option for breast-and-chestfeeding parents made me wonder if I'd missed out on an opportunity just because I'd never really considered it as an option.

So then I thought, "Hey! Maybe more people should consider it as an option. Even if it's not something that's going to work for everyone, people should probably know about it, right?"

Turns out, Francie is all about options, and graciously agreed to tell me all about hand expression so that I could pass it on to you.

You're welcome.

There's No One Way To Do It

Francie assures me that there's no Right Way™ to hand express and that, indeed, a huge aspect of hand expression is figuring out what works for your own body. That said, the key to hand-expression is compression: opening and closing the hand around the breast. A common technique she finds works for her clients is making a "C" shape with your hand and then, using your other hand, moving your fingers forward and down toward your nipple.

Practice Makes Perfect

Getting "good" at hand expression can happen in the matter of days or weeks. Certainly, determination comes into play. "They only difference I've seen between those who catch on and those who don't keep it up is practice," Francie told Romper. She encourages her clients to believe in their ability to succeed and not to get discouraged if it doesn't come right away.

How Much You Express Can Vary

Output can vary from person to person and day to day. "You can expect anything from a few drops to a few ounces per breast. My personal best is six [ounces in a session]," said Francie. Then she told me she knew a woman who could express 10 ounces. That conversation was last week and I'm pretty sure I blacked out immediately upon learning that and am only now coming out of it. As someone whose personal best is 5 ounces on a pump, I just can't process such abundance.

Francie reminded me, however, that most people cannot expect to produce that amount milk. "People shouldn't compare themselves to people with oversupply. Women don't think they're enough [as they are] but they are." And, let's also not forget that babies are better at extracting milk from a breast than a pump or your hands.

You Can Do It In Combination With Pumping & Nursing

When I asked if hand expression was an "either/or" issue, I was assured that was not the case. While some people are able to forgo the pump forever if they choose, most of Francie's clients do a combination of nursing, pumping, and hand expression. "Or they'll utilize hand expression while pumping to maximize output."

It's all about options, and hand expression is just one. Whether it works for you or not, that doesn't mean you can't utilize other options as well if they also work. Nevertheless, she feels hand expression is not given its due.

"Hand expression is usually presented as a stop-gap measure, something we use when we’re desperate or just need to use it this one time, perhaps for engorgement or to help bring milk in if the baby is in the NICU or the like. This contributes to the idea that we can’t do it ourselves, with our own bodies, for any sustainable period of time."

It Takes About As Long As Pumping

This may have been the part that surprised me the most. As with pumping, the amount of time one hand expresses to achieve desired results may vary, according to Francie, but in general it takes between 10 and 30 minutes, including breaks (to rest your hands, check you email, etc).

Things Can Get A Little Messy At First

"It can definitely be a mess, and it can take some time, especially at first. Soon, though, your aim improves and you get more efficient."

OK: it couldn't all be perfect, guys. But, turning back to the bright-side, Francie points out that it requires far less stuff than pumping. Just a clean vessel with a lid. Plus, it's not like you need an electrical outlet or batteries to hand express. And while you can't go hands-free (I mean... hand expression, friends) Francie contends that, "the benefits in getting to know your body and really having power over when and how your milk comes out are huge pros."

There Are Challenges You Might Face

While Francie has made spreading the good word of hand expression her vocation, she knows that what she teaches often runs counter to social conditioning about breasts, as well as people's own unique experiences. "People think it's weird. Breasts have been sexualized for a long time, separated from their normal and primary biological function, and that's part of it. ... There also may be trauma, including sexual trauma, that affects one's perception of and relationship with their body."

She recommends people who may be hesitant to try to lean into the challenge. "[Give] it a go, and if needed, explore the challenges that are preventing you from giving it a go. ... Talk about it. Read about it. Check out some videos. Take a workshop or a private session."

You Can Take A Break

"Sometimes your hands can get sore," Francie pointed out, which makes perfect sense but is something I hadn't considered at all. "But we teach ways to prevent discomfort so that this doesn’t happen. You can ... take a break whenever you want, and start again whenever as well."

There Are Resources To Available To Help You

In addition to a plethora of really good YouTube videos (heads up: while I find absolutely nothing scandalous or inappropriate about nude, lactating breasts, most of these videos would stupidly be labeled "not safe for work due to the abundance of nude, lactating breasts), lactation consultants can help you perfect your technique. "There are amazing lactation professionals who teach you in person and support you through the process. Often people will learn from a nurse or lactation consultant in the hospital and then never use it after that, so it’s good to have options when you get home, especially since so much about your production changes after those early days."

(Of course, there's also TheMilkinMama, as mentioned above.)

You Can Do It

Francie assured me that with practice, patience, guidance, and the belief that your body is, in fact, enough, anyone "[with] two hands and breasts or a chest with milk ... can get the second one out with the first. You can do it, even when you think you can’t."

"It’s an option, and having more options gives you more freedom."

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