Breastfeeding: Breast Massage and Hand Expression

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KEY POINTS

• Breast massage, when you are breastfeeding, can help drain your breasts, relieve soreness, and clear plugged milk ducts.
• Experiment with finding the best way to position your fingers until you find the right spots.

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Breast Massage

Breast massage is used when you are breastfeeding to help:

• Drain your breasts and relieve soreness
• Clear plugged milk ducts
• Prevent breast infections such as mastitis
• Trigger the letdown reflex so that your milk can flow
• Increase the fat content of your milk if done right before breastfeeding

You can do breast massage when your breasts are sore, before breastfeeding, or before expressing your milk.

Here are the steps to follow for breast massage:

1. Take a warm shower or bath, or put a warm washcloth on your breasts for 5 to 10 minutes. Heat improves blood flow and helps your milk let-down. Relax. Take deep breaths and think about your baby.
2. With clean hands, hold your breast in one hand and massage with the other. Using the flat of your fingertips, start at the chest wall and stroke toward your nipple and areola (the dark area around your nipple). Move your fingers in a circular motion about the size of a quarter. You may also use a circular motion when you feel a full milk duct.
3. Gradually move your hand around the whole breast. This should take about a minute.

Hand Expression

On the second to fifth day after you have your baby, changes in hormones cause your breasts to start making a lot of milk. This can cause painful swelling called engorgement. Engorgement is a problem of poor milk flow, rather than too much milk. If your baby is not nursing well, draining some of the milk from your breasts with hand expression will let you relieve uncomfortable fullness and help your milk flow. Some women find that hand expression works better than using a breast pump to express milk.

To help get your milk to flow:

• Place your thumb, index, and middle finger in a C-shape about 1 to 1 and 1/2 inches away from the nipple. Start at the 6 o’clock and 12 o’clock positions.
• Press in toward the chest wall. Don’t move your fingers, just press back. This opens your milk ducts.
• Gently press your thumb and fingers together, rolling them forward. The rolling motion expresses the milk from the ducts. Collect your milk in a clean, wide-mouthed container like a cup or small jar. The milk may spray out in several directions, so be prepared! If you lean forward slightly, gravity helps get the milk into the container.
• Repeat these motions (press back, press together, and roll) until the milk ducts are empty. Then move your fingers to another position around the nipple and repeat.

Experiment with finding the best way to position your fingers until you find the right spots.

Switch back and forth between breasts when the flow of milk slows down.

Hand expression will take about the same amount of time as it takes your baby to nurse. At first, it may take 45 minutes. As you get more practice, expect to spend 20 minutes hand expressing.