Even where women have the choice to use pumps, many prefer hand expression. Hand expression imitates a baby's suckling action more naturally. Also sterilization of breast pumps is essential for safety and may be difficult to control in emergencies.
· Wash your hands thoroughly.
· Have a clean cup or container with a wide neck.
· Make yourself comfortable.
The following instructions are just guidelines. You find the way that suits you (Figures 6a, 6b and 6c).
· Hold your breast with your four fingers underneath and your thumb on top behind the nipple. Do not squeeze the nipple.
· Gently feel the little thickenings inside your breast under the areola. These are 'lactiferous sinuses' which is where the milk collects as it comes down.
· Compress your fingers and thumb rhythmically in a way that suits you.
· Move your hand round your breast, expressing milk from the sinuses.
· Do the same with the other breast.
· If you prefer use both hands on each breast.
You may find that your milk does not 'come down' as quickly as when your baby is near you. Think about your baby. If you have a photo look at it or smell some of his clothing. Ask someone to massage your back gently. This is where women can help and support each other. If you can find another mother who has hand expressed already, ask her to teach you.
Two helpful methods to teach another woman are:
· if you are lactating let her watch you do it
· make sure she is comfortable, then stand behind her and guide her own hand on her breast. In this way she has had practice under your guidance.