How to do breast massage while pumping

What is ‘hands-on pumping’?

The hands-on pumping method involves using your hands to massage your breasts while you express breastmilk with a pump. Ever notice your baby grabbing and kneading at your breast while they’re feeding? It’s an instinct that helps them extract more milk. And it may sound a little strange, but you can use hand expression while pumping to extract more milk than with a breast pump alone.

Dr. Jane Morton, a pediatrician and lactation consultant, originally developed this technique to help mothers of very premature babies reach and maintain high levels of breastmilk production. But any mom who needs to pump more breastmilk can use it.

Why go through all the extra effort? Pumping can be a lot more effective when you learn to combine it with breast massage and hand expression, especially early on. One study showed that moms of premature babies who used the hands-on pumping method increased their milk by an amazing 48%1. Their expressed milk also had higher fat content2 , which supports baby’s brain and nervous system development. Hands-on pumping for the double win!

How do I do it?

Tip: Use a hands-free pumping bra like the Lansinoh Simple Wishes Bra to free up both hands while you pump.

1. Start by massaging both breasts and nipples to stimulate your milk ejection reflex. Having your baby nearby or thinking about your baby may help to get your milk flowing. Some mothers look at photos of their baby, watch videos, or even hold a blanket that has baby’s scent to help stimulate this reflex. Using heat can also help encourage your let-down and stimulate faster milk flow3. Lansinoh’s Therapearl 3-in-1 Breast Therapy packs are a great warm-up for your pumping routine.
2. Use a double electric breast pump on the highest suction setting that is comfortable and pump both breasts at the same time. Pumping should not hurt. Some pumps, like the Lansinoh Smartpump 2.0, offer different pumping styles and suction options to help you find the one that‘s most like your baby’s feeding pattern.
3. While pumping, use your hands to massage and compress milk out of your breasts, and be sure to include areas further back on the breast. Milk comes out through your nipples but it’s produced further back in the breast tissue, so massage or compression in those areas can improve pumping results. Feel for any areas of firmness and focus your massage there. Moms find that different techniques work for them, so try different techniques like massaging in little circles or using compression. Experiment to find what works for you, and watch as your milk sprays into the collection bottle to help guide you.
4. When your flow slows to a few drops, stop pumping and massage your breasts again for a minute or two. Pay special attention to any areas of fullness.
5. Finish expression, either by single pumping or using hand expression while pumping, alternating from one breast to the other until both breasts feel fully drained.

Tip: Recording how much milk you express each time may help you fine-tune your technique.

To maximize the amount of milk you express, spend as much time as possible holding your baby skin-to-skin. It’s not only fun to get baby snuggles, but it helps stimulate the hormones that cause your milk to let down. It takes practice and extra effort, but for many moms, hands-on pumping is worth it.

1 MORTON J et al (2009). Combining hand techniques with electric pumping increases milk production in mothers of preterm infants. J Perinatol 29:757-764. Available at: https://www.researchgate.net/publication/26335360_Combining_hand_techniques_with_electric_pumping_increases_milk_production_in_mothers_of_preterm_infants.
2 MORTON J et al (2012) Combining hand techniques with electric pumping increases the caloric content of milk in mothers of preterm infants. J Perinatol 32:791–796. Available at: https://www.nature.com/articles/jp2011195#citeas.
3 KENT JC et al (2011) Effect of warm breastshields on breast milk pumping. JHL 27(4):331-338.

Would you like an effective method for pumping more milk? Until 2009, most of us assumed that when a mother used a breast pump, the pump should do all of the milk-removal work. But this changed when Jane Morton and her colleagues published a ground-breaking study in the Journal of Perinatology.1 The mothers in this study were pumping exclusively for premature babies in the hospital’s neonatal intensive care unit.

For premature babies, mother’s milk is like a medicine. Any infant formula these babies receive increases their risk of serious illness, so these mothers were under a lot of pressure to pump enough milk to meet their babies’ needs.

Amazingly, when these mothers used their hands as well as their pump to express milk, they pumped an average of 48 percent more milk than the pump alone could remove. This milk also contained twice as much fat as when mothers used only the pump.2 In most mothers exclusively pumping for premature babies, milk production falters after three to four weeks.3 But the mothers using this “hands-on” technique continued to increase their milk production throughout their babies’ entire first eight weeks, the entire length of the study .

Hands-on pumping is not just for mothers with babies in special care. Any mother who pumps can benefit from it. How does it work? To do hands-on pumping, follow these steps:

1. First, massage both breasts.
2. Double pump, compressing your breasts as much as you can while pumping. (Search “hands free pumping” online for pumping bras or bustiers that fit any brand of pump and allow you to double pump with both hands free.) Continue until milk flow slows to a trickle.
3. Massage your breasts again, concentrating on any areas that feel full.
4. Finish by either hand expressing your milk into the pump’s nipple tunnel or single pumping, whichever yields the most milk. Either way, during this step, do intensive breast compression on each breast, moving back and forth from breast to breast several times until you’ve drained both breasts as fully as possible.

This entire routine took the mothers in the study an average of about 25 minutes. For a demonstration of this technique, watch the online video “How to Use Your Hands When You Pump”.

These three online videos are examples of three different hand-expression techniques that some mothers have found helpful and can be used as part of hands-on pumping: Handmelking (scroll down for the English version), How to Hand Express and Hand Expression. See also the article Hand Expression on the Breastfeeding USA website.

Hands-on pumping can be used by any mother who wants to improve her pumping milk yield or boost her milk production. Drained breasts make milk faster, and hands-on pumping helps drains your breasts more fully with each pumping.

References
1Morton, J., Hall, J. Y., Wong, R. J., Thairu, L., Benitz, W. E., & Rhine, W. D. (2009). Combining hand techniques with electric pumping increases milk production in mothers of preterm infants. Journal of Perinatology, 29(11), 757-764.
2Morton, J., Wong, R. J., Hall, J. Y., Pang, W.W., Lai, C.T., Lui, J., Hartmann, P.E., & Rhine, W. D. (2012). Combining hand techniques with electric pumping increases the caloric content of milk in mothers of preterm infants. Journal of Perinatology, Jan 5. doi: 10.1038/jp.2011.195. [Epub ahead of print]
3 Hill, P. D., Aldag, J. C., Chatterton, R. T., & Zinaman, M. (2005). Primary and secondary mediators' influence on milk output in lactating mothers of preterm and term infants. J Hum Lact, 21(2), 138-150.

Used with permission. Article originally appeared on the website Breastfeeding Reporter (www.nancymohrbacher.com), where you can find complete article licensing information.

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