Massage, compression, and hand expression are methods you can use to ensure the most removal of milk from your breasts.

A Deeper Look:

Hands-on pumping through the use of breast massage and compressions can stimulate the milk ejection reflex (let-down reflex) and help you remove more milk from your breasts more quickly.  

To massage, start at your chest and work towards your nipples, massaging your breasts using tapping, circular, and kneading movements and comfortable pressure.  You should massage all parts of your chest, including your armpit area (yes—you can have breast tissue there!).  You can use this technique before you begin pumping and while pumping.

To compress, cup your breast far back from the nipple with your thumb on top and your fingers beneath, or vice versa, then gently squeeze and hold.  You may notice a change in milk flow—faster or more forceful—when you compress on pockets of milk.  Rotate your hand to stimulate new areas of your breast and repeat.  If you feel any lumps while massaging or compressing, focus your efforts on them to work out the pocket of milk. 

You can alternate between breast massage and compression for efficient milk removal during your pump session, giving specific attention to any areas of your breast that feel fuller.

Some mamas also find the use of a vibrating massager helps them more effectively remove milk.  There are a few companies that make massagers designed specifically for pumping—some even have a warming feature to help encourage milk flow!

Once you have thoroughly drained your breasts of milk using the pump, consider hand expressing to finish your pump session.  To hand express, position the pads of your thumb and index finger around your breast in a C shape.  Your thumb and index finger should be on direct opposite sides of your nipple about one to two inches behind your nipple.  Gently press your fingers straight back towards your chest and compress your breast between your index finger and thumb moving them slightly towards your nipple together.  Release the hold on your breast, but do not move your hand. Try to keep your fingers from sliding too far away from their starting position.  Repeat in the same spot for a few compressions or until the milk flow stops, then rotate and repeat.  Leaning forward into your collection container may make hand expression easier and more comfortable.

The EP&Me Take:

I am a HUGE believer in the difference massage and compression can make in your milk supply.  Not only did it reduce the amount of time I needed to pump, I also pumped more milk than I would have otherwise.

During the first 4 months I EP’d I was spending approximately an hour, if not more, at every pump During the first 4 months I EP’d I was spending approximately an hour, if not more, at every pump session.  In an attempt to speed up the process, I just naturally began to “squeeze” my breasts while pumping, hoping I would eject milk faster and it seemed to work!  I thought Ha! I’m getting the hang of this.”  However, one day I noticed a red, irritated swoop-like patch of scabbed skin on one of my breasts.  It began at my armpit and ended near my nipple.  I thought is this mastitis?  Is this a yeast infection?  What has happened?  It took me a few days (and a similar patch on the other breast) to realize that my overzealous, way-too-firm compressions were the culprit—I was causing tiny tears in my skin from the way I was compressing and effectively giving myself friction burns.  Oops.  

More than just hurting my breasts, my fingers were aching and swollen from all the work they were doing.  I’m embarrassed to say that I was compressing so hard and so tightly, for so long, that I began to have problems gripping things in my hands at times.  Once I realized I was being a bit too rough, I backed off and started using gentler, lighter compressions.  

For me, the technique that worked best was to make the C-shape (described above under hand expressing), but then gently slide my thumb towards the flange.  However, if my pumping bra was not tight enough, this movement would sometimes disrupt the suction of the flange against my skin, so I would have to hold the flange against me with my other hand.

This “new” style of compression was not very effective at first, but I had no choice but to continue with it because of the irritated skin on my breasts and my aching hands.  Eventually, my body got used to this new technique and the milk began flowing more freely again.  A few weeks later, everything had returned to normal and my output had remained the same despite my gentler compressions.

Beginning at about four months postpartum, I began hand expressing for about a minute on each breast after each pump session because I realized milk would collect in the part of my beast near the flange tunnel no matter what I did while pumping.  Some days hand expressing after each pump resulted in collecting an additional quarter of an ounce for the day, other days I collected as much as half of an ounce. Whatever works right? Good luck mama!