(for a milk maid)

This method of manual expression and assisting the milk let-down reflex works well even for experienced breast feeding milk maids who have been able to hand express. It also can help prepare your breasts to stimulate them before they have begun making milk and to help produce milk when none has been produced yet. In addition it will also help produce more milk. Women who have previously been able to express only a small amount, or none at all, get excellent results with this technique. If possible try to keep on a schedule to do it the same time each day as often as practical.

--nUUrsing sUUckles,


Breast Feeding Couple


When watching manual expression the correct milking motion is difficult to see. Consequently manual expression can seem difficult - even after watching a demonstration or reading a brief description. This page will make it easy to understand. Milk can be expressed when using less effective methods of hand expressions but this technique should improve your results in quantity and quality.

When manual expressing the milk let-down reflex does not work as well when it happens naturally when breast feeding your lover. This method of massage and stimulation assists this reflex. The key to the success of this technique is the combination of the method of expression and the massage.

This technique is effective and easily can be learned by following this step by step guide. As with any manual skill, practice is important.


The milk is produced in milk producing cells (alveoli) which are simply modified sweat glands. A portion of the milk continuously comes down the ducts and collects in the milk reservoirs. They expel additional milk into the duct system. When you get a cue you connect with nursing (such as thinking of nursing), an automatic response in the milk-producing cells are stimulated called the Let-down which pushes your milk out of your alveoli and through the duct system to the milk reservoir. Letdown is often felt as a tingling or prickling sensation behind the nipple as the milk reservoirs fill. After letdown, the pressure of the suckling mouth and tongue on the milk maid's reservoirs pushes the milk out of the openings in the nipple into the Milk Man's mouth.
Milk Producing Cells (Alveoli)
Areola (Darker skin)
Milk Reservoir


(Draining the Milk Reservoirs)

   1. POSITION the thumb and first two fingers about 1" to 1 1/2" behind the nipple.


      * Use this measurement, which is not necessarily the outer edge of the areola, as a guide. The areola varies in size from one woman to another.

      * Place the thumb above the nipple and the fingers below, in a 12 o'clock and 6 o'clock position, as shown.

      * Note that the fingers are positioned so that the milk reservoirs lie beneath them.


      * Avoid cupping the breast. The fingers should NOT be in a 12 o'clock and 4 o'clock position.



Finish Roll

2. PUSH straight into the chest wall.

Avoid spreading the fingers apart.

For pleasantly large breasts, first lift and then push into the chest wall. :)

    3.ROLL thumb and fingers forward as if making thumb and fingerprints at the same time.

4. Finish Roll - The rolling motion of the thumb and fingers compresses and empties the milk reservoirs without hurting sensitive breast tissue

Note the moving position of the thumbnail and fingernails shown in red in illustration. The arrows on the show the direction of the pressure the fingers apply. See that the fingers under the breast start with the pressure on the back most finger in the 'Push' and moves to the front most finger in the 'Roll'.

5.REPEAT RHYTHMICALLY to drain the reservoirs. Position, push, roll; position, push, roll.

6. ROTATE the thumb and finger position to milk the other reservoirs. Use both hands on each breast. The fingers will move from the 12 and 6 o'clock positions, to 11 and 5 o'clock, 2 and 8 o'clock, 3 and 9 o'clock. These pictures show hand positions on the right breast.

Right Hand                Left Hand






Avoid squeezing the breast. This can cause bruising Avoid pulling out the nipple and breast. This can cause tissue damage Avoid sliding on the breast. This can cause skin burns.



This will help with relaxation and will help stimulate the milk let-down reflex.




1. MASSAGE the milk producing cells and ducts.

Start at the top of the breast. Press firmly into the chest wall. Move fingers in a circular motion on one spot on the skin.

2. STROKE the breast area from the top of the breast to the nipple with a light tickle-like stroke 3. SHAKE the breast while leaning forward so that gravity will help the milk let-down.


This procedure should be followed when expressing milk instead of a full feeding and when trying to establish increase, or maintain the milk supply when your nursing partner cannot be breast fed.

* Express each breast until the flow of milk slows down.

* Assist the milk let-down reflex (massage, stroke, shake) on both breasts. This can be done on both breasts simultaneously.

* Repeat the whole process of expressing each breast and assisting the milk let-down reflex once or twice more. The flow of milk usually slows down sooner the second and third time as the reservoirs are drained.


If little of no milk is present, follow these suggested times closely.

 The ENTIRE PROCEDURE should take approximately 20-30 minutes.

* Express each breast 5-7 minutes.

* Massage, stroke, shake.

* Express each breast 3-5 minutes.

* Massage, stroke, shake.

* Express each breasts 2-3 minutes.

Note: If the milk supply is established, use the times given only as a guide. Watch the flow of milk and change breasts when the flow gets small.


There are many advantages to manual expression over mechanical methods of milking the breasts:

  • Some mechanical pumps cause discomfort and are ineffective. Skin to skin contact is much more stimulating than the impersonal pump or feel of a plastic shield.
  • Manual expressing can help induce lactation more effectively than a breast pump.
  • Manual expression of breast milk is more comfortable and natural.
  • Manual expression allows for an easier milk let-down reflex.
  • Manual expression is convenient.
  • Manual expression is ecologically superior.
  • Manual expression is portable. (Just have to have your hands)
  • Manual expression is free!
  • Of course nothing beats an experienced pair of eager lips but manual expression is much more successful than pumping (which has a much lower success rate)

To my read about my Adult Nursing Relationship

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© 2007-2011 Ron B. with all rights reserved do not reporduce in whole or part witout prior written permission.







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