Expressing milk

Pumping or manually extracting breast milk lets your baby enjoy your milk when you’re not there to feed her, or if she is premature or sick. Expressing milk not only allows you to maintain your milk supply, but also helps relieve the effects of engorged breasts.

Tips to keep your milk flowing

Your baby’s nursing stimulates the let-down reflex, which increases milk flow. It’s sometimes harder to stimulate this reflex when you’re expressing milk by hand or with a breast pump, especially on your first attempts. With a little practice, you’ll become good at it.

Depending on what you prefer, you can use any of the following methods to stimulate the let-down reflex

  • Self relaxation
  • Breast massage
  • Warm compresses
  • Visualization of your baby nursing
  • Thinking about your baby
  • Distracting yourself with another activity (for instance, watching television)

Choosing a method for expressing milk

Breast milk can be expressed in a number of ways. Your choice of method will depend on:

  • The situation
  • How frequently you express milk
  • How you are feeding your baby—that is, breastfeeding or not
  • And of course, your own preference

Regardless of the method you choose, it’s important to handle your breasts gently and to wash your hands before expressing milk.

How to do a “gentle massage”

When your breasts feel heavy and tight (engorged), or you feel pain in one or both of them, a “gentle massage” can help reduce the swelling and pain.

To do this, gently stroke your breast, moving from the nipple toward your armpit (under your arm). Stroking stimulates liquid circulation and reduces swelling. Do not press hard. Deep massage could cause injury.

How to express milk by hand

Photos: Jean-Claude Mercier

Manual expression is a technique every mother should know. It’s the most effective way to express colostrum, you can use it any time, anywhere to relieve an engorged breast, and it’s free.

This technique is easier than it sounds. Ask hospital staff, your midwife, or a CLSC nurse to teach it to you.

  • Wash your hands.
  • Use a large, clean container.
  • To prompt the let-down reflex, massage your breast gently.
  • Lean forward slightly so the milk can flow into the container.
  • Place your thumb and index finger on each side of the areola, 2 to 5 cm (1 to 2 inches) from the nipple. With practice, you’ll find the best distance (see photo no. 1).
  • Press your fingers into your breast, pushing horizontally toward the ribs (see photo no. 2).
  • While maintaining pressure on your fingers, pinch your thumb and index finger together as if they were a pair of pliers. You don’t need to press hard. This motion shouldn’t leave any mark on your breast or cause any pain (see photo no. 2).
  • Repeat this pinching motion several times, reproducing the same rhythmic movements your baby uses when nursing.
  • Be careful not to slide your fingers along your breast. Maintain firm pressure on your breast without stretching the nipple, which is painful and not very effective.
  • Work your way around the breast with your fingers until it’s emptied.

Your milk will flow drop by drop at first, then begin to spurt. With practice, you’ll be able to work more efficiently and quickly.

Choosing a breast pump

It is not always necessary to buy a breast pump. Many women prefer to use one, however, especially if they have to express their milk on a regular basis. To find a breast pump that suits your needs, contact a community breastfeeding support group or a person trained in breastfeeding.

A number of models are available on the market:

  • Manual breast pumps
  • Various types of electric breast pumps, including some that allow you to express milk from both breasts at the same time.

You should also consider the following factors:

Quality – A poor quality breast pump may hurt you or reduce your milk production.

The number of sucking movements per minute – Choose a breast pump that allows for 60 to 70 sucking movements or cycles per minute so that it imitates as closely as possible the rhythm and strength of your baby’s sucking.

Suction – A breast pump with insufficient suction reduces the quantity of the milk expressed, whereas suction that is too strong and prolonged irritates the nipples.

Size and shape of the cup – The breast pump’s cup, which fits on the nipple and areola, must be properly adjusted to your nipples to avoid injuring them. Some companies offer a number of models and sizes.

Characteristics of any good breast pump

  • Be leakproof and maintain proper suction
  • Fit your nipples properly
  • Protect your nipples by avoiding suction that is too strong or prolonged

Characteristic of a good electric breast pump

  • Create and release suction at 60 to 70 cycles per minute

Characteristic of a good manual breast pump

  • Be comfortable and not tire your hand

Regardless of the type of breast pump you choose, it is important to clean it properly. It also needs to be disinfected before the first use (see Cleaning bottles, nipples and breast pumps).

Second-hand breast pumps

Most breast pumps, whether manual or electric, are intended to be used by only one mother. They must therefore be considered as a personal item, just like a toothbrush or underwear. Breast milk can transmit diseases like HIV and hepatitis, or less serious infections like thrush. Boiling a second-hand breast pump does not make it safe, even if it does reduce the risk of disease transmission.

Hospital-grade electric breast pumps are, however, designed to be used by multiple mothers. You can rent hospital-grade electric breast pumps from community breastfeeding support groups and some drugstores. These breast pumps are sturdy and high quality. They are intended to be used by many people, so they are designed in such a way that the pump motor never comes into contact with the milk. In fact, it is the motor you rent: each woman must buy a new set of tubes, which includes all parts that come in contact with the milk.

If you buy a second-hand breast pump that is not hospital grade, keep in mind that there may be milk remaining in the motor. Since there is no way to check this or to clean the motor, there is a risk of contamination, even though the risk is low. For this reason, it is recommended that you not buy a second-hand breast pump. If you decide to do so, be sure to buy a new set of tubes.

Expressing milk occasionally or regularly

If you breastfeed, your milk production has adjusted to your baby’s demand. So it is normal to express only a few drops on your first few attempts. Be patient.

There is no ideal time to express your milk. The ideal moment is the one that suits you the best! Try these suggestions:

  • When your baby has fed at only one breast
  • In the morning
  • When your breasts are engorged
  • Between feedings
  • While your baby is feeding at your other breast
  • When you skip a feeding

If you express milk between feedings, you will probably get only a small amount of milk. You will get more if you express the milk from a breast that your baby has not fed from for some time.

Expressing milk without breastfeeding

Information to comfort you and boost your confidenceIt is normal to get only a few drops the first few times you express your milk. The more you stimulate your breasts, the more milk they will produce.

Some women express milk for a baby who won’t breastfeed. Others simply prefer this method. Depending on your situation, you can express your milk for several days, weeks, months, or throughout the entire period you feed your baby breast milk.

During the first month, many babies who did not breastfeed at birth succeed in doing so if your milk production is high. Don’t hesitate to ask for help if you want to try breastfeeding again.

Remember that premature babies are smaller and their intestines are not yet fully developed. In the first few days, or even weeks, they only drink a little if at all and they do not suck as effectively. However, to get your milk production off to a good start, it’s better to express your milk as if your baby were full term.

The way you express your milk when not breastfeeding will change as your milk production gets going and adapts to your baby’s individual needs.

Feeding your baby with your milk without breastfeeding

Before your milk comes in


  • If possible, start stimulating your breasts within 6 hours after the birth.
  • Express your milk 6 to 8 times a day.
  • Use the breast pump at least once every 6 hours, even at night.


  • After expressing the colostrum by hand, use the breast pump for 5 to 10 minutes.


  • You will produce from a few drops to several milliliters. The colostrum (first milk) is thicker.
  • Expressing milk by hand seems to produce more milk than the breast pump during the first 24 to 48 hours. As your milk changes, it will become easier to express with the breast pump.
  • The quantity of milk usually increases from 48 to 72 hours after the birth.

When your milk comes in


  • Express your milk as often as necessary for comfort’s sake, but at least 8 times a day.
  • Use the breast pump at least once every 4 hours, even at night


  • Express your milk until your breasts are soft and comfortable.


  • The quantity of milk increases rapidly. Take advantage of this period to get your milk production off to a good start, even if your baby drinks much less that you express. Stock up.
  • Mothers who express at least 500 ml of milk per 24 hours after the first week seem to produce more milk afterwards.

1 to 6 weeks


  • Express your milk 6 to 8 times a day.
  • Use the breast pump at least once every 6 hours, even at night.


  • Express your milk until the milk has stopped flowing for about 2 minutes.


  • Try to express a little more milk than your baby drinks. That way you will always stay ahead of her needs, which will increase rapidly.
  • It’s normal that the quantity of milk you express varies each time.
  • Mothers who express at least 750 ml per 24 hours after two weeks seem to produce more milk afterwards.

After 6 weeks


  • Depending on how much milk you produce, you can adapt to your baby’s needs.
  • Some women can stop expressing milk at night, and others not.


  • Express your milk until you have have the quantity of milk your baby needs.


  • Adjust the quantity of milk you express according to your baby’s needs.
  • Ideally, try to express a little more milk than your baby drinks in order to stay ahead.

Express: Pump or squeeze milk from the mother’s breast.

Areola: Darker area of the breast around the nipple.