The Importance of Hand Expression

Before I opened my private practice @thebalancedboob, I worked as a postpartum nurse as well as lactation consultant at a busy east coast hospital. I’ve been blessed to help such a large number of new moms and babies through breastfeeding challenges, and I am on a mission to bring awareness to what I feel is such an underutilized practice. So hear me out with what I say next.


Before your baby is born, so many moms are filled with hope and high expectations for that beautiful golden hour after birth. The baby is pulled from your body, crying, and placed right on your chest, squirming and eager. He seeks your breast and latches immediately. It is amazing and awe inspiring when it happens. But sometimes…it doesn’t.

Some babies are exhausted from birth, sleepy from mother’s medications, or overwhelmed by the sheer newness of the world. They are simply not ready to latch and feed effectively at the breast. Thankfully this is not a reason for panic and stress. Mamas, we have a tool for this; a tool that will build your milk supply and support your baby as they transition to life outside the womb.


Hand Expression! It may not seem like much, but used within the first hour after birth, this skill has been linked to 130% more milk at 6 weeks postpartum, as well as milk volume increasing in a much shorter duration of time. More milk….and sooner. – who doesn’t want that?

The reality of most hospital based births in this country, especially now during COVID, is that your stay is short and intense. So much is expected of you and the baby within that brief 24 hour time frame prior to discharge: the first bath, blood work, heart screenings, circumcision, and car seat tests. Any one of these things can be stressful for the baby and disrupt early breastfeeding.

Knowing hand-expression and feeling confident with it allows you to support the baby if breastfeeding hits a roadblock. The best time to start practicing hand expression is during the last few weeks of pregnancy after being cleared by your provider. Hand expression is a learned skill and everyone’s body responds differently. Learning before the baby comes will help take away the pressure after birth, when you are exhausted and overwhelmed.

Take a look at my instagram page @thebalancedboob for resources, and head over to www.firstdroplets.com for more information. Breastfeeding a newborn may not be without its hurdles, but you, my friend, are made for this.

-Kelly Kendall RN BSN IBCLC @thebalancedboob

  • Parker LA, Sullivan S, Krueger C, Mueller M. Association of Timing of Initiation of Breast- milk Expression on Milk Volume and Timing of Lactogenesis Stage II Among Mothers of Very Low-Birth-Weight Infants Breastfeeding Medi- cine. 2015, 10(2): 84-91
  • Parker LA, Sullivan S, Krueger C, Mueller M. Association of Timing of Initiation of Breast- milk Expression on Milk Volume and Timing of Lactogenesis Stage II Among Mothers of Very Low-Birth-Weight Infants Breastfeeding Medi- cine. 2015, 10(2): 84-91 Foster DA, Moorhead AM, Jacobs SE, Davis PG, Walker SP, McEgan KM, Opie GF, et al. , Advising women with diabetes in pregnancy to express breastmilk in late pregnancy (Diabetes and Antenatal Milk Expressing [DAME]): a multicentre, unblinded, randomised controlled trial. Lancet 2017; 389: 2204–13.
  • Morton J. Hands-on or hands-off when first milk matters most? Breastfeeding Med. 2019;14(5):295-297.

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