Some women are apprehensive about the prospect of learning to express breast milk. Like any skill, though, expressing milk gets easier each time you practice it. Milk can be expressed by hand, with a manual pump, or with a battery-operated or electric breast pump. Though hand-expressing can be challenging for some women to learn, it is the most convenient first choice, because there is no need for extra equipment (and, of course, it costs nothing). You might want to try this first during a regular breastfeeding, after you have already experienced a let-down reflex. You can express milk from the second breast immediately after a feeding with the first, or even during that first feeding if your partner or someone else can help you. Some women find that expressing milk when they wake up in the morning is easiest, since their milk is more abundant then.
To express by hand, first be sure that your hands and fingernails (preferably short) are clean by washing them with soap and water. (You might even take a warm shower just before expressing, or place a clean, warm, moist towel over your breasts to help you relax and encourage the milk to let down.) Then massage your breast slowly, starting at the outer areas and working your way down toward the nipple. The massage should be gentle, never uncomfortable to your breasts or your skin.
Next, place a clean cup or jar beneath the nipple so that the milk will drip directly into it without touching your hands or your breast. Position your hand on the areola with the thumb above and two fingers below, about an inch behind the nipple. Press back toward your chest, then gently press the areola between your thumb and fingers and release with a rhythmic motion until the milk flows or squirts out. Rotate your thumb and fingers around the areola to get milk from several positions. Avoid squeezing the nipple or sliding down the breast, since this can cause bruising.
Transfer the milk into clean, covered containers for storage in the refrigerator or freezer. If you don’t collect any milk this time, try again later—but be aware that your let-down reflex may take a while to occur, and it may then take up to half an hour at first to sufficiently relieve both breasts. With practice, you will probably be able to shorten this time considerably and the amount of milk you collect will increase from perhaps 1 ounce per session to a full bottle or more.