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To Pump More Milk, Use Hands-On Pumping

Would you like an effective method for pumping more milk? Until 2009, most of us assumed that when a mother used a breast pump, the pump should do all of the milk-removal work. But this changed when Jane Morton and her colleagues published a ground-breaking study in the Journal of Perinatology. The mothers in this study were pumping exclusively for premature babies in the hospital’s neonatal intensive care unit.

For premature babies, mother’s milk is like a medicine. Any infant formula these babies receive increases their risk of serious illness, so these mothers were under a lot of pressure to pump enough milk to meet their babies’ needs.

Amazingly, when these mothers used their hands as well as their pump to express milk, they pumped an average of 48 percent more milk than the pump alone could remove. According to another study, this milk also contained twice as much fat as when mothers used only the pump. According to previous research, in most mothers exclusively pumping for premature babies, milk production falters after three to four weeks. But the mothers using this “hands-on” technique continued to increase their milk production throughout their babies’ entire first eight weeks, the entire length of the study. 

Hands-on pumping is not just for mothers with babies in special care. Any mother who pumps can benefit from it. How does it work? For a demonstration of this technique, watch the online video “How to Use Your Hands When You Pump” at: As a summary, follow these steps:

1. Massage both breasts.

2. Double pump, compressing your breasts as much as you can while pumping.  (Search "hands free pumping" online for devices that fit any brand of pump and allow you to double pump with both hands free.) Continue until milk flow slows to a trickle.

3. Massage your breasts again, concentrating on areas that feel full.

4. Finish by either hand expressing your milk into the pump's nipple tunnel or single pumping, whichever yields the most milk. Either way, during this step, do intensive breast compression on each breast, moving back and forth from breast to breast several times until you've drained both breasts as fully as possible.

This entire routine took the mothers in the study an average of about 25 minutes. 

These two online videos demonstrate two different hand-expression techniques that can be used as part of hands-on pumping: and (scroll down for the English version).

Hands-on pumping can be used by any mother who wants to improve her pumping milk yield or boost her milk production. Drained breasts make milk faster, and hands-on pumping helps drains your breasts more fully with each pumping.


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Reader Comments (7)

I have been preaching this technique as a La Leche League Leader for years now. We get tons of questions from working and pumping mothers. This is something I discovered by myself while pumping at work for my twins. I know how much more milk I got when I massaged and was patient enough to wait for the second let down. It was amazing! I have heard Nancy speak on other topics and she is fantastic. I have no doubt that her discussion on this topic will help many mothers.

June 27, 2012 | Unregistered CommenterWorking Mom of Twins

Excellent article! I discovered most of this on my own while exclusively pumping for my son. He is 7 months old now & I am still EPing 27-31 oz of breast milk per day. I wrote about the compression & the hand expression in my blog post about EP: Since breastpump is not as efficient as a baby at milk removal, I used to get painful plugged ducts several times a week. Ever since I've started to hand express after each pumping session, I haven't experienced plugged ducts again. I wish I would have done it this way from the beginning!

July 15, 2012 | Unregistered CommenterLena

I wish I'd learned this when I was breastfeeding my son! With inverted nipples, I breastfed him using a breastpump. Sad to say I stopped when he was three months old because it took too long to pump (using a manual pump) and produced very little. I remember sometimes I would massage my breasts when they felt full, and then I'd be so happy to see so much more milk coming out! It's only now that I understand why!

July 18, 2012 | Unregistered CommenterJohanna

I feel like my son eats much more than the 30 ounces. At 3 months when i went back to work, i could easily pump up to 20 ounces over 3 pumps during the day, plus a morning feeding and 2 evening/night feedings. I saw my milk production drastically decrease once he started sleeping through the night, and now I am pumping about 12-14 ounces during the day, i have to make up for it by staying up late and pumping close to midnight. I cant enjoy his sleeping through the night. He is now 6 months and i am hoping i can keep up with his demand and meet my minimum year goal.

August 13, 2013 | Unregistered CommenterSjackson

I am and have EP'd since my son was 2 weeks old. He showed a strong interest in bottle over breast and simply refused me. I was crushed, but continued EPing because it's best for him. By the way, in the hospital, he had low blood sugar at birth so the very first thing in his mouth was a nipple full of formula!! I was SO upset! Anyway, I burned through a medela PumpNStyle - didn't feel like it was really strong enough. Now I've got the Medela Symphony that I rented ($55/mo) and it works much better. PumpNStyle goes with me in the car at all times and the battery pack will last at least 20 pumps so I've never been "stranded" without milk for him. Baby Boy is now 3 months and probably consuming about 32-35 oz per day and I'm able to pump around 35-50 depending on how much I really want to build my bank. I usually dispense 5 oz per bottle, even though he most likely won't eat all that at one time.... but just in case he's a little extra hungry, I've got it there ready for him.

Pumping schedule at first was every 2 hours around the clock but well worth it because my supply could probably NEVER be what it was in the very beginning again!! I banked LOTS (which got me through my first bought with mastitis) - now, I typically pump around 7-8oz per session during the day and he's taking in lets just say 5oz of that each feeding. (or if it sits in the bottle more than 3 hours, I toss it) AT NIGHT- when baby is sleeping, its the fastest easiest pumping for me. I pump at 8, again at 10pm, then skip to 4am when he wakes up - pump again at 6:30 when I get the kids up for school. It takes dedication and hard work, and I have paid dearly for this "lifestyle"

End of July, I had a nasty case of mastitis. He was 2 months old then, but I had a large enough milk bank to pump and dump for the 10 days I was on antibiotics. Now, here it is early September and I'm not sure what I have. It's either another raging mastitis issue or a yeast infection (didn't know we could get those in the boobie and yeouch it's painful) - my GYN and Lactation Lady at the hospital seem to have differing opinions, so I went to see my primary the other day.....She did a culture on the blistery whitehead looking thing on my nipple to see what we're dealing with. (I've had this "block" for 3 weeks now... tried hot/cold/ Epson salt soak/ then just straight squeezing the stuffing out of myself/ makeshift surgery with 2 cotton swabs... still there) No one can tell me what I'm doing wrong to get myself sick this way.... all the while, my milk supply is something I absolutely obsess over and notice even the tiniest variance in my output. Im on Day 2 of a 10 day course of antibiotics again and nyastatin (sp?) just in case it's yeast and not bacterial.

If anyone else out there is also EPing at this time, please email me or message or however this works? There's such a small group of us out there and even my family whose closest doesn't understand. Would be awesome to bounce ideas around and get some reinforcement, ya know?
Take care all you Moms -

September 13, 2013 | Unregistered CommenterLanaBishop

I have exclusively EP'd for my twins and they are healthy 5 1/2 month old babies. This article was very helpful because i am constantly getting negative feedback about giving them only 3 and 3.5 oz at at feeding. My family keeps telling me that they are older so they need more ounces. I am going to print this article and have them read it. Lana Bishop please email me for support thanks

October 21, 2013 | Unregistered CommenterNellie

I have gotten better compression using the Pump Strap ( I secure it around my waist and then turn it and pull up, then it's nice and tight.

October 29, 2013 | Unregistered CommenterTFishburn
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