Prenatal Hand Expression

Pregnant women begin producing milk, called colostrum, early in the second trimester. Hand expressing this milk can have benefits for certain women. Hand expression means using your hand to rhythmically compress your breast so that milk comes out. Hand expressing breastmilk before a baby is born is called prenatal or antenatal hand expression.

Who Should Consider Prenatal Hand Expression?

You may want to consider hand expression if:

• You have had trouble breastfeeding in the past
• You believe that you may need more breastmilk at birth
• Your pregnancy is high risk for premature birth
• You have risk factors for low milk supply, such as mammary hypoplasia, obesity, PCOS, diabetes, high blood pressure, history of low supply, family history of low supply, or if you’ve had breast surgeries.

The Benefits of Prenatal Hand Expression

If you have low milk supply at birth or if your baby is struggling to breastfeed, the colostrum you collected during pregnancy can be used to feed your baby. This can limit the need for formula. It may also help your second milk to "come in" sooner than it would otherwise.

The Risks of Prenatal Hand Expression

Hand expression of milk increases oxytocin, which is a hormone important for contracting the uterus during and after childbirth. Because of this, doctors have been worried hand expression before birth could cause contractions or even prematurity.

What Should I Know to Hand Express Safely?

Talk to your prenatal care provider first. You may have risk factors for early delivery and therefore shouldn’t hand express.

Learn to do it right. There are online videos that can teach you to hand express and our Hand Expression Step-by-Step guide. You can also set up a visit to learn how at UR Medicine Breastfeeding, by calling (585) 276-MILK. 

When Should I Begin Hand Expressing?

After you’ve talked to your doctor and decided hand expression is right for you, we recommend you begin hand expressing around 36 weeks of pregnancy. Start gently, without hurting yourself, a few times a day or as much as you are comfortable. Expressed milk should be stored in safe plastic hard-sided containers or syringes, and can be frozen and brought to the hospital on ice to use for your baby after birth.