I teach moms to:
Gently pinch or roll the base of the nipple until they see one drop of milk.
Make the hand into a "C", place on the breast at about the margin of the
areola, or about 2 inches behind the nipple.
Press back toward the chest wall, hold this back pressure
Gently roll the thumb and fingers toward each other, like the fingers
are rolled from one side to the other to take fingerprints.
Release the back pressure.
Repeat from press back toward the chest wall.

I show them how it should feel by having them make a fist and
"expressing" milk from their fist.  I point out how my rolling fingers
move the skin along with them, and how they don't rub the skin.  I also
tell them if it hurts, they are using too much pressure.

I was able to remove 6-8 oz of milk in 25 mins when my kids were little,
but I could get only drops with even the best pumps.  I do rent pumps,
but I also teach every willing mom hand expression, many of them over
the telephone, esp. if I can't see them right away.

--
Catherine Watson Genna, IBCLC  New York City  mailto:[log in to unmask]

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