Jean and Others: OK, I will attempt to tell it like it is re: lactiferous sinuses and hand expression from the viewpoint of someone who has been there and done that. When a mom is hand expressing milk, even the small amounts of colostrum in the early days, there is a certain spongy "feel" to the areolar/nipple complex. Mom has to position her hand with all four fingers below the breast with thumb above just at or just beyond the areolar margin. I believe that the instinctive "push-back" into the chest that moms seem to just know to do is what helps her seat her fingers just behind the lactiferous sinuses (sorry, Peter Hartmann, but I know there is something there) and this is what causes her milk to squirt as she compresses her areola/nipple between her thumb and fingers. When she lets go of her nipple with her fingers and moves back to reposition, the nipple/areola "refill" causing a spongy feel to the areola and nipple. This "emptying/refilling" occurs quite rapidly and is how an experienced hand-expresser can fill a bottle in just a matter of minutes. When I teach hand expression to a mom who is in full lactation, I will place my fingers over hers while she expresses so that she can see the pressure/rhythm she needs to attain. When I take my fingers away, she continues, happily squirting milk into a cup. I have never not been able to hand express a lactating mother. It's all in the hand position and rhythm. I hope this makes sense, as it's hard to put the feeling into words. Pam Hirsch, RN,BSN,IBCLC Clinical Lead, Lactation Services Advocate Good Shepherd Hospital Barrington, IL USA *********************************************** To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or digest) To unsubscribe: unsubscribe lactnet All commands go to [log in to unmask] The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(R) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html