How to Express Breastmilk

Expressing breastmilk can be a useful skill for many different reasons. Sometimes it is planned, such as returning to work or study. Sometimes it becomes necessary because a baby is premature, unwell, separated from their caregiver or not currently able to feed effectively at the breast.

Expressing can also be part of a feeding plan when an infant needs additional milk to support weight gain, or when milk production needs to be increased or maintained.

There is no single way to express and no single expressing routine that works for everyone. Hand expression, manual pumps and electric pumps can all be useful, and the best approach depends on why you are expressing, your baby's needs, your milk production and what is practical and sustainable for you.

Expressing can also be hard work. It takes time, energy and organisation alongside caring for a baby. Looking after yourself is therefore part of the feeding plan too.

Why might you need to express?

There are many reasons why someone may express breastmilk, including:

• your baby is premature or unwell;

• your baby is temporarily unable to breastfeed effectively;

• you and your baby are separated;

• your baby is not transferring enough milk at the breast;

• your baby's weight gain needs additional support;

• you need to establish or increase milk production;

• you want to maintain milk production when a breastfeed is replaced;

• you are returning to work or study;

• you want someone else to be able to offer your baby expressed milk;

• you occasionally want to have some expressed milk available;

• your breasts are uncomfortably full;

• you have an oversupply and need to relieve discomfort without repeatedly emptying the breasts;

• you have been advised to express antenatally to collect colostrum.

The reason matters because the way you express may need to be different depending on what you are trying to achieve.

For example, expressing to increase milk production is different from expressing simply to relieve uncomfortable fullness. Expressing to provide additional milk for an infant who is struggling to gain weight is different again.

The NHS advises that how often you express and how much you express should depend on why you are expressing (NHS, 2026a).

Expressing to support infant weight gain

Expressing may sometimes be recommended when an infant is not gaining weight as expected, has lost more weight than anticipated, or is not transferring enough milk during breastfeeding.

The expressed milk can then be offered to the infant as additional milk while breastfeeding continues where possible.

In this situation, expressing may have two purposes: to provide additional milk for the baby and, where appropriate, to maintain or increase milk production while the underlying feeding difficulty is being assessed.

These are related, but they are not exactly the same goal.

If an infant is struggling with weight gain, it is important to look at the whole feeding picture rather than automatically assuming that low weight means there is not enough milk being produced.

Milk production, milk transfer, feeding effectiveness, the baby's health, feeding frequency and the amount of milk the baby is actually receiving all need to be considered.

NICE recommends assessing feeding and considering appropriate support when faltering growth is identified (NICE, 2017).

If your baby is not gaining weight as expected, seek appropriate feeding and clinical assessment rather than simply increasing expressing indefinitely.

Expressing to establish or increase milk production

Milk production is closely linked to milk removal. When milk is regularly and effectively removed, the breasts receive signals that milk is needed.

If increasing milk production is the goal, expressing can therefore be used to provide additional stimulation and milk removal.

For some people, this may involve expressing after breastfeeding. Double expressing after a feed can provide additional breast stimulation, and increasing the frequency of milk removal may also be useful when clinically appropriate.

However, more expressing is not automatically better.

If your baby is already feeding effectively and gaining weight well, repeatedly adding extra pumping sessions can sometimes create an oversupply. That can lead to persistent fullness, leaking, forceful milk ejection and recurrent breast inflammation.

The aim should be to achieve the amount of milk that you and your baby need, rather than producing as much milk as possible.

If you are considering expressing to increase milk production, it is worth understanding why production appears low in the first place. Positioning, attachment, milk transfer, feeding frequency, infant factors and maternal factors can all contribute.

You can also read my article on Increasing Breast Milk Production.

Expressing to maintain milk production

If a breastfeed is being replaced by expressed milk and you want to maintain your existing level of milk production, expressing around the time that feed would normally have happened can help maintain regular milk removal.

This is particularly relevant if someone else is giving your baby a bottle while you are apart, or if a breastfeed is temporarily not possible.

If you are simply looking to maintain your milk production and are expressing after a feed, you may not need to keep expressing large additional volumes. Some people find that expressing from the breast their baby has just fed from until the flow has slowed considerably is enough to provide additional stimulation, but the appropriate approach varies between individuals.

If your baby is not removing milk effectively, however, the answer may not be to keep adding more expressing. It may be more helpful to assess why milk removal is not effective.

Expressing occasionally

You do not have to express every day for expressing to be useful.

You might want a small amount of milk available for someone else to offer your baby, to cover an occasional separation, for returning to work or study, or simply because you would like another feeding option available.

Some people prefer hand expression for occasional use because it requires no equipment. Others find a manual or electric pump quicker or more convenient.

There is no requirement to build a freezer full of milk unless that is something you actually want or need.

Expressing when your baby is premature, unwell or unable to breastfeed

For some families, expressing is necessary from the very beginning.

A premature or unwell baby may not initially be able to breastfeed effectively. A baby may also be separated from their caregiver, admitted to neonatal care or temporarily unable to coordinate feeding.

In these circumstances, expressing may be an essential way of providing human milk while also stimulating and maintaining milk production.

This is one reason why the advice to simply “wait until breastfeeding is established before expressing” cannot apply to everyone. If expressing is clinically necessary, it may be needed from the first day.

Neonatal units may also have their own guidance about expressing frequency, equipment, hygiene, transport and storage. Follow the guidance provided by your baby's clinical team.

Expressing is not the answer to blocked ducts or mastitis

If your breasts are inflamed, repeatedly pumping or expressing to try to “empty” the breast can remove more milk than your baby needs. That extra milk removal can stimulate further milk production and potentially create a cycle of increasing supply, fullness and inflammation.

Current mastitis guidance recommends feeding according to your baby's needs and avoiding unnecessary additional milk removal. If you need to soften the breast because your baby cannot attach comfortably, expressing a small amount for comfort may be appropriate, but this is very different from repeatedly pumping to empty the breast (Breastfeeding Network, 2026).

Cold therapy can help with swelling and discomfort. Warmth may feel soothing for some people or help milk to flow immediately before feeding, but prolonged or excessive heat can increase swelling and inflammation. Firm breast massage should also be avoided because it can cause additional tissue trauma.

For more information, see my article on [blockages and mastitis care].

The important point is that if you have mastitis, the goal is not to keep removing more and more milk.

Expressing with an oversupply

Oversupply can make expressing a little more complicated because the aim is usually to find a balance between relieving discomfort and avoiding unnecessary additional milk removal. If your breasts are frequently very full between feeds, expressing a small amount for comfort can sometimes help you feel more comfortable while allowing your milk production to gradually regulate towards what your baby needs.

It can be tempting to express until the breast feels completely soft, particularly when it feels very full or uncomfortable, but repeatedly removing larger volumes of milk can signal to your breasts that this amount of milk is needed. This can maintain or increase the oversupply and may contribute to a cycle of frequent fullness, leaking, forceful milk ejection and breast inflammation.

Comfort expression therefore generally means removing enough milk to relieve the pressure rather than expressing until the breast is empty. If you are experiencing persistent oversupply, recurrent blocked areas, breast inflammation or significant discomfort, individualised breastfeeding support can help to identify what may be contributing to the oversupply and how milk removal can be gradually adjusted without making you more uncomfortable.

Expressing during the first 4–6 weeks

The first 4–6 weeks are an important time for your milk production to adjust to your baby's needs. During this period, your breasts are responding to how frequently and how effectively milk is removed, so adding extra milk removal can influence how much milk your body continues to produce.

For this reason, if your baby is breastfeeding effectively, gaining weight appropriately and there is no clinical reason to express, routine expressing during the first 4–6 weeks is generally best avoided. This includes expressing simply to build a large freezer supply or routinely pumping after feeds when your baby is already feeding well. Removing additional milk tells your body that more milk is needed, which can contribute to oversupply.

Oversupply can be uncomfortable and may result in very full breasts, leaking, forceful milk ejection and difficulties for your baby managing the flow. It can also contribute to recurrent breast inflammation and create a cycle in which you express to relieve fullness, only for your body to produce more milk in response.

There are, however, many situations where expressing during these early weeks is clinically important and should not be avoided. Your baby may be premature, unwell, temporarily unable to breastfeed, separated from you, or unable to remove milk effectively. Expressing may be needed to provide your baby with additional milk, establish or maintain your milk production, or protect your milk supply while feeding difficulties are being addressed.

If you need to express for a clinical reason, the frequency and amount will depend on your individual circumstances and may change as your baby becomes more effective at breastfeeding. An IBCLC can help you develop an individualised feeding and expressing plan that provides the milk your baby needs while avoiding unnecessary additional milk removal.

It is also normal for your breasts to feel softer as breastfeeding becomes established. Softer breasts do not necessarily mean that your milk production is decreasing or that you do not have enough milk. Your baby's feeding, nappies, weight gain and overall wellbeing are more useful indicators than how full your breasts feel.

Once breastfeeding is well established, you may decide that expressing is useful for occasional bottles, returning to work, sharing feeds or other reasons. There is no need to avoid expressing altogether; the aim during these early weeks is simply to avoid unnecessary additional milk removal while your milk production is establishing and your baby is learning to breastfeed.

Antenatal hand expression

Some pregnant women are advised to hand express colostrum before their baby is born so that small amounts of their first milk are available if needed after birth.

Antenatal expression is generally discussed from around 36–37 weeks for pregnancies where it is considered appropriate. It is not suitable for everyone, however, so discuss it with your midwife or maternity team before starting.

The reason for this caution is that expressing stimulates oxytocin release. Oxytocin is involved in milk ejection and also causes uterine contractions.

If you are at increased risk of premature labour or have been advised not to express antenatally, follow your maternity team's advice.

If you experience contractions while expressing before 37 weeks, stop and contact your maternity team for advice.

The aim is not to collect a large volume. Colostrum is produced in small amounts and may come out as drops rather than a stream.

Choosing how to express

There are several ways to express breastmilk, and you may find that different methods suit different situations. Hand expression can be particularly useful for colostrum, occasional expression or when you do not have access to a pump, while a manual pump can be a convenient option when you want something portable and relatively simple to use.

Electric pumps can be particularly useful when you are expressing frequently or need to express larger amounts. You can choose between single and double electric pumps depending on your circumstances. A single pump allows you to express one breast at a time, whereas a double pump allows both breasts to be expressed simultaneously. Double pumping can be useful when time is limited and, for some people, may provide additional stimulation to support milk production.

There are also a growing number of wearable or in-bra pumps and hands-free pumping options. These can be particularly convenient if you need to move around while expressing, have other children to care for, are returning to work or simply find sitting beside a traditional pump difficult. They are not necessarily the best choice for every situation, however, and some people find that a traditional electric pump removes milk more effectively or comfortably.

Some people use more than one method. For example, hand expression may be useful for collecting colostrum, a wearable pump might be convenient during the day, and a traditional double electric pump may be preferred when expressing regularly to establish or maintain milk production.

The most expensive pump is not automatically the most appropriate one. Comfort, flange fit, effectiveness, portability, noise, cleaning, battery life and how frequently you need to express are all worth considering when choosing equipment.

How to hand express

Hand expression takes a little practice. At first, you may only see a few drops.

Before you start:

1. Wash your hands.

2. Have a clean container ready.

3. Find somewhere comfortable.

4. Give yourself time rather than trying to rush.

5. If helpful, have your baby close by or look at a photograph, clothing or another reminder of your baby.

6. Some people find a warm drink, bath or shower helpful for relaxation and milk flow.

Place your thumb above the breast and your fingers below it, forming a “C” shape around 2–3 cm back from the nipple.

Gently press your fingers and thumb back towards the chest wall and then compress them together.

Release and repeat rhythmically.

Do not squeeze or pull the nipple itself, and do not slide your fingers across the skin.

When the flow slows, move your fingers around the breast to a different position and repeat.

You can alternate between breasts, returning to each breast more than once as the milk flow changes.

The NHS provides further guidance on hand expression (NHS, 2026b).

You can also read my guide to [hand expression].

What if the milk does not flow?

It can be frustrating when you know there is milk available but the pump or your hands are producing very little.

Try not to respond by immediately increasing the suction.

Milk ejection is influenced by oxytocin, and feeling rushed, uncomfortable, watched or anxious can make it more difficult for some people to trigger a let-down.

You could try taking a few slow breaths and consciously relaxing your shoulders and jaw. Having your baby close by, looking at a photograph or smelling a piece of your baby's clothing may also help some people. Gentle breast preparation, changing the position of the pump flange, returning to stimulation mode on an electric pump or changing the cycle speed or pattern can also be worth trying.

Sometimes taking a short break and trying again a few minutes later is more productive than continuing to pump when nothing is happening. Switching breasts or finishing with some hand expression may also help.

A warm shower or warm cloth may help some people with milk flow, although prolonged heat is not appropriate when the breast is inflamed.

If you consistently struggle to express despite trying different approaches, it may be worth checking your flange fit, pump settings and the overall reason you are expressing.

Using a manual breast pump

Manual pumps are operated by hand and can be useful for occasional expression. They are relatively portable and do not require batteries or a power supply, which can make them useful when travelling or when you only need to express occasionally.

Start gently and establish a rhythm that feels comfortable. As milk begins to flow, you can adjust your rhythm and change breasts when the flow slows.

You do not need to squeeze the handle as hard as possible. More pressure does not automatically mean more milk, and excessive suction or pressure can make expressing uncomfortable.

If your hand becomes tired or the pump is uncomfortable, it may be worth changing your position, taking a short break or considering whether another expressing method would suit you better.

Using an electric breast pump

Electric pumps can look complicated because they often have several settings. The exact terminology differs between manufacturers, but many pumps have a stimulation or let-down mode followed by an expression mode.

Stimulation mode

Stimulation mode is usually faster and gentler. Its purpose is to encourage the milk-ejection reflex.

You may see this described as let-down, massage, stimulation or cycle mode depending on the pump.

Once milk is flowing well, you can usually move into expression mode.

Expression mode

Expression mode generally uses a slower rhythm with stronger suction to remove milk.

Start with the vacuum low and increase it gradually. The aim is the highest comfortable and effective setting, not the highest setting the pump can produce.

If the suction hurts, your nipple is being pulled aggressively into the tunnel, your nipple blanches, the breast tissue is swelling or you notice rubbing or damage, reduce the suction and check the flange fit.

Changing the pattern or cycle speed

Some pumps allow you to change the speed or cycle rate. If milk flow slows significantly, you can try returning briefly to stimulation mode, changing the cycle speed or switching breasts before returning to expression mode.

There is no single pump setting that is correct for everyone. Your breasts, nipples, milk production and response to the pump are individual, so it may take a little experimentation to find the combination that works comfortably and effectively for you.

Flange fit matters

The breast shield or flange is the part of the pump that sits over the nipple.

A good fit allows the nipple to move freely within the tunnel without excessive rubbing or pulling in large amounts of surrounding tissue.

A flange that is too small may cause rubbing, compression or nipple swelling, while a flange that is too large may draw excessive amounts of areola into the tunnel and may also be uncomfortable or less effective.

The correct size can differ between breasts, and your size can also change over time.

Your nipple should not be bruised, pinched or damaged by expressing.

You can read more about this in my article Breast Pump Flange Fitting Assessment Explained.

How long should you express?

There is no universal length of time that everyone needs to express. How long you express will depend on why you are expressing, the age and needs of your baby, your milk production, the type of pump you are using, whether you are expressing one or both breasts and how effectively milk is being removed.

If you are expressing instead of a breastfeed or expressing frequently to establish or maintain milk production, the overall frequency of milk removal is likely to be more important than trying to achieve a particular number of minutes at every session. If you are expressing for comfort, you may only need a short session to reduce the feeling of pressure, whereas someone expressing a complete feed may need considerably longer.

Your own milk flow can also change during a session. You may notice that milk flows quickly at first, slows down, and then increases again after another let-down. Changing the pump settings, switching breasts or using hand expression at the end can sometimes help you make the most of these changes.

If expressing is taking up a very large proportion of your day, it is worth reviewing the feeding plan rather than simply accepting that this is how things have to be. Expressing can be physically and mentally demanding, and a plan needs to be effective while also being realistic and sustainable for the person doing it.

Sharing feeds with fathers, partners and other caregivers

Expressed milk can allow a father, partner or another caregiver to take part in feeding.

This can be meaningful for everyone involved, and it may be particularly useful when the breastfeeding caregiver needs to be away from their baby or wants another caregiver to participate in feeding.

However, there is an important practical point that can sometimes get missed. If a partner gives a bottle instead of a breastfeed, the breastfeeding caregiver may still need to express around that time if they want to maintain milk production.

The partner has taken over one part of feeding, but the breastfeeding caregiver may still be doing the physiological work of maintaining milk production. A bottle given by someone else therefore does not automatically create a break for the breastfeeding caregiver.

Sometimes what is needed is genuine rest rather than another feeding task. A partner or family member may be able to take over settling the baby, changing nappies, preparing food, washing pump equipment, looking after older children or simply holding the baby while the breastfeeding caregiver sleeps or has a bath.

Supporting the person who is feeding the baby is just as important as supporting the feeding itself.

Looking after yourself while expressing

Expressing milk can be exhausting, particularly when it is being fitted around frequent breastfeeding, caring for a baby and recovering from pregnancy and birth. Even when expressing is going well, it adds another task to an already busy day, and when you are expressing several times a day or around the clock, the cumulative physical and mental effort can be significant.

Rest can therefore be an important part of your feeding plan. This is not always easy when you have a baby who wants to be held, fed or settled frequently, but accepting practical support when it is offered can make a real difference. If your partner, family member or friend can prepare a meal, bring you a drink, hold the baby while you shower or give you an opportunity to lie down, allowing them to help can give you some much-needed time to recover.

It is also worth remembering that the housework does not need to take priority over you. There may be dishes, laundry or other jobs waiting to be done, but your physical recovery and emotional wellbeing are important too. Sometimes the most useful thing someone can do is take care of the household jobs while you rest with your baby.

Looking after yourself does not have to mean finding large amounts of time. A bath or shower, sitting quietly with a cup of tea, having a nap, getting outside for a short walk or simply having someone else hold the baby while you have some uninterrupted time can all be valuable. What feels restorative will be different for everyone, and it does not have to look like traditional ideas of “self-care”.

Eating regularly and having a balanced diet can help you maintain your energy during what can be a very demanding period. Drinking to thirst is generally sufficient; you do not need to force yourself to drink large quantities of fluid in the hope that it will increase your milk production. Keeping a drink nearby when you are breastfeeding or expressing can simply make it easier to respond to your thirst.

If expressing is becoming overwhelming, affecting your sleep, taking up most of your day or leaving you feeling that you cannot continue, it is worth talking to someone about the feeding plan. There may be ways to change when or how often you express, whether you need to express as frequently, how expressed milk is offered to your baby, or how other people can take on some of the practical work around feeding.

Your baby may be the reason you are expressing, but your needs matter too. Supporting your physical recovery, rest and mental wellbeing is an important part of supporting your feeding journey.

Storing expressed breastmilk

Storage recommendations can vary between organisations and countries because storage temperature makes a significant difference.

If you are in the UK, use current UK guidance rather than automatically following storage times you may find on websites from other countries.

The NHS currently advises that freshly expressed milk can be stored:

• in the back of a fridge at 4°C or below for up to 8 days;

• for up to 3 days if the fridge temperature is unknown or between 5°C and 10°C;

• in an ice compartment for up to 2 weeks;

• in a freezer at -18°C or below for up to 6 months.

The Breastfeeding Network gives slightly more cautious guidance of up to 5 days at 4°C or below, while noting that research has supported up to 8 days when the temperature remains stable at 4°C or below (Breastfeeding Network, 2026; NHS, 2026c).

This is a good example of why the temperature of the fridge matters more than simply saying “breastmilk lasts X days”.

If your baby is premature or unwell, follow the storage and transport guidance provided by their neonatal or clinical team, as this may differ from guidance for healthy full-term babies.

Always wash your hands before expressing and use clean, appropriately sterilised equipment and containers.

Label stored milk with the date and time it was expressed and store it towards the back of the fridge rather than in the door, where the temperature is more variable.

Expressing does not have to look one particular way

There is no single expressing routine that you have to follow. Your circumstances may change considerably over the course of your breastfeeding journey, and the way you express may need to change with them.

Someone whose baby is premature or temporarily unable to breastfeed may initially need to express frequently throughout the day and night. As their baby becomes stronger and more effective at breastfeeding, they may gradually reduce expressing. Someone returning to work may express during working hours but breastfeed directly when they are at home, while another family may combine breastfeeding and expressed milk in a completely different pattern.

You may also find that your preferred method changes over time. You might start with hand expression, move to a double electric pump while establishing your milk production, and later use a single or wearable pump for occasional expression. There is nothing wrong with changing the approach as your needs change.

The same applies to the amount of milk you express. Some people want enough for an occasional bottle, while others need to express most or all of their baby's feeds. Some may express for a short period while their baby develops more effective feeding skills and then stop altogether.

Rather than comparing your routine with someone else's, it can be more helpful to consider what you are trying to achieve, whether your baby is getting what they need, and whether the plan is manageable for you. A feeding plan that works well for one family may be completely impractical for another.

When might additional support help?

There may be times when individualised breastfeeding or lactation support is useful, particularly if expressing is painful, your nipples are becoming damaged, you cannot find a comfortable pump setting or you are unsure about flange fit.

Support can also be helpful if your baby is not gaining weight as expected, you are expressing frequently but milk production is not increasing, you are producing much more milk than your baby needs, or you are experiencing recurrent breast inflammation or blocked areas.

It is also reasonable to seek support simply because expressing is taking over your day, leaving you exhausted or making the feeding plan difficult to sustain. Sometimes a review of the whole feeding picture can identify ways to make the routine more manageable without compromising your baby's needs.

A feeding assessment can help identify whether the issue is related to milk production, milk removal, infant feeding skills, equipment, pump settings, comfort, or a combination of factors.

Expressing is a skill, not a test

Expressing can take a little practice, particularly if you are learning to hand express or using a pump for the first time. It is also quite normal for the amount you collect to vary from one session to another.

The amount collected during a single pumping session does not tell the whole story about your milk production, and a pump does not necessarily remove milk in exactly the same way that your baby does. Your milk may also flow differently depending on the time of day, how recently your baby fed, whether you are comfortable and relaxed, and how your body responds to the pump.

If milk is not flowing, increasing the suction is not necessarily going to solve the problem. Sometimes a change in flange position, pump settings, stimulation, comfort or simply taking a short break can make more difference.

Equally, if you are expressing because your breasts are inflamed, expressing more milk is not automatically the answer. If your baby needs additional milk, the feeding plan needs to consider both the baby's intake and your milk production rather than focusing only on how much can be expressed.

Most importantly, expressing should be considered as one of the tools available to you rather than another measure of whether you are “doing breastfeeding right”. The approach that works for you may change over time, and it is perfectly reasonable for your expressing routine to look different from someone else's.

Expressing can be an incredibly useful part of infant feeding, whether it is needed for a short period or becomes a longer-term part of your feeding journey. It should support you and your baby rather than becoming another source of pressure or exhaustion.

References

Breastfeeding Network (2026) Expressing and storing breastmilk. Available from: https://www.breastfeedingnetwork.org.uk/breastfeeding-information/continuing-the-breastfeeding-journey/expressing-and-storing-breastmilk/

Breastfeeding Network (2026) Mastitis Information. Available from: https://www.breastfeedingnetwork.org.uk/breastfeeding-information/mastitis-breastfeeding/

National Health Service (NHS) (2026a) Expressing and storing breast milk. Available from: https://www.nhs.uk/baby/breastfeeding-and-bottle-feeding/breastfeeding/expressing-breast-milk/

National Health Service (NHS) (2026b) Expressing breast milk by hand. Available from: https://www.nhs.uk/best-start-in-life/baby/feeding-your-baby/breastfeeding/expressing-your-breast-milk/expressing-breast-milk-by-hand/

National Health Service (NHS) (2026c) Storing breast milk. Available from: https://www.nhs.uk/baby/breastfeeding-and-bottle-feeding/breastfeeding/expressing-breast-milk/

National Institute for Health and Care Excellence (NICE) (2017) Faltering growth: recognition and management of faltering growth in children. NICE guideline NG75. London: NICE.

Forster, D.A. et al. (2017) ‘Advising women with diabetes in pregnancy to express breastmilk in late pregnancy (DAME): a multicentre, unblinded, randomised controlled trial’, The Lancet, 389(10093), pp. 2204–2213.

Mitchell, K.B. et al. (2022) ‘Academy of Breastfeeding Medicine Clinical Protocol #36: The Mastitis Spectrum’, Breastfeeding Medicine, 17(5), pp. 360–376.