21 Great Reasons for a “Hands On” Approach to Expressing Your Milk

Listen to Podcast, “Getting Your Milk in a Way that Doesn’t Suck”

Breast pump manufacturers have done a great job of convincing mothers that their product is as much a “must have” new-parent item as diapers and burp cloths. Many mothers accept that they’ll need to have a pump for when they go back to work, return to school, or are separated from their baby. Expressing milk is a necessity. But pumping is not the only way to express milk—even if the breast pump makers would like you to think that’s the case! Like Francie Webb, author of Go Milk Yourself and my recent guest on Born to Be Breastfed, many mothers are never told that hand expression is an option for expressing their milk. Those who are aware of the method tend to think it’s old-fashioned and inconvenient or—even worse for a new mother!—time-consuming and ineffective. Once they give it a chance, many mothers find there are many advantages. I can think of 21 off the top of my head:

  1. Your hands are always with you.
  2. Hand expression is a very clean method. There’s no need to worry about cleaning or sterilizing any nooks and crannies where milk might congregate. What could be simpler than washing your hands?
  3. Studies show that mothers can get a high volume of milk by using hand expression.
  4. Hand expression can be fast. It may go slowly at first, but with a bit of practice you’ll develop your skills and learn to do it quickly. I’ve seen mothers express as much as one ounce per minute without any real incentive to beat the clock. If you express 5 ounces each time, that’s 5 minutes for the whole process. (It can take that long just to set up, and clean up, an electric pump!)
  5. There’s no need to lug around a pump. No schlepping the thing through the turnstiles at the subway entrance or the library.
  6. There’s no possibility of losing your pump, or having it stolen, because your “pump” is at the end of your arm.
  7. It’s silent—no noise from the pump.
  8. There’s no need to worry about losing pump parts—especially one of those itty-bitty membranes (And if you don’t have that itty-bitty membrane, your pump won’t work!)
  9. It works even when there’s a power outage, making it great for emergency situations.
  10. There’s no need to make sure that you are near an electrical outlet; you can hand express your milk anywhere.
  11. You’ll never need to scramble to arrange for overnight shipping to get a lost, damaged, or worn out part.
  12. You won’t need to worry about trying to get the right size flange.
  13. If you need to express your milk during the first days after your baby’s birth, you won’t waste a drop of precious colostrum when you express it directly into a spoon or a medicine cup.
  14. It’s less work. There’s no need to set up the pump, wash the flanges afterwards, and so on.
  15. It’s cheaper. You won’t need to pay for an electric pump or any breast pump collection kits. (Pump kits are pricier than you might assume.)
  16. You’ll become familiar with the contours of your breasts. You’ll have fewer worries about “lumps” in your breasts because you’ll know if they are usually there or if they are something unusual.
  17. Perfect for the assembling-parts-challenged woman. Whew! There’s nothing to figure out or remember!
  18. It eliminates the possibility of traumatizing your breast or nipple with suction that is too high—because there is no suction.
  19. It’s the closest thing to breastfeeding your baby. The skin of your fingers on the skin of your breasts is warm and makes “rolling” motions that are similar to the baby’s motions, which can help maintain your milk supply when you are apart.
  20. Hand expression is empowering. You’re not dependent on a device when you express your milk this way.
  21. Aside from the cost of bottles or milk storage bags (which you’d need with an electric pump, too)—it’s free!
What’s your reason for expressing your milk this way?  
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11 Considerations Before You Use Creams On Your Nipples

Listen to the podcast, “Sore nipples, creams, ointments: A Quick Guide for Nursing Moms”

hand to discourage overuse of nipple creams and ointments It’s common for breastfeeding mothers to experience sore nipples in the early days after birth. In most cases, the new mothers are experiencing “new baby” soreness. What’s a mother to do? Well, before you reach for a nipple cream or ointment, stop.

Consider: It might be better for you to massage a few drops of your milk into your nipples, and seek help for positioning and latch before you buy any commercial products. Whether any creams or ointments actually help with sore nipples is debatable. Before you try them, consider the following:

Creams and ointments on nipples will not cure poor latch.

Cracked or otherwise traumatized nipple skin signals poor positioning and latch. Get an experienced professional to take a look and help you out, before your nipples start to feel so painful you consider giving up. Breastfeeding shouldn’t—and doesn’t have to—be like that.

“Hypoallergenic” products are not allergy-free.

Remember, hypoallergenic; means that a product has been manufactured in a way that reduces the possibility of an allergic response. It doesn’t mean it will completely eliminate allergies, and allergic reactions are still a serious possibility.

In a roomful of experienced lactation consultants preparing for their 10-, 20-, or 30-year IBLCE exam, at least one or two experienced IBCLCs—every city, every year—tell me they have seen an allergic reaction on the nipples after the lanolin has been used. I’m not surprised.

Let me be quick to say: The condition they report may or may not have been formally diagnosed as such. Even if it is, we can’t necessarily jump to the conclusion that it’s a cause-and-effect relationship.

But personally? If you have an allergy to wool, I encourage you to stay away from lanolin-based creams.

Use any product sparingly.

Pharmacist Wendy Jones, PhD, cautions that any of these products should be used sparingly. If you need to wipe or wash off excess cream before the next feeding, you probably applied too much. More product isn’t necessarily more beneficial, and it might even exacerbate a problem. On our recent show together, Wendy talked about the difference between “supple” and “soggy.”

Remember, too, that washing nipples is likely to cause more dryness, and consequently, more skin damage.

Look for proof of effectiveness in resolving sore nipples

Some studies claim that some of the available creams, oils, ointments, or balms prevent or cure sore nipples. Across the board, they seem to be small studies, with questionable designs. I find these studies unconvincing, and my observations when caring for many breastfeeding mothers over the years leaves me highly skeptical. Wendy Jones, PhD concurs.

Here’s another thing: Many mothers tell me they’ve been instructed to put lanolin cream on the inside of the flange while pumping. I’m unaware of any evidence to support that recommendation. However, I’m aware of anecdotal reports that suggest that lanolin cream isn’t good for the pump.

Avoid nipple creams or ointments that contain alcohol.

Here in the US, creams and lotions often contain alcohol. Alcohol has antibacterial properties. But it removes not only “bad” bacteria, but also the “friendly” bacteria, which could set you up for a yeast infection.

It also has a drying effect on the skin, leaving you at greater risk for cracked skin and, again, infection.

Avoid those that taste or smell “funny.”

Babies are much more sensitive to tastes and smells than the rest of us. Nursing babies instinctively seek the smell of their mother’s milk, which a study by Varendi and Porter (2001) show helps to guide them to their mother’s breast. (There are many studies on this topic!)

If the smell of the cream or ointment overpowers that of your milk, your baby may feel frustrated and pull away from the nipple. And, if the cream or ointment has a peculiar taste, the baby will be turned off! (Wouldn’t you be?)

Some may include “surprise” ingredients

If you’re considering a cream to put on your nipple, one that may be ingested by your baby, be sure to review the ingredients. Are there preservatives? Gluten? Genetically-modified organisms (GMOs)? Parabens (which could cause an allergic reaction)? Does it contain animal products or use animal testing? (Many people don’t realize that lanolin products are derived from sheep’s wool.) Read before you buy, so you really know what you’re getting.

Avoid products that don’t go smoothly onto nipples.

If the product doesn’t glide onto your nipples, it is likely that you will be tugging on your nipple skin when you apply it.

Thicker, stickier creams—including lanolin creams don’t glide on well. They can be difficult to get out of the tube or tub, and to get off your hands. They can also leave greasy stains on your clothing.

Be sure the lid is kept on fluid products between uses

Okay, thicker-textured products can be difficult to get out, but those with a lighter texture can make create a leaky mess.

And beware of contamination issues, if you are somehow using the same product on the baby’s butt.

Keep it simple

It’s only in the last half-century or so that special creams for sore nipples have been developed.

Rather than reach for something from the pharmaceutical aisle, why not reach for something safe and available in your kitchen cupboard—olive oil. You can apply it to cracked nipples, and even on the inside the flange while pumping. It has been used to dress wounds for centuries. It glides on smoothly, and research has shown that it has antioxidant and antimicrobial properties, and poses no threat to nursing babies. (And I suggest using olive oil on the inside of the flange.)

Olive oil readily sinks into the skin, and there’s no need to wipe it off prior to breastfeeding. While it’s possible to have an allergy to anything, including olive oil, I’ve never met anyone who did.

Petroleum jelly (the popular brand here is Vaseline) can also be highly effective in healing cracked nipples. Wow! It’s effective, simple, cheap, and has multiple uses! (I learned this from Wendy Jones, too! There’s a wealth of information on her website.

Beware of essential oils.

To be clear, I like essential oils, and use them myself. However, as we learned from my interview with expert aromatherapist Lea Harris, there are a number of essential oils that should be avoided while breastfeeding, so be careful.

I hope you’ll consider these factors before using any nipple cream, ointment, butter, or balm. There are dozens of products to choose from which may be less objectionable and more effective than the popularly-known ones—including your own milk! And, very often, the first strategy should be getting professional help to achieve optimal positioning and latch.

Have you used a nipple ointment or cream? What was your experience?
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