Place your thumb above your nipple at the edges of the areola (dark area around the nipple), or about 2 cm from your nipple and your first finger below. Using your thumb and finger, gently press your breast tissue back towards your chest wall and squeeze. The breastmilk will move down the ducts.
Do not squeeze or pinch, and do not compress your nipple. Rotate and repeat. Rotate your thumb and fingers around your breast clockwise and repeat the press/compress motions until all parts of the breast have been compressed and the flow of milk slows down.
As stated above, the primary way to induce lactation is through breast emptying: breastfeeding, pumping, or hand expression. The effectiveness of these physical techniques can be enhanced with the use of galactogogues: medications, herbs and homeopathic remedies that support the production of milk.
When your baby suckles, it sends a message to your brain. The brain then signals the hormones, prolactin and oxytocin to be released. Prolactin causes the alveoli to begin making milk. Oxytocin causes muscles around the alveoli to squeeze milk out through the milk ducts.
How do I know whether my breasts are empty? There's no test or way to know for sure. In general, though, if you gently shake your breasts and they feel mostly soft and you don't feel the heaviness of milk sitting in them, you're probably fine.
Hand expression increases the pressure inside the breast by compressing the alveoli that hold the milk and hence, pushing it into the ducts and towards the openings in the nipple. Pumping decreases the pressure outside the breast by creating a vacuum at the nipple.
If you are separated from your baby after birth, you should start pumping early (ideally within six hours after delivery). Then, continue to pump frequently (every three hours, including overnight, for a total of 8 to 10 times per 24-hour period) for approximately 15 minutes each time.
Despite views to the contrary, breasts are never truly empty. Milk is actually produced nonstop—before, during, and after feedings—so there's no need to wait between feedings for your breasts to refill.
If you're pumping for a freezer stash or to store milk for a future separation from your baby, try pumping shortly after you finish nursing – maybe 15 to 30 minutes. That way, your body will have an hour and a half or so to replenish breast milk for your next nursing session.
When you first start pumping, you might see milk start to dribble out. Then, after a few minutes, milk may start to spray - this is your milk letting down. After some time, the letdown will finish and you'll be back to a dribble.
You're not getting let down. If your breasts feel like they're full but you're not able to get the milk flowing out when you pump, it could be that you're not achieving let down. The let down reflex releases your milk from the milk ducts. This only occurs when you're either breastfeeding or pumping.
A study of 60 moms who experienced engorgement concluded that hand expression was more effective at relieving engorgement than using a manual breast pump (Source). Another study showed that mothers appreciated being taught hand expression techniques as a tool to manage engorgement (Source).
Hand expression can also be used as a technique during and after pumping to increase caloric content2 and remove more milk. It can be more reliable than a pump when electricity is scarce. It's quieter than a pump when privacy is needed. It's certainly less expensive than a pump.
If this is you, rest assured, it's not just your imagination: Most women don't get as much milk from a breast pump as their babies do from nursing. Women's bodies respond differently to babies versus pumps, and it can have a huge impact on your ability to nurse long term.
It's important to remember that your baby is much more effective at getting milk from your breasts than a pump will ever be. A healthy, thriving baby will get more milk than you a capable of pumping.
The more you breastfeed or pump, the more milk your body makes. So, if you seem to be producing less milk than usual, nurse your baby more often. You also can pump after nursing to help stimulate more milk production. Some things, like stress, illness, and some medicines, can temporarily lower your supply.
Your breasts feel softer
This happens as your milk supply adjusts to your baby's needs. The initial breast fullness reduces in the first few weeks. At around 6 weeks, breast fullness is completely gone and your breasts may feel soft. This is completely normal and has no effect on your milk supply.
Increasing your milk supply will take time, so don't give up. Even dry pumps (when you pump but nothing comes out) sends a signal to your body that more milk is needed on tap, so it's getting the work done even if there's no output to show for it right away. Stick with it and you'll see the results after a few days.
These sessions don't need to be evenly spaced, but you should be nursing/pumping at least once during the night in the first few months or anytime you notice a decrease in supply. Avoid going longer than 5-6 hours without pumping during the first few months.
Pump between breastfeeding, either 30-60 minutes after nursing or at least one hour before breastfeeding. This should leave plenty of milk for your baby at your next feeding. If your baby wants to breastfeed right after breast pumping, let them!
Your breast milk will dry up on its own, and it will take some time, but the best way to aid in that process of suppressing breast milk is to limit how much milk you express. That's because every time you release or express any milk, it sends a signal to your body that you're still nursing.
It usually gets better after several days. Over time, your body will stop making milk if you don't breastfeed or pump. This can take up to several weeks.