If baby has tried to breastfeed and cannot latch, it may be time to teach mom to hand express.  Use the Spoon Card as a guide. After demonstrating the technique with mom, she will be able to refer back to the Spoon Card and do it on her own.  Mom can hand express anytime baby is having difficulty latching or if mom wants to give baby a little extra colostrum.

How to Teach Hand Expressing Using the Spoon Card as a Guide

Begin by helping mom into a comfortable, upright position. The steps and detailed explaination below follow along with the Spoon Card, refer back to it showing mom what to do.

1. Wash hands & spoon.  Massage breast. Have mom clean her hands and have a clean spoon handy to catch the drops collected. With mom's permission, the helper may demonstrate on mom's breast.  Massage the breast for a few minutes. Teach mom to be gentle, going all over the breast in circular motions.  

2.  Place fingertips wide on breast, in line with nipple.  Have mom place her fingertips on her breast.  With her permission, show mom where to put her fingers. Fingertips should be wide apart, about 2 inches away from the nipple.  The fingertips and the nipple should make a line--finger, nipple, thumb.

3. Keep fingers wide, press straight back, in toward moms ribs. Have mom press back, in towards her ribs. She should not pinch her fingers together.  She pushes in toward her ribs. This is the action that compresses the ducts and gets the colostrum out. She needs to keep her fingers wide apart when pressing in. A common mistake is that mothers hold their breasts and begin squeezing the nipple.  They are disappointed that no milk comes. Get her to keep her fingers wide apart and press into the breast.

4. Gently compress & relax the hand. While still pressing in towards her ribs, mom can now compress the breast. She does not need to move her fingers around.  Simply compress & relax her hand.

5. Repeat steps 2-4 until drops come. After several repetitions of pressing in, compress & relax, mom can check to be sure her fingertips are still in line with her nipple. She may move her fingertips to another part of the breast---still wide & still in line with the nipple.  Teach her that the glands go all around the breast, like pieces of pie. She is trying to locate & compress the areas that are most productive for her.  Soon she should get drops. She can work on one breast for several minutes, then switch to the other side.  She can go back and forth, to each breast, several times.

6. Collect drops on a clean spoon & feed to baby. As drops start to come, mom can collect them on the clean spoon.  The drops will not spray out.  She will have to scrape the spoon up along her skin.  It is likely that she will scrape up, along her areola, under her nipple where the drop is falling.  It will take many drops to collect a teaspoonful.  Expect to spend 15 minutes or more hand expressing.  

( Click here to get to information on How to Spoon Feed a Newborn.)