Assisting the Milk Ejection Reflex & Manual Hand Expression

August 2, 2013

Every breastfeeding mama should know how to hand or manually express breast milk. Some advantages to hand or manual expression include:

  • Some mechanical breast pumps can cause discomfort and/or are ineffective.
  • Many mothers are more comfortable with manual expression because it is more natural.
  • Skin-to-skin contact is more stimulating than the feel of a plastic shield, so manual expression usually allows for
  • an easier milk ejection reflex (MER).
  • It doesn’t require electricity and is handy in an emergency or natural disaster.
  • It’s convenient.
  • It’s portable.
  • It’s free.

The Marmet Technique of Manual Expression was developed by a mother who needed to express her milk over an extended period of time for medical reasons. She found that her milk ejection reflex did not work as well as when her baby breastfed, so she also developed a method of massage and stimulation to assist this reflex.

The key to the success of this technique is the combination of the method of expression and this massage. This technique is effective and should not cause problems. It can easily be learned by following this step by step guide. As with any manual skill, practice is important.

First, you will need to know how to assist the MER to help your milk “let down.”

Screen Shot 2013-08-02 at 7.32.18 AM

Next, you will need to learn the Marmet technique of hand-expressing. Be sure to wash your hands and have sterile container ready before starting.

Screen Shot 2013-08-02 at 7.27.05 AM

Be sure to avoid these motions:

  • Squeezing the breast. This can cause bruising.
  • Pulling out the nipple and breast. This can cause tissue damage.
  • Sliding on the breast. This can cause skin burns.

The entire procedure should take approximately 20 – 30 minutes when manual expression is replacing a feeding:

  • Express each breast 5-7 minutes.
  • Massage, stroke, shake for about 1 minute.
  • Express each breast 3-5 minutes.
  • Massage, stroke, shake for about 1 minute
  • Express each breast 2-3 minutes.

Note: If the milk supply is established, use the times given only as a guide. Watch the flow of milk and change breasts when the flow gets small. If little or no milk is present yet, follow these suggested times closely. Any portion of the procedure or timing may be used or repeated as necessary.

Marmet Technique © 1978, revised 1979, 1981 and 1988. Lactation Institute, 1616 Ventura Blvd., Suite 223, Encino, California 91436

Image credit:

You Might Also Like

No Comments

Leave a Reply