Maximizing Milk Production With Hands-On Pumping

Hands-on pumping is a powerful, research-backed technique that can help increase breast milk supply, improve milk flow, boost fat content, and support overall pumping comfort. By combining breast massage and compression with electric pumping, parents can better mimic how babies naturally nurse, leading to more effective milk removal and stronger hormonal stimulation.

Whether you are exclusively pumping, returning to work, or building a freezer stash, learning the proper hands-on pumping technique can make a significant difference in both output and comfort.

Why Hands-On Pumping Works

When babies nurse, they instinctively massage and compress the breast tissue while feeding. This rhythmic squeezing helps stimulate milk flow and encourages the milk sacs, also known as alveoli, to release more milk. When milk flow slows, babies naturally increase this stimulation to trigger another letdown.

When pumping, we can recreate this same natural process by manually massaging and compressing the breasts. This added stimulation supports:

• Increased milk volume
• More complete breast drainage
• Stronger hormonal signaling
• Improved comfort during pumping

In the United States, 94 percent of parents who feed breast milk pump at some point during the first year, and about 7 percent pump exclusively. Learning how to pump efficiently is essential for protecting long-term milk supply and reducing pumping challenges.

Hormones Set the Stage

Milk production is regulated by your endocrine system. After birth, the delivery of the placenta triggers lactogenesis, which is the biological process of milk production. The hormone oxytocin, released through skin-to-skin contact, cuddling, and smelling your baby, drives the milk ejection reflex, also known as letdown.

Research shows that early and frequent milk removal during the first four days postpartum plays a critical role in establishing a robust milk supply. The more consistently milk is removed, the stronger the hormonal signals become to produce more.

Effective Milk Removal Supports Long-Term Supply

Every time milk is removed from the breast, the brain receives signals to release prolactin, the hormone responsible for milk production. Efficient milk removal directly influences:

• Milk supply regulation
• Hormonal response, especially prolactin and oxytocin
• Breast comfort and nipple health
• Milk composition, including fat content

Hands-on pumping is a highly effective complementary method for improving milk removal and supporting supply.

A well-known 2009 study published in the Journal of Perinatology examined pumping outcomes in parents of premature infants. When breast massage and compression were combined with electric pumping, milk output increased by up to 48 percent, with some participants seeing increases of up to 80 percent compared to pump-only sessions.

Hands-on pumping has also been shown to support:

Higher milk fat content
Milk fat gradually increases during a pumping session. By stimulating additional letdowns and improving breast drainage, hands-on pumping may increase the fat concentration in expressed milk.

Better breast drainage
Massage and compression can help move milk through the ducts more efficiently, especially for parents prone to clogged ducts or those with dense or fibrous breast tissue.

Stronger hormonal response
Hands-on stimulation promotes oxytocin release, which supports more complete milk ejection and improved pumping outcomes.

Note: Much of the existing research focuses on parents of premature infants, and findings may vary for parents of full-term babies.

Hands-On Pumping Technique

To maximize milk flow while pumping, use gentle massage and compression throughout your session.

Step-by-step technique:

• Ensure you are using the correct flange size..
• Position hand on upper quadrant of the breast (away from flange so you don’t break the seal)
• Use hand opposite the breast you are pumping on to squeeze and hold
• Squeeze until milk sprays out, release and repeat

For visual learners, video tutorials on hands-on pumping can help demonstrate proper technique and hand placement.

The Role of Proper Flange Sizing

Hands-on pumping works best when paired with correct flange sizing. No technique can fully compensate for a poorly fitted flange.

Most pumps include 24 to 27 mm flanges, but research shows that this standard sizing often does not fit many parents correctly and may reduce pumping efficiency.

New Research on Flange Sizing

A 2025 pilot crossover study published in the Journal of Human Lactation compared traditional flange sizing with precise nipple-tip measurement sizing in exclusive pumpers.

Key findings included:

• Approximately 15 grams more milk per session with smaller, accurately sized flanges
• Significantly improved comfort scores
• Reduced nipple swelling, tugging, and pain

While smaller flanges may improve milk output and comfort, consulting an International Board Certified Lactation Consultant is recommended for accurate sizing guidance.

Additional Tips for Improving Pumping Output

• Combine gentle breast compressions with pump suction to encourage milk flow.
• Apply pressure above the flange shield to help empty milk sacs more effectively.
• Pump both breasts simultaneously to take advantage of natural hormonal responses.
• Use a hands-free pumping bra to allow consistent massage during pumping sessions.

Breastfeeding expert Dr. Jane Morton emphasizes the importance of hands-on pumping to support milk supply. Her research suggests that hands-on techniques can increase milk output by up to 48 percent when combined with electric pumping.

An Added Boost: Sunflower Lecithin

Sunflower lecithin is commonly used to help prevent and manage stubborn plugged ducts. As an emulsifier, it helps milk fats mix more easily with liquid, reducing stickiness within the milk ducts. This can support smoother milk flow, easier breast drainage, and potentially higher fat delivery to your baby.

Conclusion: 

Babies instinctively know how to stimulate milk flow through touch, compression, and closeness. Hands-on pumping allows parents to replicate this natural process, leading to improved output, enhanced milk composition, and greater comfort.

When paired with proper flange sizing, hands-on pumping becomes a powerful tool for maintaining and increasing milk supply, reducing discomfort, and supporting long-term breastfeeding success.

Whether you are exclusively pumping, combination feeding, or building a freezer stash, your hands play an essential role in milk production. Pumping is not just mechanical. It is a full-body process, and tapping into these natural techniques can bring you closer to the rhythm of nursing itself.