Ask patient if she would prefer to hand express milk herself or have the provider do so.
Cleansing the nipple
- Place a towel in the patient’s lap before irrigation.
- Before milk expression, irrigate the nipple with sterile saline.
- Blot the nipple with sterile gauze after irrigation
- Cleanse each nipple with an alcohol wipe. Allow alcohol to dry.
Milk expression
- Remove gloves and clean hands.
- Apply clean gloves.
- Position dominant hand in a ‘‘C’’ shape, with pads of the thumb and fingers ~1.5 inches behind the nipple.
- Push straight back into the chest wall.
- Roll thumb and fingers forward to express milk without touching nipple directly.
- Allow the first few drops of milk to fall onto the towel.
- Express 5–10 mL of milk into a sterile cup without touching cup to nipple.
- Repeat for contralateral breast.