Your milk supply is driven by your endocrine system. After birth, the delivery of the placenta triggers the process of making milk, called lactogenesis.The production and release of oxytocin-triggered by things like skin to skin, cuddling, and smelling your baby, is what enables the milk ejection reflex. Studies show that early and frequent removal of milk within the first 4 days of the postpartum period is what sets the stage for a robust supply. (2) 

Effective milk removal is ultimately what drives supply for the long-term duration of breastfeeding. Every time we stimulate the breasts, we send a message to the brain to increase prolactin levels. Whether you’re pumping to build a freezer stash, returning to work, or exclusively pumping, the way milk is removed — both in volume and efficiency — impacts:

• Supply regulation
  
  

• Hormonal signaling (especially prolactin and oxytocin)
  
  

• Comfort and nipple health
  
  

• Milk composition (hello, fat content!) 

Hands-on pumping technique is a favorit  e complementary technique  for supporting milk supply for those who pump breastmilk.  

One of the most-cited studies on this topic, a 2009 trial published in the  Journal of Perinatology , looked at pumping in parents of preterm infants . When participants combined hand massage and compression with electric pumping , their milk output increased by up to 48% —in some cases, even 80% more compared to pump-only sessions (2)

Hands-on pumping also increases:

• Milk fat content: Since breast milk fat content gradually increases during a feeding, it is believed that the increase in stimulation works to increase the fat content in the milk during hands-on pumping.

• Breast drainage: If there are clogs present in the breast or a mother has fibrous breast tissue, this added support can help move milk more effectively out of the ducts.
  
  

• Hormonal response (hello, oxytocin!): Remember, oxytocin is what drives the milk-ejection reflexand the full removal of milk. It is important to stimulate the production and release of oxytocin in order to encourage the release of milk.

*Note: this study is specific to premature infants and has not been replicated for full-term babies (3). 

• When pumping, you need to replicate the hands-on massage to maximize milk flow.

• It is vital that you have the correct flange size while pumping.

• Be mindful of the placement of the flange against the breast tissue to avoid disrupting the suction.

• Begin massaging from the upper edges of the milk sacs, directing the movement downward towards the nipple.

• Use light, firm touches, similar to stroking your baby's back.

• Massage all around the breast, including above and below, either side, and across the diagonals.

Watch our video on hands on pumping here.

When we say that hands-on pumping is a complementary technique, we mean that it cannot replace the role of proper flange sizing. One cannot expect that hands-on pumping will increase milk supply if the improper flange size is being used.

Most pumps come with 24–27 mm flanges, but recent studies suggest that this “one-size-fits-most” approach is outdated and often counterproductive.

A 2025 pilot crossover study (4) published in the Journal of Human Lactation compared two sizing methods in exclusive pumpers: traditional (wider) flange sizing vs. precise, nipple-tip measurement sizing.

• Participants pumped ~15 grams more milk per session with smaller flanges
  (mean difference –15g, p = 0.004, effect size d = 0.51)
  
  

• Comfort scores significantly improved with the smaller flange
  (p < 0.001, d = 1.23)
  
  

• Participants reported less tugging, nipple swelling, and pain 

While using a smaller flange size can increase the amount of milk produced, one should always consult an International Board Certified Lactation Consultant for proper flange sizing guidance.

• Gentle compressions combined with pump suction can aid in milk removal.

• Squeeze the breast tissue above the flange shield to empty milk sacs more effectively.

• Simultaneously express milk from both breasts to take advantage of the natural milk release.

• Consider using a pumping bra for a hands-free experience, allowing you to massage the breast tissue during pumping.

• Dr. Jane Morton, a breastfeeding expert and pediatrician, emphasizes hands-on pumping to support milk supply.

• A study by Dr. Morton suggested that being hands-on during pumping can yield up to 48% more milk.(4)

• Watch Dr. Morton's video tutorial on using hands-on pumping techniques to maximize milk supply.

Explore the provided video and combine the techniques mentioned to enhance milk release and quantity during pumping.

Sunflower Lecithin is often used for the treatment of stubborn plugged ducts. It is an emulsifier that helps the milk's water and fat separate less. It can help make the fat less sticky, therefore helping it slide on through the milk ducts and release a plugged duct, but also deliver more fat from your breast milk to your baby.* 

Your baby knows how to get milk flowing — and their little hands, squeezes, and snuggles aren’t random. They’re built-in wisdom. When you’re pumping, you’re stepping into that role, and how you pump makes all the difference. Hands-on pumping isn’t just a bonus tip — it’s a research-backed method that mimics what babies naturally do at the breast to maximize output, boost milk fat content, and support hormonal feedback.

When combined with a properly sized flange, hands-on pumping becomes a powerhouse tool for parents who want to protect or increase supply, reduce pumping discomfort, and ensure better breast drainage (especially during those middle-of-the-night sessions when clogged ducts love to sneak in).

Whether you're exclusively pumping, combo feeding, or just trying to build that freezer stash — know that your hands are not just helpful, they’re essential . Milk-making is a full-body process, and tapping into the tactile, intuitive, hands-on side of pumping brings us one step closer to the rhythm of nursing itself.