How to Manually Express Breastmilk - The Marmet Technique
Draining the Milk Reservoirs
1. Position the thumb (above the nipple) and first two fingers (below the nipple) about 1” to 1–1/2” from the nipple, 
though not necessarily at the outer edges of the areola. Use this measurement as a guide, since breasts and areolas vary in size from one woman to another. Be sure the hand forms the letter “C” and the finger pads are at 6 and 12 o’clock in line with the nipple. Note the fingers are positioned so that the milk reservoirs lie beneath them.
• Avoid cupping the breast
2. Push straight into the chest wall
• Avoid spreading the fingers apart.
• For large breasts, first lift and then push into the chest wall
3. Roll thumb and fingers forward at the same time. This rolling motion compresses and empties milk reservoirs without injuring sensitive breast tissue.
Note the position of thumb and fingernails during the finish roll as shown in the illustration.
4. Repeat rhythmically to completely drain reservoirs.
• Position, push, roll...
• Position, push, roll...
5. Rotate the thumb and fingers to milk other reservoirs, using both hands on each breast.
Avoid These Motions
1. Do not squeeze the breast, as this can cause bruising.
2. Sliding hands over the breast may cause painful skin burns.
3. Avoid pulling the nipple which may result in tissue damage.
Marmet Technique copyright 1978, revised 1979, 1981 and 1988. Used with permission of Chele Marmet and the Lactation Institute, 1616 Ventura Blvd., Suite 223, Encino, California 91436
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