When I first started pumping in the hospital, I never was told to massage/hand express. It was only with clogged ducts and eventual mastitis that I've been advised to do so. Now I seem to do it just as second nature, but is it necessary? How about with BF'ing? Today I tandem breast fed 2 of my girls and again found myself massaging/hand expressing. I forgot to ask my LC today what her thoughts were.
Re: Do you always massage/hand express?
When I massage/compress when I pump, I always get more milk. I also do it when I BF when DD starts to suck multiple times before swallowing. I try to get more to her when my flow slows down.
I found this video really helpful:
https://newborns.stanford.edu/Breastfeeding/MaxProduction.html