How long do you manually express?

[@llli*crazycat80]

I started out with a hospital grade pump. I did a standard 2 minute letdown mode. Pump plus massage for 20 minutes. Took a one minute massage break in the middle with no pump. This allowed me to have two letdowns, first at about 5 minutes and the second at about 15.

I used an old pump at home which bruised my nipples and I saw a reduction from 4oz per sitting to 3 oz per sitting. I spoke to a lactation consultant and this is what she told me to do:
Nipple stimulation for 2 minutes, 10-15 minutes max pumping with massage, 2 minutes of hand expression alternating between breasts every 30 seconds.
After following this for 3 days, I find that I'm not getting a second letdown anymore, my production was 2 1/2 oz during my first sitting this morning (the lowest ever!!) and my left breast doesn't feel drained.

Needless to say, I'm a bit frustrated. I feel like I need that second letdown to help drain, THEN the manual expression. I also feel like it needs to be longer than 2 minutes. Anyone have slow letdown and use hand expression? How long do you pump and hand express? Any tips I can try? I don't want to butcher my nipples but I can't keep watching my supply drop either.

[@llli*iritita]

Have you looked into getting a different type of pump? I currently use the Medela PISA and love it!! My LO has a very poor latch which has caused my nipples to be cracked, sore, and bleed. The PISA is easy on my nipples and allowed them to heal. I ususally get anywhere from 5oz to 8oz per session (20 minutes every 3 hours). With the PISA I don't usually have to hand express unless I am unusually engorged. Just a thought...