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Breast Compression by Jack Newman, MD, FRCPC
The purpose of breast compression is to continue the flow              baby gets substantial amounts of milk when he is
of milk to the baby once the baby no longer drinks (“open              drinking with an “open mouth wide—pause—then close
mouth wide—pause—then close mouth” type of suck) on                    mouth” type of suck.
his own, and thus keep him drinking milk. Breast                  4. When the baby is nibbling at the breast and no longer
compression simulates a letdown reflex and often                       drinking with the “open mouth wide—pause—then
stimulates a natural letdown reflex to occur. The technique            close mouth” type of suck, compress the breast. Do
may be useful for:                                                     not roll your fingers along the breast toward the baby,
1.   Poor weight gain in the baby                                      just squeeze. Not so hard that it hurts and try not to
2.   Colic in the breastfed baby                                       change the shape of the areola (the part of the breast
3.   Frequent feedings and/or long feedings                            near the baby’s mouth). With the compression, the
4.   Sore nipples in the mother                                        baby should start drinking again with the “open mouth
5.   Recurrent blocked ducts and/or mastitis                           wide—pause—then close mouth” type of suck. Use
6.   Encouraging the baby who falls asleep quickly to                  compression while the baby is sucking but not
     continue drinking not just sucking                                drinking!
Breast compression is not necessary if everything is going        5. Keep the pressure up until the baby no longer drinks
well. When all is going well, the mother should allow the              even with the compression, and then release the
baby to “finish” feeding on the first side and, if the baby            pressure. Often the baby will stop sucking altogether
wants more, offer the other side. How do you know the                  when the pressure is released, but will start again
baby is finished? When he no longer drinks at the breast               shortly as milk starts to flow again. If the baby does not
(“open mouth wide—pause—then close mouth” type of                      stop sucking with the release of pressure, wait a short
suck).                                                                 time before compressing again.
Breast compression works particularly well in the first           6. The reason for releasing the pressure is to allow your
few days to help the baby get more colostrum. Babies do                hand to rest, and to allow milk to start flowing to the
not need much colostrum, but they need some. A good                    baby again. The baby, if he stops sucking when you
latch and compression help them get it.                                release the pressure, will start again when he starts to
                                                                       taste milk.
It may be useful to know that:
                                                                  7. When the baby starts sucking again, he may drink
1.   A baby who is well latched on gets milk more easily               (“open mouth wide—pause—then close mouth” type of
     than one who is not. A baby who is poorly latched on              suck). If not, compress again as above.
     can get milk only when the flow of milk is rapid. Thus,      8. Continue on the first side until the baby does not drink
     many mothers and babies do well with breastfeeding in             even with the compression. You should allow the baby
     spite of a poor latch, because most mothers produce               to stay on the side for a short time longer, as you may
     an abundance of milk.                                             occasionally get another letdown reflex (milk ejection
2.   In the first 3-6 weeks of life, many babies tend to fall          reflex) and the baby will start drinking again, on his
     asleep at the breast when the flow of milk is slow, not           own. If the baby no longer drinks, however, allow him
     necessarily when they have had enough to eat. After               to come off or take him off the breast.
     this age, they may start to pull away at the breast when
                                                                  9. If the baby wants more, offer the other side and repeat
     the flow of milk slows down. However, some pull at the
                                                                       the process.
     breast even when they are much younger, sometimes
     even in the first days.                                      10. You may wish, unless you have sore nipples, to switch
3.   Unfortunately many babies are latching on poorly. If              sides back and forth in this way several times.
     the mother’s supply is abundant the baby often does          11. Work on improving the baby’s latch.
     well as far as weight gain is concerned, but the mother      12. Remember, compress as the baby sucks but does
     may pay a price—such as, sore nipples, a “colicky”                not drink.
     baby, and/or a baby who is constantly on the breast
                                                                  In our experience, the above works best, but if you find a
     (but drinking only a small part of the time).
                                                                  way which works better at keeping the baby sucking with an
Breast compression continues the flow of milk once the            “open mouth wide—pause—then close mouth” type of suck,
baby is no longer drinking from (only sucking at) the breast      use whatever works best for you and your baby. As long as
and results in the baby:                                          it does not hurt your breast to compress, and as long as the
1.   Getting more milk.                                           baby is “drinking” (“open mouth wide—pause—then close
2. Getting more milk that is higher in fat.                       mouth type” of suck), breast compression is working.

Breast compression—How to do it                                   You will not always need to do this. As breastfeeding
                                                                  improves, you will able to let things happen naturally. See
1.   Hold the baby with one arm.                                  the videos of how to latch a baby on, how to know a baby
2.   Hold the breast with the other, thumb on one side of the     is getting milk, how to use compression at
     breast (thumb on the upper side of the breast is             www.thebirthden.com/Newman.html
     easiest), your other fingers on the other, fairly far back
     from the nipple.                                             Questions? see my book The Ultimate Breastfeeding
                                                                  Book of Answers
3.   Watch for the baby’s drinking, though there is no
     need to be obsessive about catching every suck (see          This handout may be copied and distributed without further permission,
     videos at www.thebirthden.com/Newman.html). The                  on the condition that it is not used in any context in which the WHO
                                                                              code on the marketing of breastmilk substitutes is violated.
Handout #15. Breast Compression.                                             Written by Jack Newman, MD, FRCPC. © 2005
Revised January 2005                                                                                               www.kellymom.com

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Breast Compression

  • 1. Breast Compression by Jack Newman, MD, FRCPC The purpose of breast compression is to continue the flow baby gets substantial amounts of milk when he is of milk to the baby once the baby no longer drinks (“open drinking with an “open mouth wide—pause—then close mouth wide—pause—then close mouth” type of suck) on mouth” type of suck. his own, and thus keep him drinking milk. Breast 4. When the baby is nibbling at the breast and no longer compression simulates a letdown reflex and often drinking with the “open mouth wide—pause—then stimulates a natural letdown reflex to occur. The technique close mouth” type of suck, compress the breast. Do may be useful for: not roll your fingers along the breast toward the baby, 1. Poor weight gain in the baby just squeeze. Not so hard that it hurts and try not to 2. Colic in the breastfed baby change the shape of the areola (the part of the breast 3. Frequent feedings and/or long feedings near the baby’s mouth). With the compression, the 4. Sore nipples in the mother baby should start drinking again with the “open mouth 5. Recurrent blocked ducts and/or mastitis wide—pause—then close mouth” type of suck. Use 6. Encouraging the baby who falls asleep quickly to compression while the baby is sucking but not continue drinking not just sucking drinking! Breast compression is not necessary if everything is going 5. Keep the pressure up until the baby no longer drinks well. When all is going well, the mother should allow the even with the compression, and then release the baby to “finish” feeding on the first side and, if the baby pressure. Often the baby will stop sucking altogether wants more, offer the other side. How do you know the when the pressure is released, but will start again baby is finished? When he no longer drinks at the breast shortly as milk starts to flow again. If the baby does not (“open mouth wide—pause—then close mouth” type of stop sucking with the release of pressure, wait a short suck). time before compressing again. Breast compression works particularly well in the first 6. The reason for releasing the pressure is to allow your few days to help the baby get more colostrum. Babies do hand to rest, and to allow milk to start flowing to the not need much colostrum, but they need some. A good baby again. The baby, if he stops sucking when you latch and compression help them get it. release the pressure, will start again when he starts to taste milk. It may be useful to know that: 7. When the baby starts sucking again, he may drink 1. A baby who is well latched on gets milk more easily (“open mouth wide—pause—then close mouth” type of than one who is not. A baby who is poorly latched on suck). If not, compress again as above. can get milk only when the flow of milk is rapid. Thus, 8. Continue on the first side until the baby does not drink many mothers and babies do well with breastfeeding in even with the compression. You should allow the baby spite of a poor latch, because most mothers produce to stay on the side for a short time longer, as you may an abundance of milk. occasionally get another letdown reflex (milk ejection 2. In the first 3-6 weeks of life, many babies tend to fall reflex) and the baby will start drinking again, on his asleep at the breast when the flow of milk is slow, not own. If the baby no longer drinks, however, allow him necessarily when they have had enough to eat. After to come off or take him off the breast. this age, they may start to pull away at the breast when 9. If the baby wants more, offer the other side and repeat the flow of milk slows down. However, some pull at the the process. breast even when they are much younger, sometimes even in the first days. 10. You may wish, unless you have sore nipples, to switch 3. Unfortunately many babies are latching on poorly. If sides back and forth in this way several times. the mother’s supply is abundant the baby often does 11. Work on improving the baby’s latch. well as far as weight gain is concerned, but the mother 12. Remember, compress as the baby sucks but does may pay a price—such as, sore nipples, a “colicky” not drink. baby, and/or a baby who is constantly on the breast In our experience, the above works best, but if you find a (but drinking only a small part of the time). way which works better at keeping the baby sucking with an Breast compression continues the flow of milk once the “open mouth wide—pause—then close mouth” type of suck, baby is no longer drinking from (only sucking at) the breast use whatever works best for you and your baby. As long as and results in the baby: it does not hurt your breast to compress, and as long as the 1. Getting more milk. baby is “drinking” (“open mouth wide—pause—then close 2. Getting more milk that is higher in fat. mouth type” of suck), breast compression is working. Breast compression—How to do it You will not always need to do this. As breastfeeding improves, you will able to let things happen naturally. See 1. Hold the baby with one arm. the videos of how to latch a baby on, how to know a baby 2. Hold the breast with the other, thumb on one side of the is getting milk, how to use compression at breast (thumb on the upper side of the breast is www.thebirthden.com/Newman.html easiest), your other fingers on the other, fairly far back from the nipple. Questions? see my book The Ultimate Breastfeeding Book of Answers 3. Watch for the baby’s drinking, though there is no need to be obsessive about catching every suck (see This handout may be copied and distributed without further permission, videos at www.thebirthden.com/Newman.html). The on the condition that it is not used in any context in which the WHO code on the marketing of breastmilk substitutes is violated. Handout #15. Breast Compression. Written by Jack Newman, MD, FRCPC. © 2005 Revised January 2005 www.kellymom.com