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The
purpose of breast compression is to continue
the flow of milk to the baby once the baby
no longer drinks (“open mouth wide—pause—then
close mouth” type of suck) on his own,
and thus keep him drinking milk. Breast
compression simulates a letdown reflex and
often stimulates a natural letdown reflex
to occur. The technique may be useful for:
1. Poor weight gain
in the baby
2. Colic in the breastfed baby
3. Frequent feedings and/or long feedings
4. Sore nipples in the mother
5. Recurrent blocked ducts and/or mastitis
6. Encouraging the baby who falls asleep
quickly to continue drinking not just sucking
Breast compression is
not necessary if everything is going well.
When all is going well, the mother should
allow the baby to “finish” feeding
on the first side and, if the baby wants
more, offer the other side. How do you know
the baby is finished? When he no longer
drinks at the breast (“open mouth wide—pause—then
close mouth” type of suck).
Breast compression
works particularly well in the first few
days to help the baby get more colostrum.
Babies do not need much colostrum, but they
need some. A good latch and compression
help them get it.
It may be useful
to know that:
1. A baby who is well latched
on gets milk more easily than one who is
not. A baby who is poorly latched on can
get milk only when the flow of milk is rapid.
Thus, many mothers and babies do well with
breastfeeding in spite of a poor latch,
because most mothers produce an abundance
of milk.
2. In the first 3-6 weeks of life, many
babies tend to fall asleep at the breast
when the flow of milk is slow, not necessarily
when they have had enough to eat. After
this age, they may start to pull away at
the breast when the flow of milk slows down.
However, some pull at the breast even when
they are much younger, sometimes even in
the first days.
3. Unfortunately many babies are latching
on poorly. If the mother’s supply is
abundant the baby often does well as far
as weight gain is concerned, but the mother
may pay a price—such as, sore nipples,
a “colicky” baby, and/or a baby
who is constantly on the breast (but drinking
only a small part of the time).
Breast compression continues
the flow of milk once the baby is no longer
drinking from (only sucking at) the breast
and results in the baby:
1. Getting more milk.
2. Getting more milk that is higher in fat.
Breast compression—How
to do it
1. Hold the baby with one
arm.
2. Hold the breast with the other, thumb
on one side of the breast (thumb on the
upper side of the breast is easiest), your
other fingers on the other, fairly far back
from the nipple.
3. Watch for the baby’s drinking,
(see videos)
though there is no need to be obsessive
about catching every suck. The baby gets
substantial amounts of milk when he is drinking
with an “open mouth wide—pause—then
close mouth” type of suck.
4. When the baby is nibbling at the breast
and no longer drinking with the “open
mouth wide—pause—then close mouth”
type of suck, compress the breast. Do not
roll your fingers along the breast toward
the baby, just squeeze. Not so hard that
it hurts and try not to change the shape
of the areola (the part of the breast near
the baby’s mouth). With the compression,
the baby should start drinking again with
the “open mouth wide—pause—then
close mouth” type of suck. Use compression
while the baby is sucking but not drinking!
5. Keep the pressure up until the baby no
longer drinks even with the compression,
and then release the pressure. Often the
baby will stop sucking altogether when the
pressure is released, but will start again
shortly as milk starts to flow again. If
the baby does not stop sucking with the
release of pressure, wait a short time before
compressing again.
6. The reason for releasing the pressure
is to allow your hand to rest, and to allow
milk to start flowing to the baby again.
The baby, if he stops sucking when you release
the pressure, will start again when he starts
to taste milk.
7. When the baby starts sucking again, he
may drink (“open mouth wide—pause—then
close mouth” type of suck). If not,
compress again as above.
8. Continue on the first side until the
baby does not drink even with the compression.
You should allow the baby to stay on the
side for a short time longer, as you may
occasionally get another letdown reflex
(milk ejection reflex) and the baby will
start drinking again, on his own. If the
baby no longer drinks, however, allow him
to come off or take him off the breast.
9. If the baby wants more, offer the other
side and repeat the process.
10. You may wish, unless you have sore nipples,
to switch sides back and forth in this way
several times.
11. Work on improving the baby’s latch.
12. Remember, compress as the baby sucks
but does not drink.
In our experience, the
above works best, but if you find a way
which works better at keeping the baby sucking
with an “open mouth wide—pause—then
close mouth” type of suck, use whatever
works best for you and your baby. As long
as it does not hurt your breast to compress,
and as long as the baby is “drinking”
(“open mouth wide—pause—then
close mouth type” of suck), breast
compression is working.
You will not always need to do this. As
breastfeeding improves, you will able to
let things happen naturally. See videos
of how to latch a baby on, how to know a
baby is getting milk, how to use compression.
Questions? (416) 813-5757
(option 3) or drjacknewman@sympatico.ca
or my book Dr. Jack Newman’s Guide
to Breastfeeding (called The Ultimate Breastfeeding
Book of Answers in the USA)
Handout #15. Breast Compression.
Revised January 2005
Written by Jack Newman, MD, FRCPC. ©
2005
This handout may be copied
and distributed without further permission,
on the condition that it is not used in
any context in which the WHO code on the
marketing of breastmilk substitutes is violated
1. Breastfeeding:
Starting out right
a) The
importance of Skin-to-Skin contact
2. Colic in the Breastfed Baby
3. a) Sore Nipples
b) Treatments
for Sore Nipple and Sore Breasts
4. Is my baby getting enough?
5. Using a Lactation Aid
6. Using Gentian Violet
7. Breastfeeding and Jaundice
8. Finger Feeding
9. a) You should continue breastfeeding
(Medications and breastfeeding)
b) You
should continue breastfeeding (Illness in the mother or baby)
10. Breastfeeding and other foods
11. Some breastfeeding myths
12. More breastfeeding myths
13. Still more breastfeeding
myths
14. More and more breastfeeding
myths
15. Breast compression
16. Starting solid foods
17. What to feed the baby when
the mother is working outside the home
18. How to know a health professional
is not supportive of breastfeeding
19. a) Domperidone 1
b) Domperidone
2
20. Fluconazole
21. Breastfeed a toddler –
Why on earth?
22. Blocked ducts and
mastitis
23. Breastfeeding your adopted baby
24. Miscellaneous treatments for problems
25. Slow weight gain after
the first few months
26. When the Baby refuses to
latch on
27. Expressing Milk
28. Toxins and Infant Feeding
How breastmilk protects Newborns
Risks of formula feeding
Breastfeeding and guilt
Candida protocol
Protocol to increase the intake
of Breastmilk by the Baby ("Not enough milk")
When latching
Protocols for Induced Lactation
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