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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 at www.thebirthden.com/Newman.html)
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 the videos
of how to latch a baby on, how to know a baby is getting milk,
how to use compression at www.thebirthden.com/Newman.html
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
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