I have been reading with great interest about breast compressions. In some cases I really see that it works during a bust or in between bursts. However I am finding that too many mothers seem to be milking their breast and think they need compress all the time. They are losing the latch and breaking the babies seal. Have we ever really looked at this in a research based methodology. May we not be getting similar let downs and release of milk with lad back breastfeeding, albeit not the only answer but breast compressions have concerned me for a long time.
Just a thought. Where is the research. We do see it improved milk flow when pumping but is that our only research and does that really equate to what happens with breastfeeding?
Attie Sandink, Ontario Canada
> On Nov 14, 2015, at 10:24 AM, LACTNET automatic digest system <[log in to unmask]> wrote:
>
>
> Date: Sat, 14 Nov 2015 13:37:22 +0000
> From: Pamela Morrison <[log in to unmask]>
> Subject: Long inefficient feeds and question on Breast Compression
>
> Hi Laurie
>
> Yes, guilty! It was me who suggested using breast
> compression _between_ sucking bursts, instead of
> _during_ sucking.... I've just watched Jack's
> video again and you're quite right - Jack
> suggests compressing the breast _during_
> sucking. So I think I may have misnamed this technique.
>
> Marsha Walker describes the between-sucking
> compression as "alternate massage". See
> http://www.llli.org/ba/nov00.html "A technique
> called alternate breast massage has been shown to
> significantly reduce the incidence and severity
> of engorgement while simultaneously increasing
> milk intake, the fat content of the milk, and
> infant weight gain. Alternate massage involves
> massaging and compressing the breast when the
> baby pauses between sucking bursts. Massage
> alternates with the baby's sucking and is
> continued throughout the feeding on both breasts."
>
> So it seems, for the purposes of definition, that
>
> Breast Compression = squeezing the breasts during sucking
> Alternate Massage = squeezing the breast during pauses
>
> I meant Alternate Massage. And thanks for asking
> for clarification!! To take this even further,
> while using alternate massage to compress the
> breast, I use another technique I've seen
> described somewhere! but so long ago I can no
> longer remember where, which also involves
> stimulating the baby.... so it goes like this:
>
> 1. Latch the baby in the cross-cradle position
> with mother sitting up, and supporting the breast
> very well to take the weight of the breast off
> the baby's chin and maximize milk flow to
> baby...the mother's palm to support the baby's
> back with her thumb and forefinger spread to
> support the baby's neck below and behind his ears
> 2. Allow baby to suck and drink.
> 3. When baby pauses more than just a few
> seconds, or starts to close his eyes, then mother
> should compress the breast at the back, or lift
> the breast ever so slightly, being very careful
> not to disturb the latch, but this small
> compression and/or movement will trigger another let-down.
> 4. At the same time, with the hand holding the
> baby, the mother can _very gently_ move the
> thumb and finger supporting the baby's head, to
> wake him up, so that he will drink the new let-down
> 5. When the baby is drinking the mother should
> keep still and not distract or disturb him but
> when he closes his eyes, stops drinking and dozes
> again she should use more alternate massage, eg
> stimulate breast, stimulate baby, keep still and
> note baby's renewed swallowing. These little
> movements should be quite subtle - above all you
> don't want to disturb the baby's latch, nor
> distract the baby from the business of getting as much milk as possible....
> 6. When the breast has been drained pretty well
> so that alternate massage/breast compression
> results in very little additional swallowing ,
> then the mother should switch-nurse/swop sides
> and repeat. She should definitely use both
> breasts per feeding to maximize milk transfer,
> but she can also use 3-4 breasts per feeding if
> the supply is very low. In this way, the baby
> obtains the most amount of milk with the least
> effort. She should stop breastfeeding after 30
> minutes at the most, and offer supplements by
> cup, spoon, bottle, SNS, or whatever, then
> express/pump whatever the baby has left behind, ready for the next top-up.
>
> I do find that Alternate Massage works better
> than Breast Compression. Why? Because I
> sometimes find that mothers use Breast
> Compression instead, and it seems to distract the
> baby more to squeeze the breast while he's
> actually already sucking well.... just my observation.
>
> Pamela Morrison IBCLC
> Rustington, England
> -------------------------------------------------
>
> Date: Fri, 13 Nov 2015 21:18:19 -0600
> From: Laurie Wheeler <[log in to unmask]>
> Subject: long inefficient feeds and question on Breast Compression
>
> When babies have long inefficient feeds, of
> course it is because they are unable to nurse
> effectively. Tongue-tie seems an obvious thing,
> however there can be so many things having an
> impact on feeding ability. For example, facial
> asymmetry, slight hypotonia, unilateral smaller
> nare ( often seen with assymetry), slight
> laryngomalacia or related anomalies, etc. And
> then there can be infant mouth to maternal breast
> disproportion (large nipples, small mouth), and
> suboptimal milk production (which often ensues
> due to early , infeffective feeding.
> I agree with Pamela re the strategies she
> suggested, e.g. breast compression, switch
> nursing, keeping feeds reasonable in length and
> then comping with pumped milk after. Often babies
> need extra volume for catch-up growth.
>
> Here is a question about breast compression. My
> understanding was to compress the breast when the
> baby was sucking, in order to increase the milk
> transfer and keep the baby drinking. Then to
> release the compression during the pauses and
> when baby starts sucking again, compress again. I
> think this works, itâs how I do it and teach
> mother. However, I see that someone else said
> (Pamela?) to compress during babyâs pauses to
> get him drinking again. I think both ways could work, but which do yh
> you think might work better?
>
> Laurie Wheeler RN MN IBCLC
> New Orleans LA and Mississippi Gulf Coast, USA
> Sent from Mail for Windows 10
>
>
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