If you like them, please feel free to copy them.  Here is handout 15.

Breast Compression

        The purpose of breast compression is to continue the flow of milk to 
the baby once the baby no longer drinks (open‹pause‹close type of 
suck) on his own.  Breast compression simulates a letdown reflex and 
sometimes seems to stimulate a letdown reflex.  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. Mother¹s sore nipples 
5. Recurrent blocked ducts and/or mastitis
6. Encouraging the baby who falls asleep quickly to continue drinking 

        Breast compression is not necessary if everything is going well.  
When all is going well, the mother should allow the baby to ³finish² 
feeding on the first side and, if the baby wants more, should offer 
the other side.  How do you know the baby is finished?  When he no 
longer drinks at the breast (open‹pause‹close type of suck).   

        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 
more than enough milk.
2. In the first 3-6 weeks of life, babies 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.
3. Unfortunately many babies are latching on poorly.  If the mother¹s 
supply is abundant the baby often does well as far as weight gain is 
concerned, but the mother may pay a price‹sore nipples, a ³colicky² 
baby, a baby who is constantly on the breast (but feeding only a small 
part of the time).

        Breast compression continues the flow of milk once the baby starts 
falling asleep at the breast and results in the baby:

1. Getting more milk.
2. Getting milk that is high 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, 
your other fingers on the other, fairly far back from the nipple.
3. Watch for the baby¹s drinking, 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‹pause‹close type of 
suck.  (open‹pause‹close is one suck, the pause is not a pause between 
sucks). 
4. When the baby is nibbling or no longer drinking with the 
open‹pause‹close type of suck, compress the breast.  Not so hard that 
it hurts and try not to change the shape of the areola (the part of 
the breast near the baby¹s mouth).  With the compression, the baby 
should start drinking again with the open‹pause‹close type of suck.
5. Keep the pressure up until the baby no longer drinks even with the 
compression, 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 to release 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‹pause‹close).  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 
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 baby¹s latch.

        The above works best, in our experience in the clinic, but if you 
find a way which works better at keeping the baby sucking with an 
open‹pause‹close 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 ³drinking² (open‹pause‹close 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.

Questions?  (416) 813-5757 (option 3)

Handout #15.  Breast Compression. Revised November 1996
Written by Jack Newman, MD, FRCPC

May be copied and distributed without further permission