We aren't sure that compression plays no role in breastfeeding. We know 
that milk comes out of the nipple during the suction or negative 
pressure phase of the suck. We think perhaps compression might move milk 
toward the nipple, but we don't know.

Babies generally use a combination of these two strategies to optimize 
milk removal from their own mother.

Compression is important for babies with clefts, who can't make suction 
at all. Some cleft affected infants can learn to get some milk from the 
breast using just compression, but they generally do not get sufficient 
milk to grow well from breastfeeding alone.

We know compression can be used to remove milk from the breast, without 
suction (hand expression/manual expression) and suction can be used to 
move milk from the breast (pumping).

We are still learning.
Catherine Watson Genna, IBCLC  NYC

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