Donna Ron writes: <What is RPS>,

Donna,

I am on vacation in Phoenix using my son's computer, so I don't have access to my files at the moment to attach my handout. I will try to send your URL home to remind me to send you the actual handout, or you can order an entire set of various (valuable) LEC handouts to reproduce freely for $4 shipping and handling to Jan Barger at [log in to unmask] The handout also appears in the 2004 ILCA syllabus.

RPS stands for reverse pressure softening (of the areola, during engorgement and/or edema of the areola in the first few weeks postpartum). It explains the most effective methods to position fingertips in order to apply slow, steady, firm but gentle inward pressure to the areola at the base of the nipple. (This depends on whether fingernails are short or long, whether the mother, HCP or the helper is applying RPS, whether there are two free hands or just one, or whether the mother has a language or disability barrier.)

The object is to painlessly soften the central areola right where it joins the nipple for long enough to allow the baby sufficient time to latch. The firmer the areola, the longer time the pressure must be applied to adequately soften the areola. Positioning the mother flat on her back first helps delay the re-enty of the swelling back into the areola too quickly before the baby has the chance to latch. This is especially important if the breast is quite pendulous and/or the swelling is severe. 

I have found RPS to have these effects: 1) it temporarily reverses the effect of engorgement on the central areola, making it more pliable, by relocating excess tissue fluid in the direction of natural lymphatic and circulatory drainage 2) it relocates some milk from distended subareolar ducts a short distance backward so they respond more easily and productively to the rippling of the infant's tongue, and 3) it automatically stimulates the MER.

If you have access to JHL, I wrote a detailed professional article on it in the May 2004 issue: "Reverse Pressure Softening: A Simple Tool to Prepare Areola During Engorgement", and I am delighted and grateful to report that it has won the JHL's reader's choice award for 2004. 

In case you have access to Leaven, I also wrote an article in the 2003 April/May issue called "Too Swollen to Latch:Try Reverse Pressure Softening". 

A very short illustrated article is also available on the web on several sites, some in foreign languages. One site that carries it in English, Swedish and perhaps Ukranian by now, is kellymom.com. Other lactnetters may be able to fill in which sites have it in other languages such as Dutch.

I welcome all feedback, negative as well as positive, as it is a work still in progress.

Jean
***************
K. Jean Cotterman RNC, IBCLC
Dayton, Ohio, USA

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