Breast compression is a way of gently squeezing the breast during a breastfeed to put pressure on the milk glands causing them to release more milk and increase milk flow. Breast compression simulates a milk let-down (milk ejection reflex). Increasing milk flow in this way can encourage a baby to keep sucking actively because he will be rewarded with more milk and this makes for more effective breastfeeding. As well as keeping a baby feeding actively at the breast for longer, breast compression may help to increase a milk supply by ensuring the breasts are more thoroughly emptied. The more frequently and thoroughly a baby breastfeeds and empties the breasts, the more milk will be made.
Do I need to use breast compression?
If breastfeeding is going well and your baby is getting enough milk and gaining weight you won’t need to worry about using breast compression. However if a mother has a low milk supply, a baby who is not gaining weight or a sleepy baby, breast compression may help to maximise a baby’s milk intake. Jack Newman, a Canadian paediatrician and lactation consultant, has a list of the situations when breast compression might be useful:
The technique may be useful for:
- Poor or slow weight gain in the baby
- Fussy babies. Babies who are fussy usually want more milk.
- Frequent feedings and/or long feedings
- Sore nipples in the breastfeeding parent
- Recurrent blocked ducts and/or mastitis
- Encouraging the baby who falls asleep quickly to continue drinking not just sucking
- A “lazy” baby, or baby who seems to want to just “pacify”. Incidentally babies are not lazy, they respond to milk flow, so that if flow slows, babies may start to fall asleep. Or if they are older, they may pull away from the breast.
How do I do breast compression?
- Breastfeed your baby as usual with a deep latch (plenty of breast tissue in the mouth as well as the nipple) and a comfortable breastfeeding position.
- During the breastfeed, watch for the moment when your baby stops sucking actively—this is when the deep jaw movements slow down and you can’t hear many (or any) swallows.
- Using a free hand, cup and squeeze the breast between thumb and fingers e.g. with the thumb on top of the breast and the fingers of the same hand below it. Alternatively, some mothers press the breast against the chest wall or have their fingers on top of the breast and their thumb below.
- Place your hand far enough behind the nipple and areola so you don’t disturb your baby’s latch but close enough to apply gentle pressure on the milk glands in the breast. Two-thirds of the milk making glandular tissue is thought to be within a three centimetre radius of the nipple (Douglas, Vol 18: 1–20 2022).
- Avoid sliding your thumb or fingers along the breast and do not press so firmly that it is uncomfortable or painful.
- Once milk starts to flow again, due to breast compression, your baby will start sucking and swallowing again. Maintain the pressure while your baby is still sucking and swallowing and then release the pressure and rest your hand when your baby pauses.
- Repeat the compressions until there is no active swallowing.
- Once baby stops actively sucking on the first breast even with compression, offer the other breast and repeat.
Once breastfeeding improves, breast compression will no longer be needed.
Pictures of breast compression
In the picture below, the baby is feeding in rugby hold on the left breast, and the mother uses her right hand to compress the breast and increase milk flow.
In the next picture the baby is feeding in cradle hold. The mother may need to move her thumb closer to her baby before compressing the breast but she can experiment to see what works for her.
Finding the right pressure
A little practice will reveal how much gentle pressure is needed to reproduce a let-down (milk release from the breast). The principle is similar to filling a rubber glove with water and squeezing it to find the leak—when you apply just enough pressure, water will spurt from any tiny holes in the rubber. Breast compression is sometimes likened to hand expressing breast milk into your baby’s mouth.
Dr Jack Newman popularised the technique of breast compression, he explains:
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.
Keep the pressure up until the baby is just sucking without drinking even with the compression, and then release the pressure.
Videos of breast compressions
In the video clip below, Dr Jack Newman explains when to do breast compressions during a breastfeed. The mother cups her breast with her hand, her thumb rests on top of the breast and her fingers are below it. When baby is not swallowing the mother compresses her breast and her baby starts drinking well. Mother rests her hand when her baby stops drinking.
In this second video clip from Global Health Media breast compression is discussed as one of a range of ideas to increase milk supply. To jump to breast compression go to 2:05. Note the mothers in this video are using slightly different techniques to achieve breast compression compared to the first clip.
Can breast compression cause any problems?
Dr Jack Newman noticed that women in South Africa routinely used breast compression to help babies get more milk.12 Newman found that when used appropriately (see technique above), breast compression was a useful strategy and he doesn’t highlight any problems. However, not all lactation consultants favour breast compression and, as with any general information, there may be individual circumstances where a technique is not suitable for a mother.
Cautions
Any constant, firm pressure on a lactating breast is a risk factor for breast inflammation (engorgement, blocked ducts or mastitis) whether this is pressure from a tight bra or other clothing, a bag strap or a mother’s fingers. Author and lactation consultant Pamela Douglas cautions mothers to avoid squeezing, shaping, or compressing the breast during breastfeeds as part of this concern.3 If using breast compressions, it is important to release the breast at intervals and not to press into the breast constantly throughout a feed. Breast compression should never be painful and is a short term technique to try until breastfeeding improves.
Summary
Breast compression can be a useful technique to keep breast milk flowing during a breastfeed by gently compressing and releasing the breast. Breast compression can increase milk flow, keep a baby feeding longer and, by emptying the breasts more thoroughly, it also helps to increase milk supply.