Breast compressions are a technique used during breastfeeding or pumping sessions to increase the speed and volume of milk flow from the breast. This manual method involves applying gentle pressure to the breast tissue to improve milk transfer and encourage more complete drainage. The goal of compressions is to help the baby or pump extract more milk, especially when the natural flow begins to slow down. Breast compressions can be incorporated into a feeding routine to maximize efficiency and support the milk supply.
The Physiological Rationale for Compressions
The effectiveness of breast compressions is rooted in the physics of milk flow within the mammary ducts. Milk is produced in alveoli and travels to the nipple through a network of ducts. When the flow slows down after the initial milk ejection reflex, or “let-down,” the ducts offer more resistance to the baby’s sucking efforts. Applying external pressure compresses the ducts and surrounding tissue, helping to overcome internal resistance and maintain a faster flow toward the nipple.
This faster flow keeps the baby actively drinking, converting less effective suckling into deep, active swallowing. The increased pressure can also stimulate the milk ejection reflex, which is governed by the hormone oxytocin. Ensuring more complete breast drainage signals the body to produce more milk over time, supporting a healthy milk supply.
Step-by-Step Guide to Proper Technique
To begin breast compressions, first ensure your baby is latched well and is actively drinking, which is often identified by a wide-open mouth, a distinct pause, and a swallow. Use your free hand to support the breast, positioning your thumb on one side and your fingers on the other, away from the areola. This placement ensures you do not interfere with the baby’s latch while still encompassing a large area of the breast tissue.
The compression should be applied when you notice your baby’s active swallowing slowing down or stopping, even though they continue to suckle. Gently squeeze the breast with a firm pressure, aiming for a sensation that is effective but never painful. The pressure should be maintained only as long as the baby responds by starting to actively swallow again.
Once the baby stops actively drinking, even with the compression, you should release the pressure. This release allows your hand to rest and gives the milk ducts a chance to refill slightly, potentially triggering another natural let-down. If the baby remains at the breast and begins to suckle without drinking, rotate your hand position to a different part of the breast and compress again. It is important to avoid sliding your fingers along the breast or pressing so hard that the areola changes shape, which could disrupt the baby’s ability to transfer milk effectively.
When to Apply Breast Compressions
Breast compressions are a helpful technique in specific situations where milk transfer is not optimized. One common indication is with a sleepy or premature baby who may not have the stamina or muscle tone for a prolonged, active feeding. The increased flow rate from compressions helps keep them engaged and drinking for a longer period. The technique is also valuable when the baby is suckling but not showing signs of swallowing, indicated by the absence of the characteristic jaw pause.
For parents who are exclusively pumping, using compressions, often called hands-on pumping, can significantly increase the volume of milk expressed and help fully empty the breast. Compressions are frequently recommended by healthcare providers when an infant is experiencing poor or slow weight gain, as they ensure the baby consumes more milk, including the higher-calorie hindmilk. Furthermore, fully draining the breast can help manage or prevent issues like recurrent blocked ducts or mastitis. They can be used on the first side until the baby no longer drinks even with compression, before offering the second breast.