Breast compression is a simple, non-invasive, manual technique used during breastfeeding to help sustain the flow of milk and increase the amount of milk a baby transfers during a feeding session. It involves applying gentle pressure to the breast when the baby’s suckling slows down and they are no longer actively swallowing. Parents commonly use this tool to encourage their baby to remain engaged and continue drinking when the natural flow of milk begins to diminish.
The Physiology of Increased Milk Flow
The effectiveness of breast compression stems from its ability to mechanically assist the milk ejection reflex, often called the “letdown.” Breast milk is produced and stored in small sacs called alveoli. The letdown reflex, triggered by oxytocin, causes the muscles around these alveoli to contract, pushing the milk through the ducts toward the nipple. As feeding progresses, the initial rush of milk slows, and the baby’s active swallowing transitions into a lighter, non-nutritive sucking pattern.
Applying manual pressure when this slowing occurs essentially mimics the internal pressure of a strong letdown, helping to push the remaining milk through the duct system. This external force ensures that milk continues to move out of the breast, maintaining a faster flow rate. A consistent, faster flow encourages the baby to keep actively sucking and swallowing.
The sustained emptying of the breast that compression facilitates also helps the baby access the higher-fat milk, sometimes referred to as “hindmilk,” typically retrieved later in the feeding. This higher-fat milk requires more thorough emptying of the breast to be transferred. By manually moving this milk, compression maximizes the caloric density of the feed, which is beneficial for the baby’s weight gain and overall satisfaction.
Performing the Technique Step-by-Step
Before performing compression, the parent should ensure the baby is well-latched and actively drinking, characterized by a wide-open mouth, a pause, and then a close—a visual sign of swallowing a mouthful of milk. Once the baby’s swallowing slows and they shift to a light, fluttery suck without pauses, the technique should be applied. The parent supports the breast with their free hand, placing the thumb on one side and the fingers on the opposite side, well away from the areola.
The pressure must be firm enough to increase the milk flow, visible when the baby resumes the wide-open mouth and pause-swallow pattern. Avoid pressing so hard that it causes pain or distorts the shape of the areola near the baby’s mouth, which could disrupt the latch. Hold the compression steadily until the baby’s swallowing slows down, indicating the flow has decreased.
The pressure should then be released, allowing the hand to rest and the milk to naturally flow again, which may sometimes trigger another spontaneous letdown. If the baby continues to suck without swallowing after the release, the parent can move their hand to a slightly different position and repeat the compression. Rotating the position helps empty milk from different lobes and prolongs the active feeding period.
When to Use Breast Compression
Breast compression is a tool used to improve milk transfer when a feeding is not proceeding efficiently. It is frequently recommended when a baby is sleepy or lazy at the breast, as the increased milk flow helps keep them awake and engaged. Compression helps turn non-nutritive sucks into swallows, preventing the baby who is only sucking without drinking from falling asleep quickly.
The technique is also beneficial when there is concern about the baby’s intake, such as with slow weight gain or decreased urine and stool output. By ensuring the baby receives a greater volume of milk, including the higher-fat hindmilk, compression maximizes the caloric transfer during each session. For parents who need to shorten the duration of feedings, compression maximizes the amount of milk removed.
The complete emptying of the breast facilitated by compression can help manage engorgement or prevent recurrent issues like blocked ducts. When milk is left in the breast, it can lead to discomfort and inflammation. Manual assistance helps clear the milk ducts more effectively, ensuring the baby is actively drinking, which is necessary for adequate nutrition and maintaining the parent’s milk supply.