The purpose of breast compression is to continue the flow of milk
to the baby once the baby no longer drinks (open—pause—close type
of suck) on his own. Breast compression simulates a letdown reflex
and often stimulates a natural letdown reflex to occur. The technique
may be useful for:
- Poor weight gain in the baby
- Colic in the breastfed baby
- Frequent feedings and/or long feedings
- Sore nipples in the mother
- Recurrent blocked ducts and/or mastitis
- Encouraging the baby who falls asleep quickly to continue drinking
Breast compression is not necessary if everything is going well.
When all is going well, the mother should allow the baby to "finish"
feeding on the first side and, if the baby wants more, should offer
the other side. How do you know the baby is finished? When he no
longer drinks at the breast (open—pause—close type of suck).
A baby who is well latched on gets milk more easily than one who
is not. A baby who is poorly latched on can get milk only when the
flow of milk is rapid. Thus, many mothers and babies do well with
breastfeeding in spite of a poor latch, because most mothers produce
an abundance of milk.
In the first 3-6 weeks of life, babies fall asleep at the breast
when the flow of milk is slow, not necessarily when they have had
enough to eat. After this age, they may start to pull away at the
breast when the flow of milk slows down.
Unfortunately many babies are latching on poorly. If the mother’s
supply is abundant the baby often does well as far as weight gain
is concerned, but the mother may pay a price—sore nipples, a "colicky"
baby, a baby who is constantly on the breast (but feeding only a
small part of the time).
Breast compression continues the flow of milk once the baby starts
falling asleep at the breast and results in the baby:
- Getting more milk.
- Getting more milk that is high in fat.
Breast Compression: How to Do It
- Hold the baby with one arm.
- Hold the breast with the other, thumb on one side of the breast,
your other fingers on the other, fairly far back from the nipple.
- Watch for the baby’s drinking, though there is no need to be
obsessive about catching every suck. The baby gets substantial
amounts of milk when he is drinking with an open—pause—close type
of suck. (open—pause—close is one suck, the pause is not a pause
- When the baby is nibbling or no longer drinking with the open—pause—close
type of suck, compress the breast. Not so hard that it hurts and
try not to change the shape of the areola (the part of the breast
near the baby’s mouth). With the compression, the baby should
start drinking again with the open—pause—close type of suck.
- Keep the pressure up until the baby no longer drinks even with
the compression, then release the pressure. Often the baby will
stop sucking altogether when the pressure is released, but will
start again shortly as milk starts to flow again. If the baby
does not stop sucking with the release of pressure, wait a short
time before compressing again.
- The reason to release the pressure is to allow your hand to
rest, and to allow milk to start flowing to the baby again. The
baby, if he stops sucking when you release the pressure, will
start again when he starts to taste milk.
- When the baby starts sucking again, he may drink (open—pause—close).
If not compress again as above.
- Continue on the first side until the baby does not drink even
with the compression. You should allow the baby to stay on the
side for a short time longer, as you may occasionally get another
letdown reflex and the baby will start drinking again, on his
own. If the baby no longer drinks, however, allow him to come
off or take him off the breast.
- If the baby wants more, offer the other side and repeat the
- You may wish, unless you have sore nipples, to switch sides
back and forth in this way several times.
- Work on improving the baby’s latch.
The above works best, in our experience in the clinic, but if
you find a way which works better at keeping the baby sucking with
an open—pause—close type of suck, use whatever works best for you
and your baby. As long as it does not hurt your breast to compress,
and as long as the baby is "drinking" (open—pause—close type of
suck), breast compression is working.
You will not always need to do this. As breastfeeding improves,
you will able to let things happen naturally.
Handout #15. Breast Compression.
Revised January 1998
Written by Jack Newman, MD, FRCPC
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