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The purpose of breast compression is to continue the flow of
milk to the baby once the baby no longer drinks (“open mouth
wide—pause—then
close mouth” type of suck) on his own, and thus keep him
drinking milk. Breast
compression simulates a letdown reflex and often stimulates a
natural letdown reflex to occur.
The technique may be useful for:
1.
Poor weight gain in the baby
2.
Colic in the breastfed baby
3.
Frequent feedings and/or long feedings
4.
Sore nipples in the mother
5.
Recurrent blocked ducts and/or mastitis
6.
Encouraging the baby who falls asleep quickly to continue
drinking not just sucking
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, offer the other side.
How do you know the baby is finished?
When he no longer drinks at the breast (“open mouth
wide—pause—then
close mouth” type of suck).
Breast
compression works
particularly well in
the first few days to help the baby get more colostrum.
Babies do not need much colostrum, but they need some. A good latch and compression help them get it.
It may be useful to know
that:
1. 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.
2. In the first 3-6 weeks
of life, many babies tend to 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. However, some pull at
the breast even when they are much younger, sometimes even in
the first days.
3. 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—such as, sore nipples, a “colicky” baby, and/or a
baby who is constantly on the breast (but drinking only a
small part of the time).
Breast compression continues the flow
of milk once the baby is no longer drinking from (only sucking
at) the breast and results in the baby:
1. Getting more milk.
2. Getting more milk that
is higher in fat.
Breast
compression—How to do it
1. Hold the baby with one
arm.
2. Hold the breast with the
other, thumb on one side of the breast (thumb on the upper side
of the breast is easiest), your other fingers on the other,
fairly far back from the nipple.
3. Watch for the baby’s drinking, (see videos)
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
mouth wide—pause—then close mouth” type of suck.
4. When the baby is
nibbling at the breast and no longer drinking with the “open
mouth wide—pause—then
close mouth” type of suck, compress the breast.
Do not roll your fingers along the breast toward the
baby, just squeeze. 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 mouth wide—pause—then close mouth” type of suck. Use compression while the baby is sucking but not
drinking!
5. Keep the pressure up
until the baby no longer drinks even with the compression, and
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.
6. The reason for releasing 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.
7. When the baby starts
sucking again, he may drink (“open mouth wide—pause—then close mouth” type of suck). If not, compress again as above.
8. 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
(milk ejection 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.
9. If the baby wants more,
offer the other side and repeat the process.
10. You may wish, unless
you have sore nipples, to switch sides back and forth in this
way several times.
11. Work on improving the
baby’s latch.
12. Remember, compress
as the baby sucks but does not drink.
In our experience, the above works
best, but if you find a way which works better at keeping the
baby sucking with an “open mouth wide—pause—then
close mouth” 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 mouth wide—pause—then
close mouth type” of suck), breast compression is working.
Questions?
(416)
813-5757 (option 3) or
drjacknewman@sympatico.ca or
my book Dr. Jack Newman’s Guide to Breastfeeding (called The Ultimate
Breastfeeding Book of Answers in
the USA)
Handout
#15. Breast
Compression. Revised January 2005
Written by Jack Newman, MD, FRCPC. © 2005
This
handout may be copied and distributed without further
permission,
on the condition that it is not used in any context in which the WHO code on the
marketing of breastmilk substitutes is violated.
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