by Jack Newman, MD, FRCPC
The purpose of breast compression is to continue the flow of milk to the baby when the baby is only sucking without drinking. Drinking ("open mouth wide—pause—then close mouth" type of suck -- see the video clip at Example of Baby Nursing Effectively) means baby got a mouthful of milk. If baby is no longer drinking on his own, mother may use compressions to "turn sucks or nibbling into drinks," and keep baby receiving milk. Compressions simulate a letdown or milk ejection reflex (the sudden rushing down of milk that mothers experience during the feeding or when they hear a baby cry -- though many women will not "feel" their let down). The technique may be useful for:
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 offer the other side. How do you know the baby is finished the first side? When he is just sucking (rapid sucks without pause) and no longer drinking at the breast ("open mouth wide — pause — then close mouth" type of suck). Compressions help baby to get the milk.
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.
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. However, the mother may pay a price for baby's poor latching—for example: sore nipples, a baby who is colicky, and/or a baby who is constantly on the breast (but drinking only a small part of the time).
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 and not because they are lazy or want to pacify. 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 and some babies fall asleep even at 3 or 4 months when the milk flow is slow.
(Use with Protocol for Managing Breastmilk Intake)
1. Hold the baby with one arm.
2. Support your breast with the other hand, encircling it by placing your thumb on one side of the breast (thumb on the upper side of the breast is easiest), your other fingers on the other, close to the chest wall.
3. Watch for the baby's drinking, (see videos at nbci.ca ) 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.