Also reverse pressure softening: See here from LLLI
Reverse Pressure Softening
K. Jean Cotterman RNC, IBCLC ([email protected])
What is it?
Reverse pressure softening is a new way to soften the circle around your nipple (the a-re-o-la) to make latching and getting your milk out easy while your baby and you are learning. Latching shouldn't be painful. If your areola is soft enough to change shape while feeding, it helps your baby gently extend your nipple deep inside his mouth, so his tongue and jaws can press on milk ducts under the areola. (These motions differ from those that artificial nipples force a baby to use.)
This new method is not the same as removing milk with your fingers. Don't expect milk to come from your nipple while you soften your areola this way. (But it's OK if some milk does come out.)
When is it helpful?
Try reverse pressure softening in the early days after birth if you begin to notice firmness of the areola, latch pain or breast fullness. (This full feeling is only partly due to milk. Delayed or skipped feedings may also cause the tissue around your milk ducts to hold extra fluid much like a sponge does. This fluid never goes to your baby.) Intravenous (IV) fluids, or drugs such as pitocin may cause even more retained tissue fluid, which often takes 7-14 days to go away. Avoid long pumping sessions and high vacuum settings on breast pumps to prevent extra swelling of the areola itself.
Feel your areola and the tissue deeper inside it. Is it soft and easy to squeeze, like your earlobe or your lip? Or does it feel firmer and harder to compress, like your chin? if so, it's time to try reverse pressure softening just before each time you offer your baby your breast. (Some mothers soften their areola before feeding, for a week or longer, till swelling goes down, baby can be heard swallowing milk regularly, and latching is always painfree without softening first.)
Why does it work?
Reverse pressure softening briefly moves some swelling backward and upward into your breast to soften your areola so it can change shape and extend your nipple. It sends a special signal to the back of your breasts to start moving milk forward (let-down reflex) where your baby's tongue can reach it. It also makes it easy to remove milk with your fingertips or with short periods of slow gentle pumping, combined with gentle forward massage of the upper breast, if you need to remove milk for your baby.
Where should I press?
It is most important to soften the areola in the whole one-inch area all around where it joins your nipple. Soften even more of the areola if you wish. You may also want to soften a place where your baby's chin will be able to move easily against the breast. Reverse pressure softening should cause no discomfort.