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Your question:

What is reverse pressure softening?

Expert’s answer:

Reverse pressure softening is a new way to soften the areola (the circle around your nipple).  It helps make latching and removing your milk easy while you and your baby are learning.

Reverse pressure softening is helpful:

  • during the first weeks to relieve firmness of the areola, latch problems or breast swelling;
  • at any time to get a 'let-down' reflex before or while expressing.

It is particularly helpful for Mums who have some swelling due to IV fluids or drugs given during labour and birth, especially with a Caesarean Section. Reverse pressure softening briefly moves mild or firmer swelling away from under the areola, slightly backward into your  breast for a short period of 5-10 minutes.  This allows your areola to change shape easily and makes latching easier as the softened areola helps your nipple extend more deeply into your baby's mouth. 

Reverse pressure softening also causes a 'let-down' reflex making it easier for your baby to get milk or for your to remove milk by hand expressing or slow gently expressing with a breastpump.

Reverse pressure softening should not be used if you have mastitis, plugged ducts or breast abcess.

How to do reverse pressure softening

The key is to make the areola very soft right around the base of the nipple.  This helps create a better latch. 

  • Choose one of the methods below - some Mums say the curved finger tips works best.
  • Press inward towards your chest wall, counting slowly to 50
  • Once the areola has softened, you can start to feed your baby or express (by hand or using a breastpump on low to medium pressure)

For Mums with very swollen breasts, doing reverse pressure softening lying on their back (taking advantage of gravity) will give more relief.

Soften the areola right before each feeding (or expressing) until the swelling goes away.  For some Mums this takes two to four days or more.

When expressing pause frequently to re-soften the areola.

Method 1 - one-handed flower hold

Reverse Pressure Softening method 1

Make sure your fingernails are short.  Place curved fingertips where your baby's tongue will go.

Method 2 - two-handed one-step method

Reverse Pressure Softening method 2

Make sure your fingernails are short.  Place curved fingertips on the breast, each one touching the side of the nipple.

Method 3 - two-handed two-step method

Reverse Pressure Softening method 3

Using both hands, place two or three straight fingers each side of the nipple with the first knuckles touching the nipple.  Move 1/4 turn, repeat above and below the nipple.

Method 4 - two handed thumbs two-step method

Reverse Pressure Softening method 4

Using both thumbs, place one each side of the nipple with the base of each thumbnail at the side of the nipple.  Move 1/4 turn, repeat with thumbs above and below the nipple.

Method 5 - soft ring method

Reverse Pressure Softening method 5

Cut off the bottom half of an artificial teat (nipple) to place on the areola with your nipple centred in the middle.  Press on the sides of the teat.

Adapted from K Jean Cotterman (2010), illustrations by Kyle Cotterman

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