When your baby first comes to the breast, he will do fast sucks initially. That will send impulses to the brain.
The brain then releases hormones, and those hormones will cause your milk to come down on both breasts.
This is called the let-down. Milk will come shooting down a whole network of ducts, and come out of your nipple and hit the back of your baby’s throat.
Your baby will then start to swallow, and you will see the sucking pattern slowing down and becoming more rhythmical.
Listen out for the sound of swallowing. With a tiny baby, it can be very faint, but you can usually hear a sound like a sigh.
Every time your baby swallows, your breast is emptying a little bit, and your body will then make more milk on that side (because there has been some emptying).
This is the way milk production works.
Eventually, the volume of milk will reduce, and your baby will then tend to do a bit of ‘nibbling’ on this low volume milk, which can seem like a pause.
However, after a while, your baby will then actively swallow again as another let-down happens.
Studies show that, on average, you may have up to three to five let downs on one side as your baby works through these cycles of feeding.
However, some babies will not work hard to generate those extra let-downs.
If you find that your baby starts to fall asleep at the breast very frequently at every feed or starts to pull off the breast because of lack of interest (because the flow has slowed), then the technique of breast compression can be handy.
Breast compression will help you to cause a manual let-down of milk.
It will push the milk out of the breast and keep your baby actively swallowing when your baby otherwise wouldn’t have been active.
Please know that it is normal for babies to have a bit of a pause as they work through the feed, but here I am talking about babies who are ‘hanging out at the breast’ and are not actively swallowing.
It could be that your baby is a very sleepy newborn, of which there are strategies to help with that.
If you find that your baby is cluster nursing in the evening, which means that he will be feeding very frequently, even every 10-15 minutes (which is biologically normal), breast compressions can also be useful.
If your baby is going through a growth spurt, which involves 2-4 days and nights of very frequent feeding, you can use breast compressions for this scenario as well.
Imagine your baby is attached at the breast, and he has already done the fast sucks initially and called the milk down.
However, after a short time, he falls asleep at the breast, and you know that he hasn’t drained that breast well.
If you are sitting with your baby (reclined back if you can), and allow your body to act as a mattress for your baby, with gravity keeping him close, you will have a spare hand to do the breast compression technique.
Place your thumb on top of the breast that he is attached to and place your fingers underneath.
He may even just be doing some little movements with his jaw, but no active swallowing heard.
Compress once – (one squeeze and keep it squeezed), which will manually squeeze a group of grape-like structures within the breast where the milk is made and stored, and there are hundreds of these right around the clock face of the breast.
When you compress, you are, in effect, squeezing these grape-like structures and manually pushing the milk out of the breast.
The milk will pass through a network of ducts, coming out of the nipple, and hit the back of your baby’s throat.
When your baby feels milk hitting the back of the throat, he will swallow.
Keep your hand compressed on the breast. You’re not releasing yet. You will then hear your baby swallowing.
It may be that he only does three extra swallows or four or five, but that is EXTRA milk that he is swallowing, extra milk that he wouldn’t have got had you not done the compression.
When there is no more swallowing, release your hand.
You can then rotate to another area of the breast if you find that your baby is still not actively swallowing.
Compress again, and you will push more milk out of the breast. You can keep rotating right around the clock face.
When you are in a reclined position for feeding, you will have a spare hand to do compressions.
Swap your hand over, so one of your hands is supporting your baby while the other one does compressions.
The breast compression technique will help to make more milk, and your baby will also get more milk every time he swallows.
If you do use the breast compression technique, make sure that it doesn’t cause you any pain.
Also, you won’t always have to use the technique.
Still, it can be useful during your baby’s growth spurts, and you may also find it helpful when your baby gets into the third or fourth month when he will be very distracted at the breast, and take very small feeds, before pulling off the breast.
Use this technique as needed, at all stages of breastfeeding, but use sparingly (if at all) if you have an overactive letdown or oversupply, as it could exacerbate some of the issues and wouldn’t generally be necessary.
Review dates, references & further resources
Version 1.1 published in March 2019. Next review date: Jan 2022
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