Reverse Pressure Softening

• In-hospital
  • Peri-areola edema
  • Engorgement
• Clinic and Home
  • Engorgement

Multi finger-tip

Exert steady, gentle pressure inward toward the chest wall for a full 2-3 minutes or longer, focusing on the areola where it joins the base of the nipple.

Flats of two thumbs or fingers

Use the flats of two thumbs or fingers to obtain a more even distribution of interstitial fluid. Hold the finger position up to 60 seconds, then rotate fingers around breast quadrants holding position for each rotation.

Massage all quadrants back to chest wall

Clinical Guidelines

• Berens, P., Brodribb, W. (2016) ABM Clinical Protocol #20: Engorgement, Revised 2016. Breastfeeding Medicine. 11(4):159–163. 

References

1. Campbell, S. H., Lauwers, J., Mannel, R., & Spencer, B. (2019). Core curriculum for interdisciplinary lactation care. Jones & Bartlett Learning. 
2. Cotterman, K. J. (2004). Reverse pressure softening: a simple tool to prepare areola for easier latching during engorgement. Journal of Human Lactation, 20(2), 227–237. 
3. Witt, A. M., Bolman, M., & Kredit, S. (2016). Mothers Value and Utilize Early Outpatient Education on Breast Massage and Hand Expression in Their Self-Management of Engorgement. Breastfeeding Medicine, 11, 433–439.