Reverse pressure softening is a way to soften the areola (the circle around your nipple). It helps make attaching your baby and expressing (removing your breast milk) easier.
Reverse pressure softening can be helpful:
- for attachment problems
- to relieve breast fullness (engorgement)
- if you have some swelling due to intravenous (IV) fluids or medicine given during labour
How reverse pressure softening works
Reverse pressure softening moves mild or firmer swelling away from the areola for a short time. It moves the swelling slightly backwards into your breast for 5 to 10 minutes.
This makes it easier for your areola to change shape and for your baby to attach.
With a softened areola:
- your nipple extends further into your baby's mouth so they can feed better
- it's easier to express milk (either by hand or with a breast pump on a slow setting)
Important
Do not use reverse pressure softening if you have a breast abscess, mastitis or blocked ducts.
How to do reverse pressure softening
The main aim is to make the areola very soft around the base of your nipple. This will help your baby to attach more easily.
Follow these steps:
- Choose 1 of the methods shown below.
- Press inward towards your chest wall, counting slowly to 50. Pressure should be steady and firm, but gentle enough to avoid pain.
- Repeat the process until the areola has softened.
- When the areola is softened, you can feed your baby or express milk.
Soften the areola right before each feeding until the swelling goes away. This may take 2 to 4 days, or more.
If pumping, use a medium or low vacuum setting to reduce the swelling in the areola. Make pumping sessions short, with pauses to soften the areola again if needed.
Method 1: one-handed flower hold
Make sure your fingernails are short. Curve your fingertips and place them around the base of your nipple.
Method 2: two-handed one-step method
Make sure your fingernails are short. Place 3 fingers on either side of your nipple. Press your fingertips into the base of your nipple.
Method 3: two-handed thumbs two-step method
You could ask someone you're comfortable with to try to do this with you. They place a thumb on each side of your nipple. The base of their thumbnails should be in line with your nipple. After applying pressure, repeat the steps with their thumbs above and below your nipple.
Ask our breastfeeding experts
Very swollen breasts
If you have very swollen breasts (engorgement), do reverse pressure softening while lying on your back. This will give you more relief.
Soften the areola right before each feeding (or expressing) until the swelling goes away. This may take 2 to 4 days, or more.
When expressing, pause often to soften the areola again.
Engorgement while breastfeeding
Tips on breast massage and hand expression (video)
Getting help
If you're having any breastfeeding problems, ask for help.
You can get breastfeeding support from:
- your midwife
- your public health nurse
- a lactation nurse or midwife
- a local breastfeeding support group
- a La Leche League leader
- a Cuidiú breastfeeding counsellor