Breastfeeding - Reverse pressure softening

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 breastmilk) easier.

Reverse pressure softening is helpful:

  • during the first weeks to help attachment problems or breast fullness (engorgement)
  • if you have some swelling due to IV fluids or medication 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 a short period of 5 to 10 minutes.

This allows your areola to change shape easily and makes attaching your baby easier. This is because the softened areola helps your nipple extend further into your baby's mouth. This makes it easier for your baby to get milk. Or for you to remove milk by hand-expressing or slow expressing with a breast pump.


Expressing breast milk


Do not use reverse pressure softening if you have mastitis, blocked ducts or a breast abscess.

How to do reverse pressure softening

The main aim is to make the areola very soft around the base of the nipple. This makes the areola softer so the baby can latch more easily.

Follow these steps:

  1. Choose one of the methods below.
  2. Press inward towards your chest wall, counting slowly to 50.
  3. Repeat the process until the areola has softened.
  4. Once the areola has softened, you can start to feed your baby or express milk.

Method 1: one-handed flower hold

one-handed flower hold
one-handed flower hold

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

Method 2: two-handed one-step method

two-handed one-step method
two-handed one-step method

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

Method 3: two-handed thumbs two-step method

two-handed thumbs two-step method
two-handed thumbs two-step method

If there is someone you're comfortable with who can help, you could try this method. Ask them to place one of their thumbs on each side of the nipple, with the base of each thumbnail at the side of the nipple. Move one-quarter turn, then repeat with thumbs above and below the nipple.

These methods are adapted from K Jean Cotterman (2010), illustrations by Kyle Cotterman.

Very swollen breasts

If you have very swollen breasts (engorgement), doing reverse pressure softening lying on your back will give 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 re-soften the areola.

The Basics of Breast Massage and Hand Expression from Maya Bolman on Vimeo.

Tips on breast massage and hand expression by Maya Bolman, IBCLC and Ann Witt, MD, FABM, IBCLC.

Getting help

If you're having any breastfeeding problems, ask for help.

You can get breastfeeding support from:

Page last reviewed: 19 March 2019
Next review due: 19 March 2022