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Share Softening inverse pressure: a solution to breast engorgement

Armando @armando_bastida

"The boy does not fuck with me


and for milk it will not be, because I have my tits to burst ". This is a relatively common phrase in the postpartum period, when the mother's milk rises and her breasts get so full that the child is not able to hold her breast.

The rise of milk usually takes between 1 and 3 days. The time it takes to give and how much it can bother depends to a large extent on how breastfeeding is established. If a baby is held close to the breast at birth, if it is in the room with the mother 24 hours a day and if it meets the demands of the baby offering the breast without limitations or schedules, the rise of milk often bothers little or nothing . So much so that sometimes there are mothers who, as well as they are doing, doubt if they are giving milk to their children because "I have not noticed the rise, so I do not think I have milk."

On the other hand, there are mothers and babies whose lactation is more difficult, who get worse perhaps, or who have been limited in breastfeeding for a bottle (in bad time), for absurd hours (give it every 2-3 hours) or for a mother who has tried to calm the crying differently because "he has eaten recently, he can not be hungry" and even because he has received (the mother) some intravenous drip serum before giving birth (there is more fluid in the body and the engorgement gets worse ). For these moms the rise of milk can be very annoying because the breasts get hard, almost like stones and at that moment, when it interests the baby to empty them, it is unable to catch (try to suck a ball, see who gets it?

For these mothers and for these moments so annoying and distressing there is a solution: softening reverse pressure .

What is the softening inverse pressure (PIS)

Yes, I know that the name is brought to them, I imagine it is a very literal translation of English and in Spanish it sounds strange. In any case, the important thing is not his name, but his mission.

The softening reverse pressure is a very simple maneuver that can be very useful for inexperienced moms whose breasts get too engorged. It consists in applying a positive pressure on the mammary areola in the area surrounding the nipple. With this pressure what is achieved is to move the swelling slightly backwards and towards the inside of the chest. In this way the area of ​​the areola and nipple is temporarily half-empty of the edema and therefore less hard, more flexible and with the possibility of being sucked by the baby . This helps to facilitate milk extraction by the baby, reduces the risk of injury to the nipple, because the baby can get better and helps to calm the engorgement because it gradually empties.

Why the use of a breast pump is not recommended

In case of major breast engorgement, the use of breast pumps may be contraindicated because, although a priori the milk is relieved, the operation of a breast pump is not equal to the suction and swallowing mechanism of a baby and aspiration can cause part of the excess fluid in the chest goes to the areolar area, even to press the subareolar ducts in such a way that it is difficult (or impossible) to draw milk. This happens above all when high levels of aspiration are used with an electric breast pump.

How the softening reverse pressure is made

The best time to perform the PIS is right before the baby latches onto your chest . This technique can be performed by any person, including of course the mother, which is what her breasts are for. There are three different ways to do the PIS:

Two-handed and one-step method

The nails should be short so as not to risk injuring the nipple or areola. The index and ring fingers touch each other above and below the nipple and the middle fingers touch each side of the nipple. With this position, pressure is applied to the thorax. This is usually the most comfortable position for moms who do it themselves.

Two-handed and two-step method

Two or three straight fingers are placed on each side of the nipple and pressure is applied. After a while, the fingers move 90 degrees and the action is repeated above and below the nipple.

Two thumbs and two steps method

The thumbs are placed on each side of the nipple and after pressing for a while, move the fingers to the upper and lower parts to press again. This method can not be done by the mother for obvious reasons, so it must be someone else who applies it.

Some recommendations and considerations

  • The necessary time of pressure depends on the hardness and state of swelling of the areolar tissue (can range from one or two minutes to 10 or 20 if necessary). The goal is to make it soft.

  • It may be useful for the mother to lie on her back, especially if the edema is important, to delay the reappearance of the swelling with the help of gravity and to gain a little time until the baby is held to the breast.
  • The pressure should not cause pain . If it bothers, it is better to apply less pressure and be more time.
  • Occasionally, it may be useful to perform manual milk removal just after the PIS (and before the child is breastfed) to further soften the areola. That way the baby can have more space to catch and even hollow for his chin and can suckle more easily.
  • Other strategies for breast engorgement

    The softening inverse pressure is one of the strategies that work best when there is breast engorgement, but it is not the only one and it is usually advisable to do it in combination with others.

    As I do not want to extend much more, but I want to explain them because they can help, I leave them for a few days.

    More information | California Department of Public HealthPhoto | Myllissa on FlickrIn Babies and more | Engorgement or breast engorgement, How the baby should hold on to the breast (video), Why many children do not latch on to the breast