Reverse Pressure Softening

At times, an infant may have difficulty latching due to breast fullness or engorgement. When the breasts are engorged, areola tissue becomes swollen and often draws the nipple in or makes the nipple appear flat. Reverse pressure softening, credited to the late K. Jean Cotterman, RN-IBCLC, is a simple technique that can help alleviate areola swelling and enable the baby to latch.

Reverse Pressure Softening Instructions

• Use reverse pressure softening right before latching baby
• Place pads of your fingertips on the areola, away from the base of the nipple; using both hands, place fingertips on opposite sides of the nipple
• Gently press inward towards your chest wall with a steady pressure. Hold the pressure for 1-2 minutes, or to a count of 50
• Fingers can be picked up and placed all around the areola, continuing with gentle inward pressure
• When areola feels softer, latch infant on the breastAdditional Tips

• Short fingernails or “curved” fingertips are recommended to avoid breast tissue damage
• Reverse pressure softening should not be painful. Be cautious not to apply too much pressure
• For extreme engorgement or larger breasts, a gravity assisted position such as lying on your back can be helpful
• A partner can do reverse pressure softening using their thumbs
• Reverse pressure softening can be used whenever needed
• Do not use for mastitis, clogged ducts, or a breast abscess