Mothers can soften their breasts by:
- Breast massage.
- Combining the two.
The choice should be based on how well each one works. Ideally, both breasts are softened within 30 minutes. Massage can be done by another person such as a partner or a health-care provider (Witt 2016).
1) Breast massage
Breast massage can:
- Stimulate a let-down to move milk towards the nipple.
- Push excess milk out of the breast through the nipple.
- Push lymph into the lymphatic system and away from the breast.
Breast massage can be done by:
- Gentle, steady pressure on the breast.
- Gently stroking using the thumb and fingers coated with a small bit of cooking oil:
- Towards the nipple.
- Towards the armpit.
- Upwards and towards the middle of the chest.
We recommend any stroking should start towards the nipple. Stroking towards the armpit and upwards and towards the middle of the chest can be used for remaining fullness.
The pressure is similar to pressures used to apply lotion or stroke a pet. Pain can impair the let-down and should be avoided.
Pressure is applied for five seconds and then released. Similarly, each stroke should take about five seconds. The hands are moved around the breast as it softens.
Most mothers will leak significant amounts of milk while massaging effectively. This helps to empty the breast but can be messy. To prevent this, the milk can be caught in a bowl or towel.
2) Combining massage and expression
Mothers may benefit from using both breast massage and expression after breastfeeding and can:
- Alternate a little massage and a little expression (manual expression or pumping)
- Massage first and then express.
- Express first and then massage.
They should choose approach that is the most comfortable, effective, and quick.
One example of combining massage and expressing is as follows:
- Gently massage the breast for about five seconds, then release.
- Only use as much pressure as is comfortable.
- Massage ten times; this should take about one minute.
- Monitor the breast’s response to see which technique is most effective at softening and when to change the location of the hands on the breast.
- Express until the milk no longer runs quickly.
- Continue alternating massaging and expressing.
- Stop if:
- Your breast is not softening.
- Your breast is soft.
- Fifteen minutes have passed.
- It causes more than mild discomfort.
- Use the same technique on the other breast.
If milk does not flow with expression, mothers can lightly tap the breast with fingertips around the areola or use other ways to improve their let-down.
a) Therapeutic breast massage
Therapeutic breast massage is a combination of light massage towards the armpit with manual expression. It has been reported to treat swelling caused by breast engorgement, a plugged duct, mastitis, or a breast abscess (Witt 2016).
In theory, massaging towards the armpit should help roughly three quarters of the lymph drain. It may not help the remaining quarter that needs to flow along the breast bone. If mothers notice fullness in the inner sides of the breast, they may wish to massage that area upwards and towards the centre of the chest.