Reverse Pressure Softening (RPS): Easing Engorgement for Better Latch

This article is part of our Breastfeeding Nutrition & Milk Supply: Evidence-Based Guide for Australian Mothers. Here, we focus specifically on how Reverse Pressure Softening (RPS) can ease painful engorgement to help your baby achieve a better latch.

When your breasts feel rock-hard and your baby can't latch, it's easy to feel defeated. Engorgement is one of the most common breastfeeding challenges Australian mothers face, especially in those first few days postpartum. The good news? There's a gentle, evidence-based technique that can make a real difference: Reverse Pressure Softening.

RPS temporarily moves fluid away from your areola, making the breast tissue soft and pliable so your baby can latch deeply and feed effectively. It's a simple technique that can transform a painful, frustrating experience into one where feeding actually works.

Breast engorgement occurs when your breasts become overly full of milk, blood, and lymphatic fluid. This typically happens around day 3–5 postpartum as your milk "comes in," but it can also occur anytime milk isn't being removed frequently or effectively enough.

Signs of engorgement include:

• Breasts that feel hard, tight, or swollen

• A flattened nipple that's difficult for baby to grasp

• Pain or discomfort when your baby tries to latch

• Shiny, stretched skin on your breasts

When breasts are engorged, the areola (the darker area around your nipple) becomes firm and taut. This makes it nearly impossible for your baby to get a deep latch, which means milk doesn't get removed effectively—creating a painful cycle that can quickly lead to more serious issues like blocked ducts or mastitis if left unaddressed.

Reverse Pressure Softening (RPS) is a technique developed by lactation consultant Jean Cotterman, RNC, IBCLC. It uses gentle, sustained pressure around the base of the nipple to temporarily move fluid (blood, lymph, and interstitial fluid) backward into the breast tissue, away from the areola.

Think of it like creating a small, soft "landing zone" for your baby's mouth. When the areola is firm and swollen, your baby can't get a proper latch. RPS creates a softer, more compressible area that allows your baby to take in more breast tissue—exactly what's needed for effective milk removal.

The technique is particularly valuable in the first week postpartum when engorgement is most severe, but it can be used anytime you experience breast fullness that interferes with latching.

RPS is a simple technique that takes just 1–3 minutes. Here's how to do it correctly:

Step 1: Position Your Fingers

Place your fingertips (usually your index and middle fingers from both hands, or all your fingertips if needed) in a circle around the base of your nipple, right where the areola meets the nipple.

Your fingers should be touching the nipple itself or positioned just beyond it on the areola. If you place your fingers too far out, the technique won't be as effective.

Step 2: Apply Steady, Inward Pressure

Press firmly and steadily straight back toward your chest wall (not squeezing inward toward the nipple—think backward/inward). You should feel like you're gently pushing the fluid away from the areola into the deeper breast tissue.

Hold this pressure for 1–3 minutes without releasing. The pressure should be firm but not painful. Some mothers describe it as similar to checking a pulse.

Step 3: Check the Softness

After holding for the full duration, release the pressure and check your areola. It should feel noticeably softer and more pliable. If it's still quite firm, repeat the process for another 1–2 minutes.

Step 4: Latch Your Baby Immediately

The softening effect is temporary, so latch your baby as soon as possible after performing RPS. This is when your baby will have the best chance of achieving a deep, comfortable latch that drains the breast effectively.

For guidance on achieving the best latch position, see our article on mastering attachment techniques for pain-free breastfeeding.

While RPS is highly effective on its own, combining it with other evidence-based strategies can provide even better relief from engorgement and improve your baby's latch.

Brief Hand Expression

Before attempting to latch, express a small amount of milk manually or with a breast pump on a low setting. This reduces some of the fullness, making the areola even softer. Express just enough to take the edge off—don't fully empty the breast, as this can signal your body to produce more milk and potentially worsen engorgement.

Many Australian mothers find that learning proper pumping techniques helps them manage engorgement more effectively, especially when baby isn't latching well yet.

Gentle Warmth Before Feeding

Apply a warm compress (like a warm, damp washer) to your breast for no more than 2 minutes before a feed. This can help trigger your let-down reflex and encourage milk flow.

Important: Avoid prolonged heat application, as this can increase inflammation and swelling. Keep warmth brief and gentle.

Cold Therapy Between Feeds

After feeding, apply cold compresses (like chilled cabbage leaves, gel packs, or cold washers) to reduce swelling and inflammation. Cold therapy is particularly effective at decreasing engorgement discomfort between feeds.

Feed Frequently and On Demand

The single most effective way to resolve and prevent engorgement is to breastfeed frequently—at least 8–12 times every 24 hours. Don't skip feeds or let your baby go too long between sessions, as this allows milk to build up.

If your baby is too sleepy or not feeding well, wake them for feeds every 2–3 hours during the day and at least twice at night. Consistent milk removal is essential for both relief and maintaining healthy breast milk production.

Even well-meaning mothers can inadvertently worsen engorgement or delay relief by making these common mistakes:

1. Waiting Too Long to Address It

Engorgement that's left untreated doesn't just cause pain—it can lead to blocked ducts, mastitis, or a drop in milk supply as your body receives signals that milk isn't being removed. Address fullness as soon as you notice it.

2. Over-Pumping or Over-Expressing

While expressing some milk can help, fully emptying your breasts signals your body to produce even more milk, which can create a cycle of worsening engorgement. Express only enough to soften the areola for latching—not to drain the breast completely.

3. Using Heat for Too Long

Prolonged heat (like long hot showers or heating pads) can increase inflammation and make engorgement worse. Limit warmth to 2 minutes before feeds, and focus on cold therapy between feeds.

4. Not Addressing Latch Issues

If your baby's latch remains shallow or painful after softening your breast, RPS alone won't solve the problem. Seek help from a lactation consultant to address positioning and attachment issues. A shallow latch means milk isn't being removed effectively, which will perpetuate engorgement.

When to Seek Professional Help

While RPS and supportive techniques can resolve most cases of engorgement, there are times when professional support is essential:

• Persistent pain after feeds: If latching remains painful even after softening your breast, your baby may not be achieving a deep latch.

• Nipple damage: Pinched, flattened, or cracked nipples after feeds indicate latch problems that need correction.

• Fever or flu-like symptoms: This may indicate mastitis (breast infection), which requires immediate medical attention.

• Engorgement lasting more than 48 hours: If your breasts remain rock-hard despite frequent feeding and RPS, consult a lactation consultant or your GP.

• Baby unable to latch at all: If your baby can't latch even after softening, professional support is needed to prevent complications and maintain your milk supply.

The Australian Breastfeeding Association offers a free helpline (1800 686 268) where you can speak with trained breastfeeding counsellors. Don't hesitate to reach out—early intervention prevents more serious issues down the track.

While RPS addresses the immediate mechanical problem of a firm areola, supporting your body nutritionally can help reduce inflammation and promote overall breast health during this challenging time.

Stay Well-Hydrated

Proper hydration supports healthy milk production and helps your body manage inflammation. Aim for at least 2.6 litres (about 10–13 cups) of fluids daily. Many Australian mothers find that breastfeeding-specific hydration drinks help them meet their fluid needs more easily, especially during those exhausting early weeks.

Prioritise Anti-Inflammatory Foods

Foods rich in omega-3 fatty acids (like salmon, walnuts, and chia seeds) and antioxidants (berries, leafy greens) can help your body manage inflammation more effectively. If you're looking for convenient options, lactation-specific cookies and snacks can provide both nutrition and comfort during this demanding time.

Get Adequate Rest

Your body is working incredibly hard to establish milk production. Rest supports immune function and reduces inflammation. Try to nap when your baby sleeps, and don't hesitate to ask for help with household tasks.

Reverse Pressure Softening is a simple, evidence-based technique that can transform painful, frustrating engorgement into something manageable. By softening your areola before each feed, you give your baby the best chance of achieving a deep, effective latch—which is the foundation of comfortable, successful breastfeeding.

For more comprehensive guidance on breastfeeding nutrition, milk supply, and overcoming common challenges, see our complete Breastfeeding Nutrition & Milk Supply Guide. You'll find evidence-based strategies for every stage of your feeding journey.

If you're looking for practical support alongside these techniques, explore our range of lactation teas and lactation hot chocolate—nourishing options designed specifically for breastfeeding mothers who need comfort, warmth, and nutritional support during these demanding early weeks.

Remember: You're not alone in this. Engorgement is temporary, and with the right techniques and support, you can move through this challenging phase with confidence.