Rockville Lactation

Lynnette Hafken, MA, IBCLC

Lactation Consultant

text/call: (240) 888-2123   |   se habla español

[email protected]

Coronavirus policy: Consultations are available both in home and over encrypted video-chat. For in-home visits, I ask that household members over the age of 9 wear a mask and wash their hands prior to my visit. If anyone in your household or mine develop a cough, cold or flu-like symptoms, loss of smell, shortness of breath, or a fever, we will cancel our appointment and rebook a telehealth visit at your convenience.

Reverse pressure softening technique for engorged breasts when milk is "stuck"


When engorgement becomes very severe, “milk stasis,” also known as “caked breast,” can occur. Basically the milk gets stuck, because the tissue inside is so swollen, the ducts carrying the milk are squeezed tight. This makes it hard for the milk to flow. The suction of a breast pump can sometimes make this worse, as suction pulls all fluids forward, not just the milk. However allowing the milk to remain in the breasts can make the mother’s body stop producing milk; if it’s not coming out, the body assumes it’s not needed.

Jean Kotterman, IBCLC, developed a technique called reverse pressure softening, which helps reduce the pressure on the milk ducts, triggers the letdown reflex, and allows the milk to flow out. Getting even a small amount of milk out reduces pressure inside the breast, allowing swelling to decrease, which makes room for more milk to flow out. This also softens the areola and helps baby latch on. Short, gentle pumping sessions after the milk starts flowing can also help soften the breasts. After several nursing or pumping sessions, the engorgement will be much less painful. With the milk flowing, the mother will not be in danger of losing her milk supply, and the baby will be very happy with the abundance of milk.