Breastfeeding Position Overview

Learning how to hold and support your baby in a comfortable position for you calls for coordination and patience. Yet finding a nursing hold that works for you and your infant is well worth the effort. After all, the two of you will spend hours breastfeeding every day.

This classic breastfeeding position requires you to cradle your baby’s head with the crook of your arm. Sit in a chair that has supportive armrests or on a bed with lots of pillows. Rest your feet on a stool, coffee table, or other raised surface to avoid leaning down toward your baby. Hold her in your lap so that she’s lying on her side with her face, stomach, and knees directly facing you. Tuck her lower arm under your own. If she’s nursing on the right breast, rest her head in the crook of your right arm. Extend your forearm and hand down her back to support her neck, spine, and bottom. Secure her knees against your body, across or just below your left breast. She should lie horizontally, or at a slight angle. d a cesarean section may find it puts too much pressure on their abdomen (1a).

Another position is the cross-cradle hold. This position differs from the cradle hold in that you don’t support your baby’s head with the crook of your arm. Instead, your arms switch roles. If you’re nursing from your right breast, use your left hand and arm to hold your baby. Rotate her body so her chest and tummy are directly facing you. With your thumb and fingers behind her head and below her ears, guide her mouth to your breast (1b).

Next is the clutch or football hold. As the name suggests, in this position you tuck your baby under your arm, on the same side that you’re nursing from like a football or handbag. First, position your baby at your side, under your arm. She should be facing you with her nose level with your nipple and her feet pointing toward your back. Rest your arm on a pillow in your lap or right beside you, and support your baby’s shoulders, neck, and head with your hand.  Guide her to your nipple, chin first (1c).

Finally is the lying position. Ask your partner or helper to place several pillows behind your back for support. You can put a pillow under your head and shoulders, and one between your bent knees, too. The goal is to keep your back and hips in a straight line. With your baby facing you, draw her close and cradle her head with the hand of your bottom arm. Or, cradle her head with your top arm, tucking your bottom arm under your head, out of the way (1d).

Citations:

What is the Clutch Hold?

While breastfeeding your baby there are many ways to hold your baby. Each position has it’s own nuances that may be better suited for your needs.

In the clutch hold, baby is positioned to the side of mother during breastfeeding, tucked under her arm. It is especially helpful for babies who have difficulty latching on; babies who arch their back and squirm at the breast; babies who come off the nipple frequently during breastfeeding; and babies who are small or premature (1a).

In this position you get a good view of baby latching onto the breast, while your hand at the nape of his neck gives you control of his head. Baby is bent at the waist, which helps tense babies relax better. If his body is relaxed, he’ll latch on better.

To achieve best results, sit up in bed or in a comfortable armchair with your back and shoulders well supported. Position one or more pillows at your side to bring baby up to breast level. If you’re sitting in a chair, wedge the pillows between you and the arm of the chair.Place baby on the pillow, tucked under your arm, with your hand on that side supporting his neck and shoulders. Bend him in the middle, so that his legs are pointed upward and his bottom rests against the pillow supporting your back, or against the back of the chair. Be sure that baby does not push his feet against the back of the chair, causing him to arch his back (1b).

Cup the nape of his neck in your hand. Avoid holding the back of baby’s head, as this stimulates some babies to arch away from the breast. If baby finds your touch too stimulating, put a cloth diaper or a receiving blanket between your hand and his skin.Pull baby in close to you. Once baby is sucking well, wedge a pillow under the hand and wrist that are supporting baby at the breast to help hold him close. Lean back into the pillows behind your shoulders, rather than hunching forward over your baby. Remember, bring the baby to the breast, not the breast to the baby (1c).

 

Citations:

1: http://babies411.com/information-station/breastfeeding/breastfeeding-positions-the-football-hold-the-clutch-hold-new.html

Second latch

Again, just like in ‘First Latch’ this breastfeeding video is showing excellent practice in lactation support. Mother and baby are both comfortable, Dr Jack Newman is quiet and respectful of them both. No coercion is happening at all, and most importantly, no hands are on the back of baby’s head, trying to force matters. Notice that when the mother trails her nipple across the baby’s top lip, and the baby opens its mouth really wide in response, that the mother and Dr Jack move the baby forward ever so slightly from the supportive position of holding the baby’s shoulders and the base of the neck. Nothing is pushing this baby out of alignment, just the whole body moving forward a quarter inch so that ‘gape’ now has a lot of breast in it.

If you think about it, and put your own hand on the back of your head now and push… what happens? Your head moves down, your mouth closes and your throat is constricted. This is not gong to help you open your mouth really wide and swallow well.

Baby’s head actually needs to move back and up, not forward and down. The positioning of the baby (presenting the baby to the breast) and the calm and confident way the mother is holding and supporting the baby along her body and on the shoulders and base of the neck, is allowing this baby to ‘gape’ without any stress.

But do remember – what works for your baby works for you! There is no ‘one way’ to do this. You’ll find your own path with your little one – trust yourself, trust baby!

If you ever see a breastfeeding video (especially on YouTube, where formula manufacturers place videos to lure you to their formula sites) where the baby is having its mouth forced open, or where the baby has a hand on the back of its head, being ‘pushed’ onto the breast – be aware this is not Good Practice – and may ruin your breastfeeding relationship for a while, until baby recovers from being forced.

Dr Jack discusses this so clearly in this video, that the conversation is just as valuable as seeing that powerful little mouth work that breast tissue and get loads of milk!

What he’s saying, and showing, makes good sense. Mothers need to be confident and supported and relaxed, and babies need to be with their mothers. A good milk supply comes from letting the baby have as much access to the breast as possible in the vital first few weeks. Taking baby off the breast, sticking a dummy or pacifier in its mouth when it cries, scheduling feeds for set times and for set amounts of time, having one bottle of top up formula to keep Grandmother happy… all these things can compromise your milk supply in the first few weeks. So be aware of the effect of such interventions, and use them wisely.
 
It’s hard being a new Mum, and you often feel you ‘have to get on’ and do other things in those first few weeks. But resting and letting baby breastfeed as much as you can, and getting others to do housework and laundry and bring you nice things to eat…is what ‘support’ is all about! (Not having people saying “He’s not feeding again!?! Why don’t you give him formula is he’s so hungry?” or “Well if you let me bottle feed her, I can take her off your hands and you get some sleep.” Advice like this is a poke in the eye with a blunt stick!)

Third latch

A really short clip that shows very clearly the baby’s jaw going up and down, and shows the ‘pause’ as the baby’s mouth fills with milk. So many mothers have their confidence eroded by others well meaning (and not so well meaning) comments, become paranoid that Baby Isn’t Getting Enough Milk!!!

Proper hydration is vital for the baby, especially in the first few days, whilst you wait for the transmission of your milk from gold milk (colostrum) to white milk. Production is low in the first few days, in order not to flood baby out, and let baby build in both confidence and skill. Constant licking and stimulating of the nipples as it laps up gold milk, will keep baby well hydrated, even if its not latching on yet. It will also build your milk supply wonderfully!

First Latch

This is an excellent breastfeeding video, by the wonderful Dr Jack Newman. showing a classic cross-cradle hold, and a baby latching well. Notice how gentle and respectful of the baby Dr Newman, and the mother, are. Only two interventions happen – one to pull the baby’s hand gently out of the camera view – so you can see what’s happening, and one very gentle encouraging finger to the chin after latch has happened.

This baby is small and quite young. Notice how easily the mother is supporting the baby’s shoulders and neck, and managing to keep the length of the baby’s body snug and secure across her body. This can be an excellent hold for new mothers, but all that’s important is that you and baby are comfortable, and the breastfeeding is working well. As baby gets older, and heavier, Mum and Baby will find different holds that keep them both feeling supported and happy.

The important part of this video is what’s happening at the mouth/nipple exchange. You hear Dr Newman say to wait for the ‘gape’ and then you let baby attach. The point is that quite a lot of breast needs to go into the mouth, for milk to transfer.

Baby having too shallow a latch is a classic way to have sore nipples. If it’s painful – something is wrong!

Incidentally that jaw action you see is one reason breastfeeding contributes so much to the overall development of the baby – that jaw action is working on moving the plates in the baby’s head back into place from the birth canal squish, and is building excellent muscle tone in the jaw and face, helping build up to good chewing and speaking skills.

 

Flailing Hands

For some mother’s their child’s flailing hands can present a challenge fora proper breatfeeding latch.  A hungry baby can sometimes be their own worst enemy by batting at and inadvertently pushing the breast away.

Here are several strategies you can try if flailing hands becomes a problem.

  1. First you might try  giving your baby some time to massage and feel your breast as this is a normal behavior, though in this case it may take some additional time for them to quiet down and be ready to eat.
  2. Another way is when you are holding your baby front, try sliding your child’s body closer to the opposite breast and snuggling her belly closer.  By shifting your baby’s body position slightly toward the breast you are not offering will keep their hands from reaching your breast and the feeding should go more smoothly.If you are holding your baby against your side, pull them further back.
  3. Another way is to use a baby blanket to swaddle your baby and make them a “baby burrito”.  This is a great way to keep their hands down and out of the way, out of trouble.  When using this approach it is a good idea to undress your baby down to their diaper to that they don’t get overheated and fall asleep too quickly.

Co-bedding and breastfeeding

Although a cultural practice in most of the world, co-bedding isn’t for everyone.  Some breastfeeding moms swear by it feeling that it helps then get in sync with their co-bedded infants.  As sleep cycles are shared these mothers report feeling more rested as a result.  It is also easier for a co-bedded infant to breastfeed and return to sleep.  As the mother you simply gather your infant and side-lie breastfeed.  You and your infant are generally more relaxed in this arrangement.

Some words of caution: Be sure not to place your baby on waterbeds, beanbag chairs, or padded mattresses.  Also remove  all pillows and thick blankets and comforters.  Also make sure your bed is not overcrowded.  Toddlers should not sleep with infants as toddlers thrash about in their sleep without any awareness of what is around them.  It is also thought that since men sleep more soundly than women that they should not lie next to the baby.

Baby Stimulation

It may seem that your new baby has no more energy than it takes to eat and sleep, but they are soaking up everything around them in their environment.  The time while you are breastfeeding is a great opportunity to begin introducing your baby to the larger world.  Begin with small steps and changes, use different positions when breastfeeding.

  • Rock your baby.
  • Sing and talk to your baby.
  • Take them for short walks.
  • Do a little baby massage while they are nursing.
  • Read to your baby.
  • Play different styles of music.
  • Eat different and healthy foods to your baby can experience the changes in your breast milk

All sorts of small things to you are a big thing to your baby who has never experienced them before.  The world is a big and exciting place and you can do much to introduce them even while breastfeeding. Be creative and enjoy!

Latch Evaluation

How can you tell if your baby has established good latch?

  • Does your baby have your entire nipple and about one inch of the areola in their mouth?
  • After you get the let-down feeling can you hear your baby swallow?
  • Does your baby follow a “suck, suck, suck, swallow” pattern
  • Can you see noticeable movement in the jaw that should also make your baby’s ears wiggle?
  • Is the area around your baby’s temple moving?
  • Are your baby’s lips everted (turned outward) around the nipple?
  • Is the nursing session pain-free?

If you cannot answer yes then your baby may not have good latch.  You should break suction by inserting a finger into your baby’s mouth at the inside cheek.  Hook your nipple and pull it out as you draw your breast away.  If you allow your baby to slide off the nipple without breaking suction then you will wind up with sore and cracked nipples.

Breastfeeding Step-by-Step

The following steps outline and help explain the general flow of a breastfeeding session.

  1. Position yourself properly.  Pillows are generally a must as your arms and back will get sore from trying to maintain the same position while your baby is feeding.  Use the pillows behind your back, under your elbows, and on your lap. If you are trying a position other than sitting down pillows are still a great way for you to help be relaxed and not have any of your muscles straining. Have your partner or a friend help you the first few times in positioning the pillows for your best comfort.
  2. Position your baby properly. Your baby should be lying on its side with the whole body facing you with knees pulled in close to your body.  Each of the different positions or hold has a different way to align the baby to you and your breast.  Take some time and practice.
  3. Hold the baby at the level of your nipple. This is so that you are not leaning forward to reach them.
  4. Offer your breast to the baby. Your thumb and for finger should form a C or U shape.  Support your breast as close to its natural height as possible.  Keep the fingers and thumb behind the areola and off the nipple so they are not in the way when your baby latches on
  5. Encourage your baby to latch on properly. If your baby turns away gently stroke the cheek on the side nearest you.  Touch their lips lightly and repeatedly to your  breast to encourage their mouth to open very wide, like a yawn.
  6. Move your baby onto the breast quickly and firmly. When the mouth open pull them to your breast so the lower jaw is as far back on your breast as possible. Once there is latch pull your baby in very close. if their nose seems blocked bringing their legs and hips closer to you will help angle out the nose.
  7. Encourage your baby to suck effectively. Your baby should take all of your nipple into their mouth and cover all or most of your areola behind the nipple with their gums.
  8. Avoid nipple soreness or pain. Breastfeeding should not be painful.  If you are feeling pain while your baby nurses or they seem to be having difficulty in sucking, gently break the suction and latch and restart.  Breaking suction can be easily done by putting a finger in your baby’s mouth and either pressing in on your breast or pulling out on your baby’s cheek.
  9. Watch for effective sucking patterns. Some babies know exactly how to suck the first time and others take a few days to learn and need a little more patience.  A baby who is sucking vigorously will be working their jaw muscles so much that you can see their ears wiggle. Once their initial hunger is met they will slow down and relax throughout the rest of the feeding.
  10. Let your baby finish and then offer your other breast. When you are first starting to breastfeed it is a good idea to offer both breasts during each feeding.  This will help with engorgement issues and also help your body adapt to the feeding needs of your child.