Positioning and latch-on

The way you hold your baby and how he latches-on to the breast are the keys to comfortable feeding for you and satisfying feedings for your baby. Correct positioning and latch-on can prevent many of the common problems mother’s encounter when starting to breastfeed. Although breastfeeding is natural, it is a learning process for both you and your baby. Allow yourself several weeks to perfect these techniques. At any time that you are unsure that you are feeding correctly, seek the help of a lactation consultant or other knowledgeable health care provider. Once breastfeeding is fully established, it can be one of the most rewarding experiences of new motherhood.

Choose a comfortable chair or sofa with good support for your back. Use a footstool to bring your knees up so your lap is slightly inclined and the pressure is off the small of your back. Position pillows where ever needed to support your arms and relax your shoulders.

With any position you choose to hold your baby, turn your baby completely onto his side, "tummy to tummy", so his mouth is directly in front of the breast and he does not need to turn his head at all to get to the nipple.

Use pillows to support the baby horizontal above your waist at breast level. A pillow that makes a flat "shelf" provides better support that a "stuffed" pillow.

Position your baby with his nose to your nipple so he has to "reach up" slightly to grasp the nipple.

Place your baby’s lower arm around your waist. This will draw him close to you. Look for a straight line from your baby’s ears, to shoulders, to hips. His legs should curl around your waist.

The cross-cradle hold is one of the preferred positions for the early days of breastfeeding. You will have good control of the position of your baby’s head when you place your hand near your baby’s ears.  Roll the baby to face you "belly to belly".

The football hold (clutch hold) is good for mothers who have had a cesarean delivery because the weight of the baby is not on the abdomen. Note that the baby’s feet and legs are placed up the back of the chair.

Place your baby’s head in the bend of your arm or on your forearm and support his body with your arm in the cradle hold.  Roll the baby towards you "belly to belly".

Side lying is great for getting a bit of rest while your baby nurses or if you want to avoid sitting because of soreness.  Notice the pillow support and your back and the baby's back, and between your legs.  Roll the baby towards you "belly to belly".

Latch-on

Compress your areola slightly to make a "nipple sandwich" for the baby. This will allow the baby to get a deeper latch-on. Make sure your fingers are well behind the edges of the areola (1 to 1 ½ ‘’ from the base of the nipple).

U hold. Support the breast with your hand in a "U" position, then squeeze gently to form a "sandwich" for the baby.  Use a "U" hold for positions where your baby is across your lap (cross-cradle or cradle hold).

C hold. The "C" hold is used when the baby is in the football hold.

An easy way to remember how to hold your hand is to keep your thumb by your baby's nose and your fingers by the baby's chin.  That way you will automatically rotate your had to match the baby's positioning.

Stroke your baby’s lips up and down with your nipple and pull him quickly to the breast when he opens his mouth wide. Be sure to wait for his mouth to open WIDE (like a yawn) and his tongue to come forward. He should get the nipple and a "big mouthful" of the areola (the dark brown part of the breast) in his mouth. Bring the baby to the breast, not the breast to the baby!

Listen for swallowing every 3 to 5 sucks (May not be apparent until your milk comes in). Once your milk has come in and you have a let down reflex, you will notice swallowing with every suck.

Check your latch-on

The nose and chin should touch the breast

Worried that your baby can’t breath while at the breast? Don’t! If the baby truly can’t breath, he will let go. Usually, babies can breath easily even when pressed close to the breast because they can breath around the "corners" of their noses. Do not press on the breast to make a breathing passage for the baby. This can distort the shape of the nipple in the baby’s mouth and contribute to soreness as well as limit the drainage from the area of the breast above your fingers. If necessary, pull the baby’s hips in closer to you. This should free up the nose.

Some mothers describe pain as their baby latches-on that eases as the milk begins to flow. This will subside over time, as your body adapts to breastfeeding. If it persists, remove your baby from the breast and re-attach him.

Look for these signs

The angle of your baby's lips at the breast is greater than 140 degrees

Most of the areola is in your baby's mouth (1" from the base of your nipple, slightly more towards the baby's lower lip than towards the upper lip)

Both upper and lower lips are flanged (rolled out).

You feel deep pulling sensation as the baby nurses. It should not be sharp pain or last more than a moment during the latch-on.

If you need to remove your baby from the breast, slip your finger between his lips and gums to break the suction. Wait for the suction to release, and remove him.

Let the baby nurse for 15-20 minutes on each breast or 20-30 on one breast. 8 - 12 feedings each 24 hours is normal for a newborn. Refer to "How do I know my baby is getting enough?" for details.

Place a rolled towel or small blanket under your breast for support.

Focus on holding the area just beyond the areola and use the sandwich techniques described earlier.  

Sometimes a "tea cup" hold works well.  Try gently pinching up a big to skin on the edge of the areola to make a flat area across the tip of the nipple, hold your fingers like holding a fancy tea cup.

Some mothers feel more comfortable with a very supportive bra that provides support to the breast while the cup is opened for feedings. Others prefer to go without a bra.