Breastfeeding Positions and Latch-On

Good Positioning and "Latch-On"
For successful, comfortable nursing it is important to hold the baby’s body in a proper position. It is also crucial that your baby’s mouth is well “latched-on” to your nipple.

All About Latch-On

• It is crucial that baby gets a lot of the areola (the darker skin around the nipple) in her/his mouth whenever breastfeeding.
• Once the baby is in position, line the baby up so that her/his nose is facing your nipple. Try having some expressed colostrum or milk on your nipple for your baby to taste and smell. Your nipple should be in alignment with the baby’s nose. Gently tickle the baby’s lips with your nipple until her/his mouth opens as wide as a yawn.
• Holding your breast with your thumb above the areola and your other fingers below (not on) the areola, quickly pull your infant close to you so that the nipple is centered toward the back of the baby’s mouth, or slightly raised. Your baby’s mouth should cover most of the areola. It is normal for the tip of the baby’s nose to touch your breast while nursing.
• There should be no pain associated with breastfeeding. Make sure it feels comfortable.
• Check to make sure that both of your baby’s lips are flanged out when your baby is nursing. This can be difficult to see and you might need to ask a nurse or your partner to help. If the baby only gets the nipple and not some or all of the areola, the mother will feel nipple pain and can quickly get cuts that take a long time to heal. This will also prevent the baby from getting enough milk.
• It is very important to teach your baby to open wide for each feeding. All babies need to learn how to breastfeed even though they are born with reflexes that help. At the beginning, you may need to reposition the baby a few times before she/he latches on properly. If the baby is latched well, the sucking should give you a moderate pulling and tugging sensation.
• Try to resist the temptation to keep the baby on the breast even when it hurts. To remove your baby from the breast, put your finger in the corner of your baby’s mouth between the gums until the suction is broken. Reposition the baby and try again.
• If you are having trouble, ask for help "early and often." Your nurses and the lactation consultants are happy to assist while you and your baby learn to breastfeed in the hospital.

Breastfeeding Positions
There are a number of good breastfeeding positions. You may try a few of them to see which is most comfortable. Descriptions of four popular positions are described here. Many mothers find the crosscradle and clutch or "football" positions to be easiest with a newborn since these two positions give mothers the most control over their babies’ heads.

The side-lying position can also be quite comfortable and restful, though some mothers find it easier after their baby has grown and gained some head control. Side-lying and the clutch positions are often suggested for mothers who have had Cesarean birth because the baby does not have to lie against the mother’s stitches.

To prepare for a nursing session, start by bringing the baby’s body level with your breast and supporting your baby with a firm household pillow. Your nipple should be in alignment with the baby’s nose. Your hands and arms should not be supporting the baby’s weight, but rather guiding the baby’s head. Many new mothers find it helpful to use a nursing pillow, particularly one that fastens around the mother’s back. A nursing pillow should be relatively firm because it helps keep their baby up and close to your breast. Without a pillow, gravity can slowly pull the baby away during the course of feeding. This can result in the baby sucking on the end of the nipple, which will eventually cause nipple pain and damage. Nursing pillows are available through lactation consultants and baby stores.

When using any of the following positions, use one hand to hold the base of your baby’s head. The palm of your hand should support the baby’s neck and upper back, with your thumb and index finger on either side resting under each ear. If you place your hand or fingers higher up on the back of the baby’s head, you will trigger a newborn reflex that encourages your baby to turn toward the direction of the touch of your fingers and away from your breast. For the same reason, try not to touch your baby’s face while nursing. If you touch your baby’s cheek, for example, the baby will turn to the side where she or he was touched rather than stay focused on the nipple. In addition, position the baby so that the baby’s ear, shoulder and hip are in a straight line. This allows the baby to lie comfortably and not turn or twist to reach the breast.

Football or Clutch Hold: Begin by finding a comfortable chair, preferably with arms, and gather some firm pillows. Sit and place the pillows at your side to support your baby, who will lie next to you. Lay your baby next to you on her or his back. The baby’s bottom should be all the way back against the back of your chair, with her or his legs going up the back of the chair. Support the baby’s back and shoulders with your arm, and cradle the base of your baby’s head with your fingers. Use your other hand (on the opposite side of the baby) to support your breast.

Cross-Cradle Hold: The cross-cradle position gives you good control over your newborn’s head and your breast. To begin nursing, gather a firm pillow and make yourself comfortable in an armchair. Place your pillow on your lap, and lay your baby on her/his side on top of the pillow. Extend your arm that is closest to the baby’s feet along her/his back and use your hand to support the baby’s head by cradling the base of her/his head with your fingers. Your other hand can support your breast. Make sure the baby stays on her/his side so that you can remain "belly-to-belly" with your baby.

Side Lying: In this position, lay on your side with your baby on her/his side next to you. Put a pillow behind your back and lean into it. This will help raise your breast up off the bed a bit. Lay your baby down along side you, with the baby resting on her/his side. The baby’s abdomen should be facing yours ("belly-to-belly"), with her/his head level with your breast. It may be necessary to put a thin pillow under the baby to raise her/him to nipple level. It can also help to put a pillow behind your baby’s back to keep her/him from rolling away from you. If you have had a Cesarean birth, you may also wish to put a thin pillow between your abdomen and the baby. This position can be very restful for a new mother, but some mothers find this position difficult with a newborn. If you find it difficult at first, try again in another week or two when your baby has developed a little head control.

Cradle: The cradle position is most commonly associated with nursing and usually preferred for older babies. To begin, find a comfortable armchair and hold the baby in your arms with her/his body entirely on its side. You should be belly-to-belly with your baby. The baby’s bottom arm will be around your waist, and the baby’s head will be in the bend of your elbow. You may want to put pillows under your elbow and your baby to keep him or her raised and close to your breast. Support your breast with your free hand, placing your thumb above the areola and your four fingers below it. This can be a challenging position with a newborn if your elbow doesn’t cradle the baby’s head in alignment with your nipple. If this is the case, try again when your baby is bigger.