The virtue of breastfeeding, also known as biological nursing, is a well-touted fact, but, like many parts of early motherhood, the awkward, practical reality of it can sometimes be overlooked for that mythic, romanticised image.
Some would treat it like just another wonder in the miracle of life, when the truth is that, while amazing, breastfeeding is a bodily expression, and it needs practice, patience, and sometimes what feels like a degree in engineering to get right.
After all, how are you supposed to make sense of all of the nuances of human lactation? And what do different breastfeeding positions mean?
How are you supposed to know the difference between a cradle hold, a cross-cradle hold and the football position? And how do you know what's going to be best for your baby?
Finding the right position for you, getting into it comfortably, and ensuring your baby latches, can take time to figure out, and, like many things, what’s going to be best for you won’t necessarily be best for everyone.
Working out your best breastfeeding positions though is crucial to ensuring a good milk supply that keeps both you and your baby healthy and happy.
The first feed
So you’ve just had your baby, now what? The first time you breastfeed is important, as it’s what’s going to help your new baby learn how to find your breasts and start nursing.
It’s the first step on a long journey, so starting on the right foot puts you in a good position.
The Journal of Midwifery & Women’s Health recommends that you start with a position known as laid back breastfeeding.
To do this, you place your baby's body on your chest directly, skin-to-skin, with your baby’s head between your breasts. Let yourself lean back and relax and your baby will either rest or start to move around.
Eventually, your baby should make its way to one of your breasts, and you can guide the baby's mouth to your breast to latch. This is known as baby led attachment.
A good latch is hard to find
Well, not always, but latching is a crucial part of the breastfeeding process, and ensuring a secure one is not only going to help your baby's position to get their fill, but it’ll also keep your breasts healthy and stave off infections such as mastitis.
When we talk about latch, we’re talking about how the baby attaches to the breast while breastfeeding.
A good latch is important for a whole range of reasons — it helps your baby to suck effectively, it tells your body not only to produce milk, but encourages the healthy flow of it, and it helps to prevent breastfeeding problems such as sore nipples, mastitis, low breast milk supply, and poor infant weight gain.
How can you tell if it’s a good latch?
Luckily, there are a number of ways to tell if your baby has latched well, and the Government of Ontario’s Department of Health has even come up with a handy acronym for it.
- L – lips flanged out. In other words, make sure your baby’s mouth is wide open and their lips curled out.
- A – asymmetric latch. More of your areola should be visible above the baby’s top lip and below your baby's nose than underneath it.
- T – tummy-to-mummy. You should position baby close so that their ears, shoulders and hips are all in a straight line and pressed gently into you.
- C – chin touching breast. This means the baby’s neck should be extended, leaving the chin at the breast and the baby's nose free and up, not buried into the breast.
- H – have a listen and watch. Your baby should be actively suckling and swallowing once they’re well-latched, and you should feel a tugging sensation as they do. This might be a little uncomfortable at first (this process is known as the letdown for more reasons than one), but should become more comfortable as you feed.
Is there only one way to latch?
Nope, there’s a few, and while baby-led latching is often optimal, there are other ways to support your baby to latch.
In particular, you can try nipple tilting, which is where you can align your nipple with your baby's upper lip while you have them in either a cradle hold or a cross cradle position (more on these soon), tilt your nipple with your index finger and guide the baby’s chin towards it, or the breast sandwich, where you gently squeeze your breast from top to bottom or side-to-side, and touch your breast to the baby's face, until baby opens their mouth wide.
How do you unlatch the baby when they're done?
A lot of the time, your baby will come off your breast on their own once they've finished feeding and don’t need to be unlatched, but in the case that you do need to assist your baby, gently insert your clean index finger into the corner of the baby's mouth.
This alone should help the baby to open their mouth wide and unlatch, but you can also gently pull down on your baby’s chin if they need a little extra encouragement.
Preparing for breastfeeding
Preparing for breastfeeding can be as important as a good latch to ensure a comfortable, filling feed for you and your baby, so it really is a key part of the process too.
First things first — find yourself a comfortable spot where you and your baby feel safe, secure and relaxed (or at least as relaxed as you can be with a newborn).
Gather anything you need beforehand, in particular something to drink such as water, extra support in a partner or friend, a blanket if it’s cool, and maybe your remote to play some music or watch some TV.
The kit contains the soothing Nipple Balm, which relieves sore and damaged nipples, as well as Breast Pads, which are reusable and help to absorb moisture while easing discomfort from sensitive nipples.
Then, you’ll want to get yourself into a comfortable breastfeeding position.
How many breastfeeding positions are there?
There are a lot, and that’s good news! Every mother is different, and the way your body will be able to rest comfortably during breastfeeding is likely going to be pretty unique to you.
From a cradle hold to a reclining position to a clutch hold, many mothers find experimenting with other positions in the early weeks of motherhood can help you to find your breastfeeding groove.
Here are a few to try:
1. Laid-back or reclined breastfeeding position
Laid-back breastfeeding is the most common breastfeeding position, particularly for newborns and new mothers, and is the first position we described above.
It's where you place your baby on your chest with the baby's nose and head tilted to the side, and encourage baby to self-guide to latch.
2. Cradle hold
In this position, you cradle your baby in your left arm with their head nestled into your elbow, and your left hand holding your baby’s bottom. You then guide your baby’s head towards the breast on the same side.
This is a common position, and works well when the mother is comfortable, but when you’re still learning how to breastfeed, it can be a little challenging, particularly as you have less control over the baby’s head.
3. Cross cradle hold
Basically a reverse cradle hold, in this position, you will use your left arm to hold your baby along their spine, using your left hand to support their shoulders and neck, guiding the baby in to latch onto your right breast.
This position works well for head and neck control, and works especially well for babies with weak rooting reflex or suck.
Be warned though, your arm might get tired from the baby’s weight, so having a support for your arm such as a pillow is recommended.
4. Rugby ball hold
This is another position that works well for mother’s still learning to breastfeed who might need a little more control. Like with the cradle hold, you scoop your infant up and in with your forearm.
This way, your baby is lying on their back looking up at you, and their legs and feet are facing towards the chair. You can keep your free hand behind the baby’s head, guiding them to latch.
This particular position is especially good for mothers who’ve had a C-section as it keeps the weight off your abdomen, and can also be good too for mothers with larger breasts.
On top of that, the football hold can be a practical option for mother’s with multiple babies, as it’s easier to breastfeed two babies at a time. That said, this position might get a little harder as your baby grows.
5. Side-lying position
Another good one for the early days after a C-section is the side lying position.
Lying on your side with a pillow under your head can be especially beneficial when you're tired as it allows both you and your baby to rest together during feeds.
In this side lying position, you place your baby opposite you and manoeuvre them so their entire body faces you.
You can support them by placing a hand on their back, or if you think they need more support, by placing a rolled towel or infant blanket behind their shoulders, and guiding them to latch.
6. Koala hold
For this position, make sure you're sitting upright and position your baby on your lap, facing you.
Allow your baby's legs to straddle your knee, as you support them with one hand and guide your breast to them with the arm opposite for them to start feeding.
This position is best for slightly older babies, as you will have less control over their head, neck and shoulders.
7. Dangle feeding
In this position, position your baby on their back on the floor or bed, and crouch over them on all fours to dangle your nipple into their mouth.
This position is particularly helpful if you’re having issues with milk flow or have an infection like mastitis. The gravity of it all can help free up those clogged ducts.
Are there any breastfeeding positions to avoid?
There are a few actually, and it's recommended to avoid these as they could impact milk flow or your baby’s breathing.
Hunching over your baby, having your baby too far away from your breast, or having the baby’s body and head facing in different directions are all positions to avoid.
Many peer-reviewed studies also observe that the position you breastfeed and the quality of your baby's latch can also cause babies to have diarrhoea, and you to have sore nipples or nipple trauma.
One peer-reviewed study in Brazil even found that newborns whose necks were bent, whose chins were held away from the breast and whose lips were turned in had a significantly higher case of nipple lesion and inflammation for their breastfeeding mothers.
Working out what position is best for you and your baby is a process of trial and error, so be kind to yourself, listen to your and your baby’s bodies, try a few breastfeeding positions, and if you have any concerns, talk to a lactation consultant when you can.
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