Breastfeeding Positions

 

Comfortable breastfeeding

There are general principles of breastfeeding positioning that aid a deep latch and ensure comfort and have been taught over many years. 

However, over the last few years, many studies show the benefits of a laid back position.

Here a breastfeeding mother reclines back and places her baby on top of her, and this can promote latching.

The work of Suzanne Colson has been particularly helpful in this field.

She has helped us to understand that when babies are born, they naturally display breast-seeking behaviors when placed with their full front, tummy, chest, and legs on their mother’s body, rather like a cuddle position.

These behaviors are displayed over weeks and months.

Babies tend to do lots of head movements up and down, as well as twisting head movements from side to side.

They also display lots of other pre-feeding behaviors which help them to locate the breast, even to crawl down using their natural reflexes, and to eventually self-attach at the breast.

We know from the work of Christina Smiley that many young, and even older babies, after six months of age, display very similar breast seeking behaviors when placed against their mother’s body.

So we know that this is a natural biological approach that can be encouraged with all babies.

Breastfeeding in this laid back position, you can be at any angle.

Additionally, your baby can also be at any angle while lying against your body. Doing this gives you lots of opportunities to try different positions – but the same principles will apply.

Your body, in effect, acts as a mattress, offering fantastic support.

You will find your baby will feel so safe and stable that he will be far more able to concentrate on latching and staying latched.

Babies in these positions often get a much deeper and better latch.

It seems that gravity helps the tongue to initially come down lower, and so enables your baby to scoop up a better mouthful of breast tissue.

Alongside these natural laid back biological positions, doing at least two hours per day of skin to skin time can also help to promote your milk supply – boosting the hormone prolactin.

Because of this research, mothers are encouraged to feed in these laid back positions, and the results are fantastic! 

Mothers are often surprised to understand that their baby can do this and that their little one does not need to be taught how to latch!

In the past, many health professionals have possibly done things the wrong way around, teaching more regimented principles when those principles have come from laid back normal biological feeding. 

It’s terrific that Suzanne Colson’s work is helping to encourage this more natural approach to latching.

This ‘biological nurturing’ as it’s termed, is becoming more popular and accepted.

So please be encouraged to go with your instincts and try lots of positions, allowing your baby to go through his natural sequence of events, leading to latching, and promoting that deeper and more comfortable latch.

It is best not to overthink the latch – too many women appear to be getting over-technical regarding the appearance of the latch, and sometimes get quite distressed in the process.

If your baby can swallow milk actively and you’re not in pain once your baby has started swallowing milk, then they are the most important signs to observe.

(Sometimes the initial fast sucks to ‘call’ the milk down can be uncomfortable in the first two weeks after birth),

It is worth reiterating that if you are not doing laid back biological positions, then you will still need to understand certain PRINCIPLES.

Those principles come from normal biology, and one of the first things to think about is that your baby can potentially feed anywhere around the clock face of the breast.

Even over the shoulder is a potential position! There are hundreds of possible positions; in fact, 360 degrees worth of positions.

Three main principles of breastfeeding positioning

1) Your baby’s head and body need to be in a straight line, which means that whatever position your baby is in, this principle needs to apply.

Aligning your baby’s head and body enables your baby to swallow better, and it will also be more comfortable for both of you.

 If you were drinking a cup of water, you wouldn’t naturally turn your head and then swallow.

You may still be able to swallow some water, but it’s likely to feel uncomfortable, and you may not be able to swallow as much.

Babies are far more likely to drain the breast better if attached well at the breast and in alignment.

Also, your baby needs to be able to tilt his head. All too often, and especially historically, many women have been tempted just to put a little finger on the back of the baby’s head. 

There is a rationale to this, but it can cause quite a bit of unnecessary pressure and can prevent a baby from being able to tilt his head just before latching naturally.

Tilting the head is essential for latching well.

2) The second principle is that whatever position your baby is in, ask yourself a question.

Does my baby feel completely safe and stable for the whole length of this feed?

Sometimes, once your baby is latched, if you recline back a little bit, that can be enough to enable him to feel even more close and supported, with gravity helping to keep him close against your body.

If you are lying on a bed next to your baby, the bed will provide stability.

If your baby is over your shoulder, feeding upside down, your shoulder will provide stability – and it’s that principle that you need to think about, no matter which position you use.

Historically, we used to encourage nursing mothers to use lots of pillows to prop babies up to enable them to get to a suitable height, which would allow them to latch.

Pillows and accessories can have their part to play.

However, now that we understand more about laid back positions, a very slight recline can often cause your baby to feel more stable against your body instead – so we don’t generally need to use pillows.

3) Enable your baby to get a big wide mouth before latching.

Many breastfeeding mothers say that their baby doesn’t really do a wide mouth – or they see the wide mouth and lose it a split second later!

Many women bring their baby onto the breast with a mouth that isn’t wide, and get very sore in the process!

In normal biology, using those laid back positions, your baby will brush past your nipple, and his mouth will open naturally, scooping up breast tissue.

This happens because of the stimulus of the nipple sitting in this little area under his nose.

So for any position, you need to try somehow to replicate this.

With your breast at its natural level, bring your baby close to you.

Your nipple should naturally sit in that little groove under your baby’s nose, and all you need to do then is to wait for a big wide mouth (like a yawn).

The critical thing is to wait for that wide mouth.

At the point of the wide mouth, very swiftly bring your baby close, where he will then attach at the breast.

You can also recline back a little to help him to feel stable against your body.

Naturally, your nipple will be heading for the roof at the back of your baby’s mouth, where there is lots of space!

It’s good to know that there is lots of space there because this means that even if your nipples are damaged right now, they have an opportunity to heal up – and they will heal up well, usually in a couple of days, because they have such good blood supply.

If, however, you find that you keep losing the wide mouth in a split second, try to be strict with yourself and not allow your baby to latch at that point. 

Too many mothers allow their baby to latch but experience pain throughout the whole feed because the nipple was not in that lovely safe place at the roof at the back of their baby’s mouth.

Instead, the nipple was sustaining damage because it was getting squashed up against the hard palate area of their baby’s mouth. 

If you do lose the wide mouth, instead of letting your baby latch, bring him back to the start position (nipple sitting in that little area under the nose).

The contact of your nipple there causes that wide mouth.

Remember to let your baby feel the nipple there.

Even if you have to bring your baby back there a dozen times before a latch, it’s better that way to achieve that perfect wide mouth and comfortable latch.

Pain is your guide. Once the milk lets down and baby is swallowing, although you may feel pulling and tugging, there should be no pain.

If it is painful, unlatch and start again.

You and your baby are hard-wired to breastfeed, but there is a learning element, and you are both working it out together for the first few weeks.

Remember that positions that work well for you and your baby may not work well for another mother and baby. 

If you find that you’re still having some difficulty with latching and achieving a comfortable latch, consider the information in sore nipples, which can help you to identify some possible extra factors, and seek out skilled one-to-one support.

 

Review dates, references & further resources

Review Dates

Version 1.1 published in March 2019. Next review date: Jan 2022

References

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