When I first started working with breast feeding mothers I generally taught principles of positioning, and those principles DO work – and in fact I still talk about those things. However over the last few years there’s been a lot of studies which are showing that when the breastfeeding mum is in a semi reclined position, with the baby on top, can work really really well for latching, and often help babies to get a deeper latch.
The work of Suzanne Colson has been particularly helpful in this field, helping us to understand that when babies are born, and even over the weeks and months, they will display breast seeking behaviours when they are placed with their full front, tummy and chest, on the mother’s body.
They tend to do lots of head movements, twisty movements to the side, lots of pre-feeding behaviours kick in, helping them to locate the breast, even to crawl down using their natural reflexes and to latch on- to self-attach, in fact.
And we know from work that Christina Smiley has done, that many babies young and older babies, even into the second half of the year, would display very similar breast seeking behaviours when placed against their mother’s body – so we know that you can do this with your babies of all ages.
And breastfeeding in this laid back position, where you are at any angle, and your baby can also be at any angle, gives you lots and lots of opportunity to try slightly different positions – but the same principles will apply, and your body is acting as a mattress basically, providing that support, and your baby is so well supported that he is able to concentrate on what he’s doing as well with latching. Babies often do get that deeper and better latch.
And of course we also encourage lots of skin to skin, at least two hours a day, which can help to promote your milk supply, by boosting (the hormone) prolactin. So all these positions are brilliant for doing that skin to skin and allowing your baby also to be latching on as well and getting that deeper latch in the process.
And because of this research I’ve been encouraging hundreds of women over the last few years, if not thousands, to feed in these laid back positions, and the results that we’ve seen have been fantastic. The mums are often really really pleasantly surprised to understand that their baby can do this and we don’t have to teach them to latch.
So I think that I’ve come to believe that as health professionals we have possibly done things the wrong way around, teaching more regimented principles, when really those principles have come from laid back normal biological feeding. So I’m delighted that Suzanne Carson’s work is helping us to encourage this more natural approach to latching and getting that deeper look.
And this ‘biological nurturing’ as it’s termed, is becoming a bit more in the forefront now in the literature. So please be encouraged to go with your instincts and try lots of positions, but allow your baby to go through his natural sequence of events leading to latching, getting that deeper and better latch.
And I would really discourage analysing the latch too much – too many women are looking at all of the detailed things about the latch and getting tied up in knots in the process. If your baby is swallowing milk and you’re not in pain after latching, then they’re two really good signs that everything is okay.
But I do want to reiterate that if you are not doing laid back biological positions, then you will still need to understand certain PRINCIPLES, those principles that 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, anywhere around the clock face.
So I usually talk to breastfeeding mothers about three main principles, and one of those things is: generally, your baby’s head and body need to be in a straight line, and that means whatever position he is in, head and body in a nice straight line, head and body in a straight line – and that is simply to enable your baby to swallow better, and it will be more comfortable as well.
Babies are far more likely to drain the breast better if he is attached well and in alignment, and coupled with that he needs to be able to tilt his head. All too often, and especially many years ago, we would be tempted just to put a little finger on the back of the baby’s head. And I do understand the rationale there, but that can really cause quite a bit of pressure, and babies need to be able to do that head tilt to get a good latch.
And the second principle is that whatever position your baby is in, ask yourself a question. Does he feel stable for the whole length of the feed? And sometimes, once your baby is latched, if you then recline back a little bit, that can be enough to enable him to feel close and supported, with gravity helping to keep him close against your body, and that can really help.
But it may that you are lying on a bed next to you baby – the bed will provide stability there. 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, whatever position you are using.
And historically, we used to talk about using lots of pillows and propping your baby up with this pillow to enable him to get to a good height, and pillows and accessories do have their part to play, but now that we understand more about laid back positions, a very slight recline can often cause your baby to feel that stability that he would have felt on these pillows. So we don’t always need to be using those things.
The final principle is enabling baby to get a big wide mouth before latch, and a lot of mums will say that the baby doesn’t do that wide mouth – or they see the wide mouth and lose it a split second later, and then they end up bringing the baby onto the breast and getting sore in the process.
In normal biology and those laid back positions, as your baby brushes past your nipple, his mouth will open naturally and he will scoop up breast tissue – and that just happens because of the stimulus of the nipple sitting in this little area under his nose.
So we’re going to replicate that with any other position that you try, and that is, bringing your baby to the point where naturally your breast is going to sit at its natural level – you’re not going to raise your breast necessarily, bring your baby to the point where your nipple can sit in that little groove under your baby’s nose, and all you do then is waiting for a big wide mouth, and we’re looking for a mouth that’s as wide as a yawn.
And the key thing there is to wait for that wide mouth. At that point of the wide mouth, very swiftly bring your baby close, recline back if you can to aid that stability. Naturally your nipple will have headed for the roof at the back of your baby’s mouth where there is loads of space.
But if you find that you saw the wide mouth, and then you lost it, split second, try not to be tempted to let your baby latch at that point. Too many women have allowed themselves to do that and then have struggled with pain because their nipple was getting squashed in the baby’s mouth. So instead bring your baby back to the start off position, nipple sitting in that little area under the nose. The contact of your nipple there, causes that wide mouth – so remember to let your baby feel the nipple there.
Even if you have to bring your baby back there a dozen times before latch, then it’s better that way to get that really good wide mouth and a comfortable latch.
And remember that you and your baby are hard wired to breastfeed, but there is a learning element and you’re both working this thing out together for the first few weeks, particularly, – and what works position-wise for another mother and baby pair could be different for you two.
If you do find that you’re still having some difficulty with the latching and with a comfortable feeding, then please seek out that skilled one-to-one support, and look at the related videos which can help you to identify the cause.
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Version 1.1 published in March 2019. Next review date: Jan 2022
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