Breastfeeding is instinctive for babies, but for mothers its a learned skill. This article may help you to speed up the learning process by describing different feeding positions, latching techniques, what your baby’s different sucking actions mean and more.
- RN, RM, CHN, MHN, IBCLC
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1. Cradle hold
The most popular feeding position is the 'cradle hold'. Lay your baby across your body so that he's lying on his side with his whole body facing yours. (He shouldn't need to turn his head to reach your breast.)
When offering your left breast, use your left hand to support your breast and your right arm and hand to support your baby. Reverse this hold, and your baby's position, when offering your right breast.
2. Football hold
The 'football hold' is another common breastfeeding position. This position may be more comfortable than a 'cradle hold' if you have had a C-section or are breastfeeding twins. To try this feeding position you will need a pillow to support your baby as you lay him at your side. Position his legs under your arm and his head near your breast. Lay him on his side so that his body is facing yours.
Use your left arm to support him when offering your left breast and your right arm when offering your right breast. Support him in position with your forearm long his back and your hand supporting the nape of his neck. Support your breast with your free hand.
3. Side-lying hold
Lying down can be a very comfortable way to breastfeed your baby. Lay on your side on a bed or couch, with your baby on his side facing you. You can offer both breasts while lying on the same side, by changing your position slightly or you can roll over both you and him onto your other side to offer your other breast.
This position may be best left until you are confident that your baby is latching-on correctly. Care should be taken to ensure your baby's safety if you choose to use this feeding position, as there's the possibility that you may fall asleep while feeding.
How to latch-on
1. Mother's sitting position
Most mothers find sitting upright in a chair the most comfortable position. Be sure the arm of the chair is at the right height to support your arm. A footstool may also be helpful to elevate your feet. You may find it more comfortable to use pillows to support your back, your arm and your baby (once he has successfully latched-on).
2. Support your baby
Hold your baby in either a 'cradle hold' or 'football hold' using your forearm to support his back and your hand to support his head - your thumb near one ear and your third finger near his other ear. (You will find you can control the tilt of his head by your wrist movement.) Position your baby so that his nose is at the same level as your nipple before attempting to latch-on.
3. Support your breast
Support your breast in a 'C-hold' i.e. your thumb on top and index finger underneath, at least 1" back from your areola (the area of color tissue surrounding your nipple). Gently squeeze your finger and thumb towards each other to compress your breast.
4. Encourage your baby to open his mouth
Tilt your baby's head back just slightly by lifting between his shoulder blades with the heel of your hand. (When your baby's head is tilted back he can open his mouth much wider.) With his chin up and head tilted back, lift him towards your nipple. Tickle or lightly brush his upper lip with your nipple to encourage him to open his mouth wide (as wide as if he was yawning).
If he doesn't open his mouth or doesn't open it wide enough, gently but firmly pull down on his chin with your index finder of the hand supporting your breast.
5. Bring your baby to your breast - not breast to baby
Avoid bending to feed your baby. As he opens his mouth wide, watch for his tongue to drop and then push gently between his shoulders (not his head) with the heel of your hand, to bring him deep into your breast. As you bring him towards your breast (with a wide open mouth) his chin should touch your breast before any other part of his face.
6. Encourage your baby to take in as much of your areola as possible
As soon as his chin is deep into your breast, tilt his head forward slightly so that his upper jaw will position well behind your nipple. Keep your thumb pressing down to flatten your breast as you tilt his head forward. This is a timed movement, where you will assist your baby to take in more of your breast than he would otherwise. (This move may take a little practice.)
7. Release your hold on your breast
Wait until you feel confident that your baby is latched-on successfully and then release your hold on your breast. If you would like, you can now move your arm (the one that was supporting your breast) around under the nape of his neck and shoulders to support him.
8. If your baby is not latched-on successfully
Remove him by breaking his suction and try again. Do not let him suck on the end of your nipple or continue to suck if it's painful for you, as these are both signs that he's not correctly latched-on. Allowing him to continue to suck when he's not correctly latched-on may damage your nipple.
Why a good latch-on is important
To support successful breastfeeding a good latch-on is the most important skill you can achieve. Getting it right from the beginning may save your lots of worry further down the track. A good latch-on is important for a number of reasons...
- To assist your baby to get enough milk.
- To avoid damage to your nipples.
- To adequately empty your breasts - which help to avoid complications such as mastitis.
- To effectively stimulate your breasts to continue to make milk. (See our article on increasing your breast milk supply for more information.)
Signs of a good latch-on
1. Mother's comfort
You may feel a slight tugging sensation as your baby draws your nipple to the back of his mouth. If he's latched-on and sucking correctly, you should feel no pain. Sore nipples almost always mean you need to latch your baby on more deeply, so that he takes more breast tissue into his mouth. (It's common for mothers to have sensitive nipples in the first week following birth due to the many hormonal changes at the time.)
2. Baby's lips are flanged
You baby's mouth should be wide opened and lips flanged (turned back, not rolled under).
3. Baby has taken your breast deep into his mouth
Your baby's lower lip should cover more of your areola than his upper lip. You can see his tongue between your breast and his lower gums if you carefully pull back his lip to look.
4. Baby's chin and nose are touching your breast
Your baby's chin should be indenting your breast and his nose should be lightly touching your breast. He needs to be this close because a tongue and chin movement is necessary to extract milk. You do not need to press down on your breast to assist him to breathe. If his nose is buried deep into your breast, just tilt his head back ever so slightly so that you can just see his nostrils.
5. Your nipple looks fine when baby comes off
Once your baby comes off your breast look at your nipple. There should be no ridging or blanching of your nipple i.e. a line on your nipple or a slightly lighter colored area which occurs if your nipple has been compressed (restricting circulation) during feeding.
Signs of a good suck
1. Comfortable for mother
Apart from the initial tugging sensation as your baby draws your nipple into the back of his mouth, his sucking should cause you no discomfort.
2. Sucking pattern
Learning to recognize and understand your baby's feeding behavior can assist you to gain confidence with breastfeeding. While observing your baby's feeding behavior you will notice 2 distinct sucking patterns...
When he's feeding, initially there will be a few quick sucking movements until your milk-ejection reflex (let-down) is triggered and then you will see a suck-swallow motion with pauses in between. His jaw movement is strong (you can see his ear move slightly) and you can see and/or hear him swallowing after every suck or two.
Not all the time your baby spends on your breast is actual feeding. When he's comfort sucking, you will notice that his sucking motion is softer (with no movement of his ears) and quicker (like a flutter). During this time you will notice there's little or no swallowing seen or heard.
3. Not too noisy
The only sound you should hear is your baby swallowing. There should be no clicking sounds, which a baby will make with his tongue if he is poorly latched-on.
4. Little leakage
There should be little or no leakage of milk from the sides of your baby's mouth.
One-sided or two-sided feeding
One-sided feeding means only one breast is offered at each breastfeed. (The other breast is offered at the next breastfeed.) Two-sided feeding is where both breasts are offered during the same feed. (The starting breast is alternated at each breastfeed.)
One-sided feeding is often adequate in the early weeks of breastfeeding, when nursing mothers tend to have an abundance of breast milk. Many mothers continue to successfully breastfeed while one-sided feeding the entire time they are nursing. Others find they need to offer both breasts at each feed.
During these early weeks your body is adjusting to your baby's needs and by the time your baby is 6 - 8 weeks the abundance of breast milk, you initially experienced will generally settle to meet his needs. When (or if) you need to commence two-sided breastfeeding depends on...
- Your baby's weight gains.
- His contentment following breastfeeds.
- How often he's breastfed.
You may need to offer both breasts at each feed if you are finding your baby is not gaining enough weight; seems hungry soon after breastfeeding; or if you are trying to encourage him to go a little longer between breastfeeds.
However, if your baby has large weight gains and also experiences symptoms such as abdominal discomfort, extreme gassiness, frequent watery bowel movements or excessive spitting up, it may be helpful to one-side breastfeed until these symptoms settle. (See our articles on gastro-esophageal reflux and lactose overload to understand why these conditions are often linked with over-feeding.)
When to switch sides
In the past women were encouraged to time breastfeeds. We now know that this is not the best option and nursing mothers are now encouraged to observe their babies feeding behavior for signs to indicate when to switch sides, rather than watch a clock.
Your baby may be ready to change sides; when you can no longer see or hear him swallowing and he also starts to squirm and wiggle. However, this can also occur if he wants to burp. So try to burp him first and return him to the same breast. If he continues to fuss, then offer him your other breast.
2. If he's falling asleep on your breast
Some babies start to fall asleep when the flow is slow. (They can also fall asleep when they have had enough to eat).
If you don't feel your baby has fed well because he's sleepy, take him off your breast, wake him up, but offer the same breast. If he continues to drift off, then offer your second breast. If he is still hungry he will suck more vigorously, but if he has had enough he is likely to drift off the sleep again.
3. When it feels right!
Don't worry! Breastfeeding is not like sitting a science exam. There is no one 'right way' to breastfeed your baby. Change sides whenever you feel its right to do so. In time you will learn the subtle signs that indicate your baby's needs regarding breastfeeding - often without realizing you have.
When to burp
A well latched-on baby will swallow less air than a baby who is poorly latched-on. However, as swallowing some air while breastfeeding is unavoidable, you may need to burp your baby. (See Burping your baby for tips.)
Observe you baby's feeding behavior, if he starts to fuss or wiggle around take him off for a burp (make sure you break his suction first). Also try to encourage him to burp before switching sides and at the end of the breastfeed. Don't try for too long, if he hasn't burped in a couple of minutes either return him to your breast or give-up. (He won't burp every time!)
Passing gas (out the other end) is normal. We all do it! If your baby passes excessive amounts of gas this is not always due to swallowed air. (See our article on infant gas for more information.)
How to tell when your baby is finished
You may have been told "your baby will come off by himself when he's finished!" In reality, this is not always the case. Many babies love to sleep in their mothers arms with her nipple in their mouth. Some babies will remain firmly latch-on for hours on end, not feeding but sleeping. This can be confusing for mothers and many become unnecessarily worried about their milk supply.
If you are happy to allow your baby to sleep at your breast, by all means continue to do so. If on the other hand, you find you are not able to sit for lengthy periods of time nursing your baby while he sleeps attached to your breast, it's OK to take him off. You will know when it's time to do so by observing his sucking patterns.
You can take him off at any time you recognize that he continues to comfort suck rather than feed (as described 'Signs of a good suck' above). Before taking him off you may first like to attempt to encourage him to continue to feed. If despite your best efforts (i.e. stroking his face or tummy, or taking him off to wake him up before trying again) he continues to comfort suck, then it's okay to take him off.
If he searches (or cries) for your breast shortly after taking him off, the reason may be that he has learned to relate sleeping with breastfeeding. (Breastfeeding may have become a sleep association for him.) In this situation it's unlikely that he's searching for your breast because he's still hungry rather he is searching for it because he wants your nipple in his mouth so that he can go to sleep.
How often to feed
Each baby is different, so each will want to be breastfed at different times. No doubt you have already received advice to "feed your baby on demand". Although this is wise advice, it's somewhat simplistic as it's not always easy to tell when a baby is hungry. (See our article on hungry baby to understand why babies often appear hungry, when they're not).
Breastfed babies tend to feed more frequently than formula fed babies. The reason most often given for this is that breast milk is digested more quickly (1.5 to 2 hours) compared to formula (up to 3 hours or more). (Digested means the milk is broken down in the small intestine by digestive enzymes, so that the nutrients can then be absorbed into the blood stream). However, even though breast milk is digested in such a short time, it's your baby's blood sugar level that triggers his need for nourishment and thus his hunger. So, although it's perfectly fine to breastfeed your healthy baby every hour or two, it's not essential to do so.
Finding the right balance for you and your baby may take a little while to work out. By observing your baby during feeding you will start to understand his different sucking patterns and will learn to tell at what times of the day he feeds hungrily and at what times he seeks your breast for comfort.
No matter how often you feed your baby, provided he's happy and gaining enough weight and you are also satisfied with the frequency of his feeding, then whatever you are doing is perfect. However, if either he's not happy or you are not happy , then you may like to look at changing your approach to one where you slowly and gently encourage a flexible breastfeeding pattern that suits you both. (This is not to be confused with strict feeding schedules, which are not advisable for breastfed babies).
As with everything else regarding parenting, there is also more than one 'right way' to breast feed a baby. You will know when you have found 'your right way' when it feels right.
Coming off the breast
You may want to take your baby off your breast...
- When your baby has not latch-on properly.
- When you feel it's time to switch sides.
- If your baby needs to burp.
It is important to first break your baby's suction (to avoid damaging your nipples) by one of these methods...
- Pressing on your breast near your baby's mouth.
- Pulling down on your baby's chin.
- Inserting your finger into the corner of your baby's mouth.
Written by Rowena Bennett
© Copyright www.babycareadvice.com 2004. All rights reserved. Permission from author must be obtained to copy or reproduce any part of this article.
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