First, get comfortable
Mom: First, make yourself comfortable. Ideally, you’ve taken time to set up “nursing stations” around the house, where there’s a comfortable place to sit, pillows if needed, water to drink, snacks, and entertainment (a book, remote control for the TV, etc.)
But wherever you are, use good posture, use pillows to bring baby up to your breast, rather than leaning over to bring your breast to the baby.
Baby: Hold the baby close to you throughout the feeding, his chest, belly, and bottom tucked in close. Make sure baby’s body is in a straight line: ears, shoulders, and hips all lined up. If baby has to turn to reach your breast, it will be more difficult for him to grasp breast well and swallow. His nose will be at the breast, and his chin may indent the breast.
Laid-back breastfeeding position: (Note: This is shown in the video at the top of this page.)
This is one of the easiest positions, and works with baby’s natural instincts. (Learn more here about the “breast crawl” – baby’s first feeding. The video on that page shows how a newborn can bring itself to mom’s nipple when she is in a laid-back position. Learn more here about the benefits of this method.)
For laid-back breastfeeding, get into a comfortable position, where you are leaning back, with head and shoulders well supported. Place baby on your chest, belly to belly with you. Gravity holds baby there, and when baby feels the light pressure on his chin, chest, legs, and feet, it stimulates him to get into position and nurse.
Baby-Led Latch: Once baby is in position, he will bob his head side to side, opening his mouth, and searching for the nipple. When he finds it, he will latch on on his own. Watch a video about this process here.
Other Breastfeeding Positions
Hold your baby so his head is nestled on your forearm near your elbow (in the “crook of your arm”) on the same side as the breast you will offer. His body lays along your arm, with your hand holding his bottom. Bring him up to the same height as your nipple, then if desired, place a pillow or two on your lap to support him. Snuggle baby close to you.
Use the opposite hand to support your breast. Your hand makes the shape of the letter U. Keep fingers away from the areola.
Use the arm on the opposite side from the breast you plan to feed on. Hold the baby’s head in your hand, and support his body along your forearm. Raise him up to the same height as your nipple, then tuck pillows underneath to support him, if desired. You can use your other hand to support the breast, in a U shape.
When holding baby’s head, don’t touch the top or back of the head – some babies will pull away from the breast if you do that. Instead, the fingers and thumb make a “hammock” supporting baby’s ears and neck, your palm rests between his shoulder blades. To move him closer to you, you’ll move his shoulders forward, not just bend his head in toward you. Cross-cradle is good for premature babies, and for babies with low muscle tone.
Put a pillow or two at your side to help support your arm and your baby. Hold your baby as if you were carrying a football (or a clutch purse), tucked in snug against your side. His bottom rests on the pillow, and the legs are tucked up, so he can’t push off of the back of the chair while you nurse. Hold baby’s neck and the lower part of his head in your hand, level with your nipple.
Use the opposite hand to support your breast in a C-hold: Thumb above the areola, fingers are cupping and supporting the breast. Football hold is a good position after a cesarean; it’s also good for large-breasted women.
Side-lying: Lie on your side. Place your baby on his side facing you, with his face even with your nipple. Tuck a pillow behind him to hold him snuggled close to you.
It can be harder for you and baby to learn about latch in this position, since it’s harder for you to see what is happening, and harder to adjust things. Therefore, it may be easiest to refine the latch in a sitting position. Or, you may be able to have your partner help with getting baby latched on. However, this position can be wonderful for tired moms, allowing them to rest while nursing. So, it is well worth learning and practicing. Be aware that it is easy for moms to fall asleep while nursing, so you should make sure the environment is a safe sleeping environment for baby.
Vary positions: If you fed in the side-lying position last time, try the laid-back position this time.. Changing positions will help you build the best milk supply, and will help avoid clogged ducts and sore nipples.
Mama-Led Latch: Helping Baby Latch on to Your Nipple
For babies who don’t latch on by themselves, using the technique above.
Start with your nipple by baby’s upper lip, or nose, so he has to “reach up” to latch on. His head may be tilted back slightly; he shouldn’t have his chin tucked down on his chest.
Encouraging Baby to Open Wide.
Use your nipple to gently tickle or stroke baby’s upper lip, then move away slightly, then tickle again, until he opens his mouth very wide, as wide as a big yawn, with his tongue forward. (You have activated the “rooting” reflex.)
When baby’s mouth is wide open, quickly pull him close, so that his chin and lower lip go as far onto areola as possible, and upper lip takes in much of the areola. (Note: you can see a video of this “deep latch” here. There are more latch videos here.)
Checking for a Good Latch
Once baby is latched on, check his latch. If it’s not a good one, you should take him off the breast and try again. Do not allow a poor latch, as this can lead to sore nipples for you, improper suckling habits for baby, and baby not getting as much milk as possible during a feeding.
If you need to remove baby from the breast, first release the suction. Slip a finger into the corner of baby’s mouth, between his gums. Hold your finger there to protect your nipple while removing it from baby’s mouth. Try latching on again. (As baby gets older and more experienced, this will get easier!)
Signs of a good latch and good milk transfer
Look at the areola: Baby should have part of the areola in his mouth, not just the nipple!
- Baby may be perfectly centered on the areola. This is called “bulls-eye” latch.
- Baby may take in more of the breast by his lower lip, and you may see part of the areola above his top lip. This is called an “asymmetric” latch.
Look at the baby:
- Lips are flanged out, like “fish lips.” The tongue is over lower gum, under the nipple. (This can be hard to see.) Make sure lower lip is not tucked under, though again, this may be hard for mom to get a good view of when baby is latched on well.
- Baby’s chin indents breast tissue a little.
- Baby’s nose is touching breast. Don’t worry that this is blocking baby’s breathing. Baby can breathe easily with nostrils flared out specifically for this purpose. If he has any trouble breathing and pulls away from the breast, try lifting your breast a little, or pulling his bottom and his legs closer to you. Don’t press on your breast to move it away from baby’s nose because this may pull your nipple out of the back of baby’s mouth, which could cause nipple soreness.
- Baby’s cheeks look full, not sucked in as if sucking on a straw.
- You can see swallowing motions in his temple, lower jaw, or ear. He begins feedings with rapid sucks, then, once milk lets down, there is a slower pattern of bursts of sucking and short pauses. In the early days, he may suck 5 times without swallowing. After day 5, it’s typically suck, swallow, suck, swallow
Listen: You should not hear lip smacking, or clicking, or “kissy noises”. These aren’t possible if mom’s nipple is far enough back in baby’s mouth.
Feel: Mom may have some nipple pain when baby first latches on. If it hurts for more than one minute, call a lactation consultant to check in.
Nurse on the first side till he shows full cues: he falls asleep, or lets go of the nipple, or pauses more often than he sucks. (Note: he needs to feed for at least ten minutes, so if he falls asleep before that, wake him up and encourage him to keep going.) You can see a video of newborn full cues at http://youtu.be/En50oEsm6BE
Then, if he has not already let go, break suction, and take baby off your nipple.
Give the baby an opportunity to burp; change his diaper if need be, then switch sides to finish the feeding. On the second side, let him feed for as long as desired.
For the next feeding, start on the opposite side to where you started this feeding. This ensures good milk production in both breasts.