Parentpedia

What Experts Say^*

It looks so natural, a baby at the breast, but you might have learned that positioning your own little one is not as easy as it appears. Don't worry, it gets easier.

"The Womanly Art of Breastfeeding" by La Leche League International reassures new moms, "Getting your baby started at the breast smoothly and easily will soon be second nature to you. Breastfeeding a baby is actually much less involved than any description of the process."

The authors recommend visiting a La Leche League meeting to see other moms nurse their babies. "This can help you more than photos or written explanations because you can observe a variety of mothers with babies of different ages and sizes who have adopted comfortable ways to breastfeed."

Positioning Pointers

First, find a comfortable place to feed your little one. If you'll be nursing sitting up, choose a supportive chair with arm rests. Have several pillows handy. Undress your baby, down to her diaper. Skin-to-skin contact stimulates babies, helping them to remain awake and alert during a feed. For this reason, it's best not to swaddle your baby while nursing.

No matter what position you choose, tuck your baby in close, make sure her whole body is well supported and her head, neck, and back are in a straight line. You shouldn't be leaning back or forward as you get ready to bring your baby to your breast.

During your baby's first weeks, try a few of these common nursing positions to see what works best for you and your baby.

• Clutch (Football) Hold
  When this works best: This can be one of the easiest positions to use with a newborn. It works well if you have large breasts, if your baby has latch-on or sucking problems, if you've had a cesarean, if your baby arches at the breast, if you have a rapid milk ejection reflex, if your baby is small, or if you have twins. This position allows you to see your baby latch on, giving you better control.
  
  How to do it: Sit in a comfortable chair. Use pillows, if needed, under your baby to bring her to breast level, and for support under your arm. In this position, your baby is lying alongside you, upper back resting on your forearm with her neck supported by your hand. Her head faces your breast. Your hips are flexed, bottom rests against the chair back, and feet point to the ceiling. Your opposite hand will support your breast. Your baby should not be so far forward that she has to bend her neck to latch on.



• Cradle Hold
  When this works best: Experienced breastfeeding moms will be most comfortable with this common position. New moms often find it difficult to control the baby's head and watch latch-on in this position.
  
  How to do it: Sit in a comfortable chair. Use pillows, if needed, under your baby to bring her to breast level and for support under your forearm. Your baby will be on her side, her chest facing your chest. Make sure her lower arm is comfortably placed along her side. When nursing from the left breast, cradle your baby's head in the crook of the left arm, and her back will be along your inner arm and palm. If you look down at your little one, you will see her side. Use the opposite hand to support your breast.



• Cross-Cradle (Transition) Hold
  When this works best: This position works well for feeding a newborn, for babies with difficulty latching (and staying) on, and for small or premature babies. This position allows you to see your baby latch on, giving you better control.
  
  How to do it: Sit in a comfortable chair. Support your baby with a pillow on your lap to raise her to breast level, and use pillows as needed to support your arms and hands. Your baby will be lying on her side, facing you. Support your breast with the hand on the side that you will feed your baby (left breast, left hand). Use your other arm to support your baby's body. Guide her to your breast, placing your hand on her neck, the palm of your hand between her shoulder blades.



• Lying Down (Lying on Side or Flat on Back)
  When this works best: Lying down can be very helpful when a baby is having trouble nursing. It is also a good choice when you want to get rest while your baby nurses, if you have a very abundant milk supply, and if you must remain flat after a cesarean. This position may take a little practice, but it's well worth the effort.
  
  How to do it: Lie on your side on the bed with your baby facing you. Tuck pillows behind your back and your baby's back, and under your head and upper knee, as needed for comfort and support. Your bottom arm can be up or held slightly below shoulder level, cradling your baby's head. Her ear, shoulder, and hip should be in a straight line, with her knees pulled in close. You can feed from both breasts, leaning over your baby to offer the other side, or hold your baby to your chest and roll to the other side. If you want to lie on your back and nurse, drape your baby across your body and allow her to latch on. You can also sit on the side of the bed and get your baby latched on and then lie back.

A Quick Latch-On Reminder

Make sure your baby is facing you. As you get ready to nurse, support your breast with your thumb on top and fingers cupped below, staying away from your areola. Tickle your baby's lips with your nipple. When she opens her mouth widely, bring her quickly to your breast.

Your baby is well positioned if she is taking in 1/2 to 1 inch of your areola, her nose is very close to your breast, her chin is pressed into your breast, her lips are flanged, more of your areola shows above your baby's upper lip than below the lower lip, and, most importantly, nursing is comfortable.

If you are not comfortable, gently break the suction by inserting your finger into the corner of her mouth. Calm your baby and try again.

Safety Notes

• Pain is an indication that something is wrong. Though passing nipple tenderness is normal in the first few days, if nursing hurts or you have trouble positioning your baby, get help. Breastfeeding should be comfortable, even in the early weeks. Schedule a visit with a board-certified lactation consultant (IBCLC) who can observe a complete feed and offer recommendations.
• Pillows can pose a suffocation hazard for babies, so remove any pillows under your baby when it's time to sleep.