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While breastfeeding is natural, it is also a technique that needs to be learned by both mother and baby – and sometimes this takes a little time. Proper positioning, and in particular the attachment of the baby to the breast, enables him to receive enough breastmilk and helps to prevent sore nipples and insufficient milk supply.
As a mother will spend several hours each day feeding her baby, she needs to be as comfortable as possible. If she is going to feed sitting up, a straight-backed armchair is better than a cushioned seat, so that she is fully supported and sitting upright. Her feet should be either flat on the floor, with slightly raised knees, or propped on a low stool. The baby, too, should be well supported with cushions or pillows so that the mother does not need to strain her muscles to do this. The baby should be at nipple height, so a mother with large breasts may find it helps to use a rolled up small blanket or towel to lift the breast to enable the baby to latch on more easily.
If feeding lying on her side, pillows behind the mother’s back and under her head, are again important. The baby needs to have his whole body facing his mother, so that he is not turning his head or neck to latch on, as this can make swallowing difficult.
As each mother is different, it is a good idea for her to experiment to see which positions work best for her, and also to keep experimenting as her baby grows.
Cradle hold
The mother holds the baby with his head resting in the crook of her elbow or on her forearm, with his whole body facing her, and supported by the same arm. His ear, shoulder and hip should be in a straight line. It is important that the baby latches on chin first (rather than nose first) for an effective, comfortable feed.
Cross-cradle hold
This is a good position for babies who may be having difficulty latching on, as it offers the mother more control. The baby is held at breast height by the opposite arm to the breast being offered, with head, neck and hips in a straight line. The baby’s upper back is supported by the mother’s palm, with the thumb behind one ear, and fingers on his neck to support his head. With the baby’s head tilted slightly back, he should latch on chin first. If the mother finds it more comfortable, she can change to the cradle hold (above) once a good latch has been established, by bringing her other arm under her baby’s head.
Rugby or clutch hold
This may be a good option for a mother who has had a caesarean birth. The baby’s body is tucked under the mother’s arm along her side, facing her, with his feet out behind her, and his neck supported by her hand. His bottom will rest on a pillow near the mother’s elbow and his body will be positioned so that the breast is in front of his mouth, thus allowing him to latch on comfortably without the mother having to lean over. The mother can feed comfortably, with her elbow resting on the pillow, and can see the baby more clearly than in some other positions.
Side-Lying position
Mothers who have had a caesarean, or need to stay in bed, often find this position works for them. It is also a popular position with mothers for night feeds. Baby and mother are on their side, facing each other. The mother can use pillows under her head and behind her back, and behind or between her knees to get comfortable, and it may help to have a small pillow or folded towel propped behind the baby’s back, to keep him on his side. If the mother has had a caesarean, it may also be useful to protect the scar with a pillow, towel or blanket. The baby’s ear, shoulder and hip should be in one line. This position may take a little more time to master, as the mother is less in control of how her baby latches on, and may need to guide the baby with her free hand.
Laid back position
This is where a mother and baby follow their own natural breastfeeding instincts. The mother leans back (not flat, and with head and shoulders well supported), with her baby’s body facing her, his whole front touching and supported by her body.
It is very important that, even though certain positions are recommended in particular situations, a mother should use the one that is most comfortable for her and her baby at that stage in their breastfeeding relationship, and continue to experiment with different positions if she wishes.