- Principles of a deep/correct latch
The foundation of breastfeeding is an optimal latch. An International Board Certified Lactation Consultant (IBCLC) Lactation Consultant will always review this first whenever there are any breastfeeding issues. The principles of a good latch are the same in each breastfeeding position, as it is how the baby’s mouth and body are fitting the mother’s breast and body.
- Reclined Cradle Hold
This position is very intuitive for mum and baby and is generally the most common position for mother-baby dyads once breastfeeding is established.
Baby’s weight is spread over mum’s torso, rather than being concentrated in her forearms which tire quickly during long feeding sessions.
Mum can choose to recline as far back as she likes, and this position works great in bed and on the couch. Partners often comment on how comfortable their breastfeeding parent looks in this position compared to other feeding positions.
- Cross Cradle Hold
This is the most commonly taught breastfeeding position in hospitals – however, there is evidence that lifting and shaping the breast can cause up to four times more nipple pain. Because of the increased risk of nipple trauma using this technique, it is essential that parents learning to breastfeed or who are experiencing nipple pain are looking for the four points of contact; discussed below.
- Underarm hold
Ideal for twins once feeding is established and each baby is getting a good latch. Also suitable for smaller babies. I find this position doesn’t work well if your baby is average or above-average birth weight (>3.3 kg) as they quickly run out of room, and are generally heavier to support with the wrist. Be very mindful that shoulders do not slump forward, I find this posture can be very straining on the back, neck and shoulders. More pillows are required with this position, and this leads to difficulty feeding outside of the house.
This position works extremely well to support postpartum recovery, and also for night feeding.
I also love trying this position when the baby is particularly fussy at the breast, as they are much calmer when lying down. Side-lying can be a great position to try when the baby is distracted and just before nap/sleep time.
Ideally semi-reclined/laid back, and well supported with firm yet comfortable pillows. In early postpartum, the feet should be elevated where possible. Hips should be aligned, shoulders rolled back and the spine should be straight to avoid excess muscle strain and tension.
Four points of contact (Thompson Method) or Symmetrical-Face-Breast-Bury (Gestalt Breastfeeding) are what mums should be looking for:
- Chin buried into the breast, this will trigger the baby to vacuum the nipple into their mouth.
- + 3 Each cheek pressed into the breast symmetrically – see if the top and bottom cheek are pressed into the mother’s breast evenly.
4. Nose should be flush with the breast – there is no need to pull the breast tissue away from the baby’s nose to support breathing.
Baby-led vs Mother-led attachment
Baby-led attachment usually starts to occur naturally as mum and baby grow in confidence throughout their breastfeeding journey. In the early days, a breast crawl will help to support the neural pathways in the baby’s brain when learning how to breastfeed. Mother-led attachment occurs in the cross-cradle position and overrides the natural instincts of both mother and baby.
Baby-led attachment allows the baby’s instincts to guide the way by supporting the baby’s body as the mother is in a reclined or laid-back position, and the baby’s mouth is placed opposite the nipple (not nose to nipple as taught in the cross-cradle position).