Lynnette Hafken, MA, IBCLC
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Positioning Your Baby
Positioning Your Baby
Nipple comfort while breastfeeding, and how much milk baby gets, depend on getting a good latch, and getting a good latch depends on how your baby is positioned relative to your body. The following videos will show you how to position your baby different ways to get an optimal latch. Before watching, please look over these general principles, because they apply to every breastfeeding position:
- Always start in a comfortable position, then bring your baby to you; do not lean over to bring yourself towards your baby, as this will lead to a sore back and tension on your nipple that will negatively affect your baby’s latch.
- Make sure your baby’s hips and shoulders are held tight against your rib cage. If your baby feels unstable or they can wiggle around, hold them more firmly, especially their hips.
- Do not lift your breast up or move it over to the baby. Let your breast fall naturally, then bring your baby to right where your nipple is. (Again, make sure you are holding their body firmly against you.) Lifting your breast or moving it will put tension on your nipple.
- Make sure your baby is in a position where they can tilt their head back. Think of the position of your head when you’re chugging a water bottle. This is important for ensuring your baby can open their mouth wide. You may need to move baby a little in the direction of their feet to optimize their position. (Again make sure you’re holding their body, especially the hips, firmly against your rib cage.)
- Make sure you’re supporting your baby’s head with your thumb and fingers behind their ears. If there is any pressure on the back of your baby’s head, it will cause their jaw to close slightly—try this with your own head.
- Make sure your baby is so close to you that their chest and chin are touching your skin. If they don’t feel your skin against their face, they will get their hands in the way. Move their arms around your breast so they’re hugging it.
Watch the following video (no sound) by Registered Midwife Carla Mastroianni. I suggest stopping at 2:15, then coming back to it after you have finished reading about positioning and are ready to focus on latching.
This is a great pillow for newborns. But everybody’s anatomy is different. If you have large, pendulous breasts, a pillow might be counterproductive, as it can raise your baby higher than your nipple’s natural position. A rolled up receiving blanket under your arm may work better for you.
The goal of a pillow is to support your arm, while your arm supports your baby. You can fine tune your position by putting a rolled up washcloth or receiving blanket under any areas of your arm or hand that don’t feel fully supported.
Relaxing Baby-Led Positions
Lying on your side or laying back with your baby on top of you are usually very comfortable (laid back is better for post-op c-sections in my experience), and babies will often latch on all by themselves if held in the right position (see general principles above):
Be sure to follow the general principles of (a) having the baby’s body tight against yours (wedging the rolled up blanket behind their back will help) and (b) position the baby so they’re below the nipple and need to tilt their head back to reach it. Once your baby’s body is stable against yours, bring them closer so they can feel your breast right on their face, and watch as they latch with barely any help!
Source: Gabriel Sainhas
These videos are of older babies, but laid-back breastfeeding works perfectly well with a newborn, even for their very first feeding. Your job is to put your baby on your stomach/chest area and keep them calm, awake, and not falling off of you; your baby’s job is to find the nipple and latch on.
Source: Nancy Mohrbacher
Source: Emma’s diary
Latching Your Baby
Latching Your Baby
Let’s now focus on techniques for latching your baby (or letting them latch) after you have positioned them well.
How a latch feels is much more important than how it looks. It should feel like strong pulling when baby sucks, with no pinching, biting, or rubbing sensations. Your nipple should come out of baby’s mouth at the end of the feeding looking round and slightly elongated, not misshapen.
If you are not feeling a strong pulling sensation when your baby sucks, the pain is greater than a 2–3 on a scale of 1–10,* or your nipple comes out of baby’s mouth looked pinched, flattened, or lipstick shaped, then your baby is not latched on well. Take another look at the Positioning section above and confirm that you have done all of the recommended parts.
*A little tenderness, or pain of 2–3 on a scale of 1–10 is normal for the first few weeks. Other conditions not related to your baby’s latch can also cause pain.
To get baby onto the breast correctly, your nipple should end up far back in the baby’s mouth, at what is called the junction of the hard and soft palate. Run your tongue along the roof of your mouth from front to back; you will notice a soft fleshy spot in the back. This is where the nipple has to be in order to (a) trigger baby’s suck reflex, (b) to protect your nipple from injury, and (c) to ensure your baby gets milk effectively.
Go back to the first video, and start it at 2:15; then look at this one:
In the following picture of a nice latch, you can see the baby’s chin deeply smushed into the breast, with the nose lightly resting on it.
I would also recommend making sure both cheeks are pressed into the breast; if the baby’s head is tilted with only one cheek touching, this can put tension on the nipple and make swallowing more difficult for the baby. (Once a baby is a few months old, they’ll have figured out the best way for them to latch, and you won’t have to micromanage everything so much—but for a newborn, it’s a good idea to know all these details.)
If the baby’s lower lip isn’t flared out (and it looks like the above baby’s may not be), you can put a little gentle downward pressure on the baby’s chin as they suck.
You can see that this baby is able to tip their head back fully, enabling their jaw to be fully open. Since we cannot see the mother fully, we don’t know if this position is optimal, however I suspect that she may be leaning over a little to make sure her breast is in her baby’s mouth deeply. If this is the case, I would recommend she pull the baby’s body more firmly against her rib cage with his chest snuggled into the base of her breast, then lean back in a comfortable position, bringing baby along for the ride.
“Flipple” Latch Technique
This technique essentially involves flipping the nipple into the baby’s mouth:
Tongue Ties and Other Tethered Oral Tissues
Many parents are told to “have their babies checked for ties.” It’s important to understand what ties are and are not, and what the scientific literature shows. Click here for a deeper look.