Positioning for Breastfeeding

Before beginning the latch, positioning of both you and your baby is critical.

Poor maternal positioning can cause:

• Strain on your extremites, causing stress on the nerves which supply the breast. This in turn creates difficulty with milk flow.

• Difficulty positioning your baby tummy to tummy, an important step in helping your baby use reflexes to latch and to stay the perfect temperature during skin-to-skin time.

  
  

Poor infant positioning can cause:

• Chin to point down toward chest, causing problems with latching, sucking, breathing, and swallowing, which also leads to increased gas and fussiness.

• Body to be out of alignment, causing problems with latching, sucking, breathing, and swallowing, which also leads to increased gas and fussiness.

• Neck to be twisted, causing problems with latching, sucking, breathing, and swallowing, which also leads to increased gas and fussiness.

• Head to be even with or lower than remainder of body, causing difficulties with swallowing and increasing risk of choking.

• Lack of contact between your body and your baby's, decreasing effectiveness of skin-to-skin and decreasing ability to use reflexes for latching.

What is the Best Position for my Baby to Breastfeed?

The best position is the one that allows:

• Baby's belly and body to be in close contact with your belly (or side of your body if in football hold) to maintain adequate temperature and use reflexes to latch.

• Baby's head higher than the rest of their body to enable comfortable swallowing.

• Baby's body is alignment with ear, shoulder, and hip in a straight line.

• Baby's face directly across from the front of your breast with their nose level with your nipple.

• Baby's head slightly tipped back as if drinking from a cup.

• Mother's feet supported.

• Mother's arms, elbows, and wrists supported.

• Mother's body to be in alignment with ear, shoulder, and hip in a straight line.

• Mother comfortable in this position for a stretch of time.

Proper positioning may need to be reassessed each time you breastfeed, each time you switch breasts, and as lactation progresses.

Mothers have a tendency to adjust the way they hold their babies as they grow and get heavier. Often this means positioning them in the crook of their elbow, which causes mis-alignment and poor latch.

Breastfeeding pillows often interfere with proper positioning of newborns. As babies grow in length and get heavier, breastfeeding pillows may become more useful, but may need to be adjusted at an angle and/or rotated around your body to support your baby correctly. Bed pillows, rolled up baby blankets or towels, or couch arms can be used for support at any time.

Limitations of several traditional breastfeeding positions:

Cradle:

• Baby is often postioned in the crook of the mother's elbow, not across from the front of the breast. Even if originally starting with correct positioning, as the baby gets heavier and longer, mothers often shift them, resulting in poor positioning.

• Sometimes difficult to position baby tummy to tummy, especially right after birth, while sitting up in bed, or if you have a combination of large breasts/larger belly.

• There must be space between belly and breasts to fit your baby in tummy to tummy.

Cross Cradle:

• A good way to start while baby latches, but often easier to switch arms to cradle once latched.

• Sometimes difficult to position baby tummy to tummy, especially right after birth, while sitting up in bed, or if you have a combination of large breasts/larger belly.

• There must be space between belly and breasts to fit your baby in tummy to tummy.

Football:

• Requires lots of pillows for support, both under the baby and strategically behind the mother's back. The baby has to be able to fit in a straight line between mother's breast and the head of the bed.

• Great right after birth when mother is sitting up in bed and has limited space between breasts and belly.

• Sometimes easier to visualize the latch in this position compared to others.

• Best done while wearing a nursing bra, keeping breasts supported and nipples facing forward. Difficult with unsupported large breasts.

• Difficult to do on a couch or chair due to limited seat depth.

• Not practical long-term.

Side-Lying:

• While it allows mother to rest, it can put strain on arms and shoulders. The nerves that innervate the breast are located between the shoulder blades and the base of the neck, so you need to ensure these are relaxed.

• Sometimes difficult to position the baby level with the front of the breast.

• Sometimes difficult to visualize the latch.

• Not always practical.

Laid-Back:

• Usually the first position baby ever feeds from. It allows the baby to use reflexes to latch. With help from gravity, baby's complete body is in contact with mother's- the ideal situation. No problems here!

• Baby's head can end up anywhere from mother's wrist up to her elbow, depending on where the front of her breast lands. Easy for mother to support her arms, but depending if in bed or on a chair/couch, may need a foot rest.

Find the right position for both you and your baby each time your baby latches.