First, don’t get worried about finding the perfect position. “There’s no right or wrong,” says lactation consultant Edith Kernerman, executive director of the Newman Breastfeeding Clinic and Institute in Toronto. “A good position is one that helps you get a good latch; a good latch is one that is comfortable for the mother and works for the baby to get milk.” It doesn’t have to look a particular way if it works — although, generally, you want to see baby’s chin pressed into the breast and his head tipped back. Secondly, know your options:
In this position, the mother feeding her baby on the left breast would use her left hand to support her breast, and her right arm and hand to support the baby. “Many mothers are taught this position in the hospital,” says Kernerman. “It’s not one that’s used around the world, though.”
Jean Kouba, president of the Canadian Lactation Consultants Association, agrees that the cross-cradle position is good for teaching because the mother can more easily see what’s happening as the baby latches on. “It doesn’t work well for all babies, though, especially those who have bruising on their heads from the birth or those who have some asymmetry in their facial development.”
This position is sometimes called the transitional hold, and for good reason. “It’s uncomfortable to keep using this position as the baby gets bigger,” Kernerman says.
Also called “biological nurturing,” this involves having the mother find a comfortable, well-supported, semi-reclining position, and putting her new baby tummy down on her belly or chest in a vertical position. With as much physical contact as possible with the mother, the baby then uses his instincts to search for the breast — usually with some help from mom.
“With this position, the baby is encouraged and allowed to do what comes naturally,” says Kernerman. “He feels in control, and he has the innate ability to find the breast and eat. Not only is this a great way to start breastfeeding, but if the baby has been resisting latching on or there have been problems, this may solve the problems.”
The position is also quite relaxing and easy for mom; with the baby glued to her body by gravity, she doesn’t have to worry about holding or supporting him, and can have at least one hand free. Kouba finds it doesn’t always work well, however. Some newborns may take quite a while to find the nipple, so patience is necessary.
When cross-cradle and laid-back breastfeeding positions haven’t worked, Kouba finds it’s often helpful to get the baby vertical. “I’ll have the mom sit cross-legged, and she can rest the baby against one thigh or knee, or perhaps on a pillow. Or she can position the baby so that he is straddling her leg. We want the baby to come from under the breast to latch on. The mother has her hand behind the baby’s back with his head in the V between her thumb and fingers, and she brings him to the breast by pressing with the heel of her hand so that his chin comes into the breast first and his head tips back.”
This position needs to be adjusted depending on the mother’s height, the baby’s length, and the size of the mother’s breast, Kouba adds, but it can be especially helpful for a newborn with bruising to the back of his head due to forceps or vacuum extraction. Many older babies like it too.
You’ll often see mothers using this position: The baby lies on his side, tummy against mom’s tummy, supported by her left arm while he nurses on the left breast. The mother may put her right hand under baby’s bottom, or use it to support or adjust her breast. “I think of this as a hold for an older baby, when nursing is going well,” says Kouba. “I don’t encourage it with a newborn.”
Kernerman thinks that it can work well for any age of baby, but the positioning is critical. “The baby’s head needs to be able to tip back so that the baby can get a wide-open mouth. And you need to bring the baby up to the breast from underneath.”
With mom lying on her side, and baby lying on his side facing her, she can position one hand behind baby’s back and bottom to bring him in close. “Babies like this because they feel supported on the bed, and moms like it because they can get some rest while nursing,” says Kouba. The baby’s nose needs to be at nipple level so that as mom draws the baby to her by exerting pressure on his back, he tips his head back as he latches on.
For this position, baby is tucked between mom’s arm and her side. Both Kouba and Kernerman warn that the football hold can be tricky. “Often you end up with the mother’s hand on the back of the baby’s head, pushing it to the breast,” explains Kernerman. “That pushes the baby’s chin into his chest, and it’s hard to latch and drink effectively that way.”
It can work, though, says Kouba “if the mother understands that she needs to bring the baby onto the breast from underneath, and that her hand needs to be behind the baby’s shoulders, not his head. It can also work for some mothers with very large breasts, who can better position the baby this way.”
Ultimately, the best position is the one that works.
Are there any rules?
“There are no real rules,” says Kernerman. “The only bad latch is one that is causing problems for mother and baby.” If you’re not able to get comfortable feedings where baby’s swallowing plenty of milk, contact a La Leche League leader or lactation consultant for extra help.
Do you need a nursing pillow?
Nursing pillows are firm pillows shaped like a C, and often with a strap to hold them in place around the mother’s waist. The baby is then positioned on top of the pillow to nurse. They sometimes help, says lactation consultant Jean Kouba, but often they aren’t a good fit for mother and baby, and can actually make it harder to get a good latch.