Breastfeeding - Latching on, feeding and positioning

Latching on, feeding and positioning

When the baby's cheek is stroked with the nipple, the baby will open its mouth and turn towards it. So that the baby will latch on well, the nipple should be pushed into its mouth so that the baby has a mouthful of nipple and areola. The nipple should be at the back of the baby's throat, with the baby's tongue lying flat in its mouth. Inverted or flat nipples can be massaged so that the baby will have more to latch onto.

Many women wear nursing brassieres for easier access to the breast, but these are not always necessary and certainly not required. In the very early days a nursing bra can make breastfeeding complicated and uncomfortable. Wearing a bra at any time after birth will not affect how the breast changes with pregnancy and breastfeeding. Many women find that the size of their breasts change dramatically and so fitting a bra is better done after childbirth rather than before. An ill-fitting bra, whether designed for nursing or otherwise, can cause plugged ducts or mastitis.

Pain in the nipple or breast is linked to incorrect breastfeeding techniques. Failure to latch on is one of the main reasons for ineffective feeding and can lead to infant health concerns. A 2006 study found that inadequate parental education, incorrect breastfeeding techniques, or both were associated with higher rates of preventable hospital admissions in newborns.

The baby may pull away from the nipple after a few minutes or after a much longer period of time. Normal feeds at the breast can last a few sucks (newborns), from 10 to 20 minutes or even longer (on demand). Sometimes, after the finishing of a breast, the mother may offer the other breast.

The length of feeds varies a lot. Regardless of the time taken, the breastfeeding mother should be comfortable.

* Upright: The sitting position with the back straight and leaning back comfortably.
* Mobile: The mother carries her nursling in a sling or other baby carrier while breastfeeding. Doing so permits the mother to incorporate breastfeeding into the varied work of daily life
* Lying down: Good for night feeds or for those who have had a caesarean section
o On her back: Mother is usually sitting slightly upright; particularly useful for tandem breastfeeding (nursing more than one child)
o On her side: The mother and baby lie on their sides
* Hands and knees: The mother is on all fours with the baby underneath her (not usually recommended)

While most women breastfeed their child in the cradling position, there are many ways to hold the feeding baby. It depends on the mother and child's comfort and the feeding preference of the baby. Some babies prefer one breast to the other, but the mother should offer both breasts at every nursing with her newborn.

* Cradling positions:
o Cradle hold: The baby is held with its head in the woman's elbow horizontally across the abdomen, "tummy to tummy", with the woman in an upright and supported position image
o Cross-cradle hold: As above but the baby is held with its head in the woman's hand
* Football hold: The woman is upright and the baby is held securely under the mother's arm with the head cradled in her hands. This position is especially useful for feeding twins simultaneously image
* Feeding up hill: The baby lies stomach to stomach with the mother who is lying on her back; this is helpful for babies finding it difficult to feed
* Lying down:
o On its side: The mother and baby lie on their sides
o On its back: The baby is lying on its back (cushioned by something soft) with the mother on her hands and knees above the child (not usually recommended)

When tandem breastfeeding, the mother is unable to move the baby from one breast to another and comfort can be more of an issue. As tandem breastfeeding brings extra strain to the arms, especially as the babies grow, many mothers of twins recommend the use of more supporting pillows. Favoured positions include:

* Double cradle hold
* Double clutch hold image
* One clutched baby and one cradled baby
* Lying down