Breastfeeding Positions and Latching On

Techniques and Tips

Mother breastfeeding baby at home
Breastfeeding positions and latching on. Camille Tokerud / Getty Images

Breastfeeding positions and latching on are the most important parts of the entire nursing experience. It doesn't matter how prepared a woman was during her pregnancy; how many books she read about breastfeeding; how many other women she talked to about their experiences: When a new mother holds her baby in her arms for the first time, it's surreal...it's beautiful...and, it's daunting. "Whoa, this is awkward!

I've never had to sustain a life with my breasts before!" But the truth is, babies are born with the instinct to latch on and suckle. They might just need a little assistance with the positioning, which is where the mother's practice comes in.

Two of the most common assumptions are that the latch means everything and that it doesn't matter what position the baby is in. Positioning is key to getting a perfect latch, which is essential for establishing proper milk transfer for the baby and keeping you comfortable at the same time. Taking this step-by-step will ensure the best start.

Learn How Your Baby Latches On
Knowing how a baby latches on to a breast can help you feel more comfortable about what to expect.
VIDEO: Latch Positioning and Breastfeeding

Keep Your Baby Alert for the Feeding
A baby must be awake and alert to be able to latch-on. Here are some tips and techniques to help awaken a sleepy baby for a feeding.

Assume the Position
Not sure how to position your baby when breastfeeding? This video gives you a primer on the three most popular breastfeeding positions.
VIDEO: Breastfeeding Positions - How to Position Your Baby During Breastfeeding

Some positioning how-tos:

  • Football Hold: A wonderful position for a mother who has very large breasts or who has had a c-section. This position is also great for premature or very tiny babies.

  • Cradle Hold: A comfortable, natural position for older babies with better head control.
  • Side-Lying Position: An excellent position for nursing in bed. This position is also great for a mother who has had a c-section.

So now that the baby is latched on and positioned correctly, what happens?

Just let her nurse. At the beginning of a feed, the baby will take long, well-drawn sucks, then swallow, and pause. When the baby sucks, the nipple and surrounding breast tissue are drawn into a teat (essentially, an elongated nipple) by suction created by the baby's mouth. The teat extends back as far as the hard and soft palates. The base of the nipple is held between the upper gums and the tongue which covers the lower gum. The sides of the tongue cup around the teat, which forms a long, narrow space in which the nipple lies. Milk is then expressed from the nipple and pushed toward the back of the mouth by a wavelike motion along the surface of the tongue.

If the amount of milk taken in is adequate to activate swallowing, the baby's soft palate rises and closes off the nasal cavity.

As the feeding progresses, the suckle will turn to more of a flutter. Feedings are baby-led, which means that the baby determines when he is done. It's unfair to take a baby off of one breast when he's in a groove. If a baby comes off the breast in a totally relaxed state, the baby is done. At the next feeding, offer the other breast.

If the baby or mother is frustrated, they should take a break and just hold the baby skin-to-skin, perhaps with a finger in the baby's mouth for comfort. Once everyone has relaxed, try again. Babies learn very quickly, and soon enough the mother will feel the confidence that goes along with successful breastfeeding. The best advice? Be persistent and consistent. Practice. It will work out beautifully.

What happens if my baby doesn't latch on at all?

If the baby is having trouble latching and nursing effectively, the mother must be patient, persistent and consistent. We don't want to frustrate the baby so that he's turned off from the whole experience, but we do want to keep trying as often as possible. Even if we have a baby who is having difficulty latching, but licks a few times and stops, we know there's potential. In many cases, we need to teach the baby technique. If the baby, for example, has a "peanut-butter tongue" (where the tongue does not come down and out, as it should, to cup the breast, and rather turns upward to the roof of the mouth), we can practice by simply putting our index finger in her mouth, pad side up, to elicit a suck. This teaches her tongue to come down and cup the finger, just like it should at the breast. A lactation consultant can work with the mother on these techniques and give other tips on how to teach the baby to latch.

What happens if I have to supplement my baby with expressed breast milk or formula?

This happens, and the last thing we want is for the mother to feel stress about sabotaging her breastfeeding goals. If the baby needs to be supplemented with expressed breast milk or formula, there are many different ways to mimic what the baby would be doing at the breast.

  • Cup or spoon: The baby is swaddled and held upright. The cup is touched to the bottom lip and the baby's tongue will come down and out to lap up the milk. Don't pour it into the baby's mouth. This should be giving them practice to latch on.
  • Syringe or dropper: The baby sucks on someone's finger, while the supplement is slowly delivered by syringe or dropper at the same time.
  • Supplemental Nursing System: This is a system of tubes that the mother wears at the breast to entice the baby to feed. This is an intense intervention, but has proven to be very successful
  • Bottles: The best choice is a bottle designed for breastfeeding mothers, such as Second Nature. The nipples allow the baby to go from breast to bottle easily because the technology mimics that of the mother's nipple. There are many pores and the baby has to put negative pressure on the nipple to extract the milk.

During this time, the mother should be pumping every three hours to stimulate her supply until the baby is fully able to feed at the breast.

As babies get older, they can be in any position and nursing well. We have to be careful in the newborn stage to get the positioning and latch correct, but patience is key.

Babies learn quickly. They don't "forget" how to latch on as they get older. It's common that other breastfeeding problems arise that seem like latch problems. Be sure to seek help from a Board Certified Lactation Consultant if that is the case.

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