Clinical Reference Systems: Pediatric Advisor 10.0
THE ROOTING REFLEX
A key to breast-feeding in all positions is to get the baby
to turn her head toward your breast. To do this, simply
stroke the baby's cheek nearest the breast with your finger.
This triggers your baby's rooting reflex.
PROPER NIPPLE POSITION
Be certain the baby has a good grasp of the nipple as well
as the areola (brown area around the nipple). NEVER allow
the baby to suck on just the nipple! You can guide your
breast into a good nursing position by holding your breast
from below so that the nipple and areola don't get pulled
out of your baby's mouth by the weight of the breast.
In all positions be sure that the baby's nose is not pressed
into the breast so that she can't breathe. Also be sure
that your baby's body is directly facing the breast.
The most common position is sitting with baby in your
lap, with the baby's head in the crook of your arm. The
baby's chest should be against your chest so that she
doesn't have to turn her head to reach your nipple. Be
sure the arm of the chair is at the right height to
support your arm. Use pillows to support your back,
your arm, and the baby's head. A footstool is also very
helpful to elevate your feet.
- Lying down
Breast-feeding when you are lying down is useful for
night feeding. Lay on your side and place the baby on
her side facing you, with her head at your breast. You
may want to place a couple of pillows at your back for
some extra support. Be sure that the baby's nose is not
This position is restful for you; often both you and the
baby will drift off to sleep after feeding. By
adjusting your position slightly you can feed the baby
from both breasts while lying on one side. (Make sure
that you feed from both breasts. If you don't empty
both breasts, you can get a plugged milk duct. See here
Plugged Ducts. )
- Football hold
Hold your baby like a football along your forearm, with
the baby's body on your arm and her face toward your
breast. Use your other hand to support and position the
The football hold is useful if you are prone to having
plugged ducts (it empties the bottom ducts) or if you
are lucky enough to be nursing twins!
NURSING AFTER HAVING A CESAREAN SECTION
The lying-down position may be more comfortable for
breast-feeding after you have had a cesarean section. The
hospital nurses will help you change from side to side.
If you nurse using the sitting position, put a pillow on
your lap to protect the incision.
The football hold can also be used, since it keeps the baby
from pressing on your incision.
NURSING PREMATURE INFANTS
Support the baby's head with the crook of your arm while
placing your hand under her bottom. Use your other hand to
guide your nipple into her mouth.
If the nursing reflex of the baby is weak, pull down on the
baby's chin and direct the nipple into the back of her
Use the football hold with pillows under each arm to support
Or use a regular sitting position with the babies
You can combine the regular sitting position for one baby
and the football hold for the other.
HINTS FOR NURSING TWINS:
- Use pillows to free up your hands.
- Alternate between feeding each baby separately and
nursing the babies at the same time.
- Don't let one baby feed from just one breast. Alternate
breasts to keep a good milk supply in both breasts.
- Nurse the hungriest baby on the fullest breast.
HINTS ON BREAST-FEEDING POSITIONS:
- General rule: Anything that works is OK as long as the
baby has the whole nipple in her mouth (both nipple and
areola) and she can breathe.
- Vary the nursing position to make sure all of the milk
ducts are drained of milk.
- Always find a relaxed and comfortable position.