Children & Adolescents Clinic

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Clinical Reference Systems: Pediatric Advisor 10.0

Breast-Feeding Positions

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.

BREAST-FEEDING POSITIONS

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.

  1. Sitting

    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.

  2. 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 obstructed.

    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. )

  3. 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 baby's head.

    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 mouth.

NURSING TWINS

Use the football hold with pillows under each arm to support the babies.

Or use a regular sitting position with the babies overlapping.

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.

Written by Kate Capage.
Copyright 1999 Clinical Reference Systems