IBCLC Charlotte Treitl shares her top tips for supporting optimal position and attachment in the breastfed baby.
What I'm looking for I do a feeding assessment is making sure that mum, or the breastfeeding parent, is not hunching their shoulders and they're not leaning forward. If their body is scrunched up and feeling uncomfortable then mums end up carrying all this tension in their body. What we want to do is make sure that that parent is feeling relaxed and their shoulders are dropped.
Use a cushion
The next thing that I would suggest is for when you’re holding baby in a cradle or cross cradle position, is that the bottom end of the baby is supported with a cushion or a pillow. This can then help the parent hold and support the baby's neck and shoulders and keep baby pressed firmly against the body without having to support their whole weight. This is particularly good for babies who are quite heavy at birth or older babies, who may be starting to move away from the breast due to their weight. Also great for parents who just find it more difficult to hold the baby for long periods!
Nipple to nose
Make sure that when you're bringing baby to the breast, that the nipple is pointing up the nose. We often hear about “nipple to nose” when supporting good position and attachment, but what that actually means is putting the nipple right at the tip of baby's nose. We want it to be coming up from underneath as if it's pointing up the nose, not just pointing straight at it. This means that as the baby tilt’s their head back the nipple will go much further back into the roof of the mouth.This will make feeding more comfortable and avoids experiencing pain or nipple trauma.
Being patient with the baby and take time to learn together. Breastfeeding your baby is a new experience, even if you've done it before. It's a new baby and your body may have changed during pregnancy. It takes time to learn. I often see parents that are rushing to get their baby onto the breast, usually because they are anxious that baby is hungry and don’t want them to have to wait too long. This often means baby's mouth is not as wide as it possibly could be. If you take that little bit of extra time and be patient with baby, and catch their early feeding cues, you've got a little bit of time to work out how to get them in to that optimal position and get them onto the breast comfortably. If we try to latch baby when they're displaying their really frantic feeding late cues, and they're really, really hungry, then they won't have as much patience as you do.
Laid back feeding / reclined position
This is a great position at all ages and stages, but I find is not often suggested in the early days. It’s a little bit tricky to do this sat up straight in a chair! I recommend that parents move to the front of their chair or sofa, then you’ve got a bit more space to lay back when they you lean back. We want to place the baby in the middle of the breasts so that their body supported on the parent’s body. Let gravity do its job! Babies will tend to find their own way to the breast – we just need to support them in place and lean back so that it's comfortable. It's a really great way for parents to feed in a relaxed and comfortable position.