Breast milk is the best gift that a mother can give her newborn baby. It is a unique way with which a mother fulfils her role of a nurturer . This is a natural opportunity to communicate love at the very beginning of a child's life, providing hours of closeness, nurturing every day, laying the foundation for a caring, and trusting relationship between mother and the child. Although breastfeeding is a natural phenomenon, successful breastfeeding can be a quite a challenge for the mother and infant, especially in the early days. This is a two part series on breast feeding techniques

Factors to consider

Some factors that play a key role while breastfeeding your baby:

  • Correct positioning of your infant at the breast.
  • Your level of comfort
  • Type of nipple
  • Infant-feeding techniques such as rooting, latching, active sucking, and audible swallowing[ii]

Why focus on breastfeeding techniques?

Breastfeeding is a natural instinct for a newborn but a learned behavior for the mother. First-time mothers  may face some challenges in breastfeeding  such as sore nipples, breast engorgement, gaseous abdominal distension in newborns and even lactational failure. Using the correct breastfeeding technique can help prevent many of these conditions.

Breastfeeding during the first few days of childbirth

If possible, put your baby to your breast within the first hour after birth. This will help your uterus to contract and stop bleeding excessively after childbirth. For the first two or three days, the milk is scanty, thick and yellow. This is called colostrum.  It is normal for babies to be sleepy during the first 24-48 hours after birth. Experts advice that the baby should be breastfed every 1 to 3 hours per 24 hours (8 – 12 times per 24 hours). Also, frequent feeding sessions are the best way to prevent breast engorgement.

Getting Started

  • Create a peaceful atmosphere and allow yourself to relax

The success of breastfeeding is greatly influenced by your physical and emotional well-being. If you are tensed or uncomfortable, the negativity could have an impact on your hormones. Thereby, resulting in decreased milk production.

Try the following steps to prepare yourself for breastfeeding your newborn:

  • Select a comfortable room that gives you enough privacy
  • Enjoy something that creates a positive mood –eg-cuddle your baby, play your favorite music
  • Avoid possible interruptions before your start feeding your baby. Empty your bladder, ensure that your mobile phone is accessible to you or keep it on thesilent mode
  • Unwrap your baby and check his/her diaper; change it if needed. This will help arouse and stimulate your baby to nurse, especially if your baby is sleepy. If your baby is awake and ready to nurse, wait until after the first breast to change your baby's diapers.
  • Find a comfortable position
  • Sit comfortably on a chair with your back and foot well supported
  • Make sure your feet are elevated at a comfortable level. Sitting up in bed with pillows under your legs or using a footstool when in a chair will help you be comfortable.
  • Prefer chair with ample room on the sides and back for pillows to support your baby and your arms.

Ideal Breastfeeding positions

You can choose one of the below mentioned breast feeding positions based on your preference, familiarity and expertise in adopting the position. Your physical conditions, and the number of babies to be fed also important factors to consider.

1. Cradle Hold

  • Sit straight and place a pillow behind you.
  • Cradle your baby in your arm, i.e, her stomach against yours and her head resting on the ‘bend’of your elbow. If she's nursing on the right breast, rest her head in the crook of your right arm.
  • Extend your forearm and hand down her back to support her neck, spine, and bottom. Secure her knees against your body, across or just below your left breast. Her ear, shoulders and hip should be in a straight line.
  • Tuck your baby's lower arm out of the way, with her mouth close to your breast.
  • Support your breast with your free hand; place all of your fingers underneath it, well away from the areola.
  • Rest your thumb lightly on top of your breast above your areola.
  • Lift your breast upward and lightly stroke your nipple on your baby's lower lip. As part of the rooting reflex, her mouth will open wide.
  • Pull her quickly onto the breast to latch-on when her mouth is opened wide, like a big yawn, and her tongue is down.
  • Do not lean over your baby; keep your back straight, and pull your baby up to your breast.

2. Cross Cradle Hold

For this position, follow the steps for cradle hold except for the cradling method. In the cross-cradle hold, you shouldn't support your baby's head with the crook of your arm. Instead, your arms switch roles.

Cradle your baby with your arm, her tummy against yours and your hand behind her head. Her ear, shoulders and hips should be in a straight line.

Use your left hand and arm to hold your baby when you nurse from your right breast. Rotate the baby's body so that the chest and tummy are face you. With your thumb and fingers behind his head and below his ears, guide his mouth to your breast. You may benefit from this position especially if you find a problem with latching.

3. The clutch or football hold

In this position, you may tuck your baby under your arm (on the same side that you're nursing from) like a football or handbag. Hence, it is called the football hold position.

  • Position your baby at your side, under your arm. She should be facing you with her nose level with your nipple and her feet pointing toward your back.
  • Rest your arm on a pillow in your lap or right beside you, and support your baby's shoulders, neck, and head with your hand. Guide her to your nipple.
  • Place your fingers below your breast. Allow your baby to latch-on while pulling her in close, holding her head tightly against your breast.
  • Keep your baby's body flexed at the hip with her legs tucked under your arm. Sitting upright may encourage her to remain alert for a longer period.
  • Make sure that you do not push her toward your breast so much that she resists and arches her head against your hand.She should be well supported at her upper back with your forearm.

The football hold is a good position when you:

  • Have had a caesarean section and want to avoid placing your baby against your abdominal incision.
  • Need more visibility in getting your baby to latch-on, especially when your breasts are large
  • Are nursing a small baby, especially if she or he is born prematurely
  • Have inverted nipples

It is also wise to do so when:

  • Your baby tends to slide down your areola frequently indicating difficulty in latching.
  • The baby is fussy, restless and hard to latch-on as well as when he or she is sleepy

4. Side-lying Position

  1. First, position yourself and your baby on your sides tummy-to-tummy.
  2. Bend your upper leg and position with pillows.
  3. Place your fingers beneath your breast and lift upward, and then pull your baby in close as she latches-on.

This position is a good choice for breastfeeding when you need to lying flat, such as after a caesarean birth with spinal anesthesia. At the same time, this position is risky due to a chance of suffocation, choking, aspiration for the newborn. There is an increased chance of ear infections among children who are breastfed in this position.

(Continue to Part 2)

The author

This article has been written by Namitha Subrahmanyam. She has been working as a nurse for over 13 years and holds an M.Sc in OBG Nursing. Presently, Namitha Subrahmanyam is pursuing her PhD and is working as an Associate Professor at the Department of Obstetrical and Gynaecological  Nursing of the MOSC College of Nursing, Kochi, Kerala, India.