From La Leche League
How do I position my baby to breastfeed?
Note: Please know that we are aware that babies come in two equally wonderful genders. For clarity, we are referring to your baby as "he" because mother is most certainly "she."
During the early weeks optimal positioning is especially important. When you and your baby are well positioned, your nipples stay healthy and your baby can feed most efficiently. Concern about sore nipples is a common reason that mothers contact La Leche League. Proper positioning helps eliminate many cases of sore nipples.
You may have noticed this is a long FAQ. Be assured that breastfeeding has been successfully accomplished by mothers and babies for centuries. However, like other seemingly simple tasks, it takes a lot of words to describe. LLL Leaders are experienced in guiding mothers through the positioning process. If you feel overwhelmed by preparing to breastfeed your baby, contact your local Leader for information and support. She will be happy to simplify matters for you.
Basic Steps for Optimal Positioning
- 1. Position yourself comfortably with back support, pillows supporting your arms and in your lap and your feet supported by a footrest or a telephone book.
- 2. Position baby close to you, with his hips flexed, so that he does not have to turn his head to reach your breast. His mouth and nose should be facing your nipple. If possible, ask your helper to hand you the baby once you are comfortable. (See "Going Beyond the Basics" section of this FAQ for details.)
- 3. Support your breast so it is not pressing on your baby's chin. Your baby's chin should drive into your breast. (See "Breast Support Techniques" below for descriptions.)
- 4. Attach or latch baby onto your breast. Encourage him to open his mouth wide and pull him close by supporting his back (rather than the back of his head) so that his chin drives into your breast. His nose will be touching your breast. Your hand forms a "second neck" for your baby. (See "Is My Baby Latched on Well" below for further information.)
- 5. Enjoy! If you are feeling pain, detach baby gently and try again.
These steps may need to be repeated frequently during the early weeks. You and your baby will find a technique that works for you after some practice.
Going Beyond the Basics
As you and your baby become more experienced at breastfeeding, you will find that breastfeeding positions can be altered in many ways, even from feeding to feeding. As long as you are comfortable and baby is nursing successfully, use what works for you. Try experimenting with the four positions below.
Remember, in any of these positions, it is very important to bring the baby to your nipple height. Leaning over your baby can cause backaches, neck/shoulder strain or sore nipples.
Laid-back breastfeeding, or Biological Nurturing
Laid-back breastfeeding, or Biological Nurturing, means getting comfortable with your baby and encouraging your own and your baby’s natural breastfeeding instincts. See Biological Nurturing for further information.
- Dress yourself and your baby as you choose.
- Find a bed or couch where you can lean back and be well supported— not flat, but comfortably leaning back so that when you put your baby on your chest, gravity will keep him in position with his body molded to yours.
- Have your head and shoulders well supported. Let your baby’s whole front touch your whole front.
- Since you’re leaning back, you don’t have a lap, so your baby can rest on you in any position you like. Just make sure her whole front is against you.
- Let your baby’s cheek rest somewhere near your bare breast.
- Help her as much as you like; help her do what she’s trying to do. You’re a team.
- Hold your breast or not, as you like.
- Relax and enjoy each other.
The cradle position is most commonly used after the first few weeks. The cross-cradle position (see below) gives you more control.
To nurse your baby while cradling or holding him across your lap, he should be lying on his side, resting on his shoulder and hip with his mouth level with your nipple. Use pillows lifting your baby and supporting your elbows to bring your baby up to nipple height especially during the first few weeks. Support your breast with either the "U" hold" or "C" hold as described in the "Breast Support Techniques" section below. Your baby's head will be on your forearm and his back will be along your inner arm and palm. When you look down, you should see his side. His mouth should be covering at least a half inch of the dark area around your nipple. Be sure his ear, shoulder and hips should be in a straight line. As a newborn, your baby's head and bottom should be level with each other.
During the early weeks, many mothers find a variation of the cradle position, called the cross-cradle position to be useful. For this position, your baby is supported on a pillow across your lap to help raise him to your nipple level. Pillows should also support both elbows so your arms don't hold the weight of the baby; they will tire before the feeding is finished.
If you are preparing to breastfeed on the left breast, your left hand supports that breast in a "U" hold. (See the "Breast Support Techniques" section of this FAQ for a description of this hold.) You support your baby with the fingers of your right hand. Do this by gently placing your hand behind your baby's ears and neck with your thumb and index finger behind each ear. Your baby's neck rests in the web between the thumb, index finger and palm of your hand, forming a "second neck" for baby. The palm of your hand is placed between his shoulder blades. As you prepare to latch on your baby, be sure his mouth is very close to your nipple from the start. When baby opens his mouth wide, you push with the palm of your hand from between the shoulder blades. His mouth will be covering at least a half inch from the base of your nipple.
Clutch or Football Position
This is a good position for a mother who has had a Cesarean birth, as it keeps the baby away from the incision. Most newborns are very comfortable in this position. It also helps when a mother has a forceful milk ejection reflex (let down) because the baby can handle the flow more easily.
In the clutch position you support your baby's head in your hand and his back along your arm beside you. You support your breast with a "C" hold. (See "Breast Support Techniques" section of this FAQ for a description of this hold.) He is facing you, with his mouth at nipple height. Your baby's legs and feet are tucked under your arm with his hips flexed and his legs resting along side your back rest so the soles of his feet are pointed toward the ceiling. (This keeps him from being able to push against your chair.) Pillows again help bring the baby to the correct height.
Many mothers find lying down to nurse a comfortable position, especially at night. Both mother and baby lie on their sides facing each other. You can use pillows behind your back and behind or between your knees to help get comfortable. A pillow or rolled blanket behind the baby's back will keep him from rolling away from you. The baby can be cradled in your arm with his back along your forearm. Having his hips flexed and his ear, shoulder and hip in one line helps your baby get milk more easily. Some mothers find that practicing with this position during the daytime is very helpful.
Breast Support Techniques
As you hold your baby in any of the above positions, you may need to support your breast with your free hand. This removes the weight of the breast from the baby's chin, allowing him to breastfeed more effectively.
"C" hold--See the cradle hold illustration above, and the photos at left. Support your breast with your thumb on top, well back from your areola (the darker skin surrounding the nipple) and the fingers underneath. Your fingers should also be well back from your baby's mouth. This hold is helpful when breastfeeding in the clutch or football position as well as the cradle position.
"U" hold--Place your fingers flat on your ribcage under your breast with your index finger in the crease under your breast. Drop your elbow so that your breast is supported between your thumb and index finger. Your thumb will be on the outer area of your breast and your fingers will be on the inner area. This hold is helpful when breastfeeding in the cradle and cross-cradle positions.
Is My Baby Latched on Well?
When latching on your baby, use your nipple to tickle the center of your baby's bottom lip. This will encourage him to open his mouth wide (like he is yawning). Aim your nipple slightly towards the roof of his mouth, bringing baby to you, chin first.
Good latch-on checkpoints for your baby include:
- his nose is nearly touching your breast, that is, no further away than a credit card edge
- his lips are flanged
- at least ½ inch of your breast around the base of your nipple is in his mouth.
If the latch is uncomfortable or painful, gently place your finger in the baby's mouth, between his gums, to detach him and try again.
A baby who is offered the breast will suck without swallowing as he positions the nipple in his mouth and tells your breast he is ready for the milk to let down. When he begins to receive milk, you will see his jaw working all the way back to his ear. His temples will wiggle. You will also hear him swallowing,