The How-To of Breastfeeding: Positions and Ensuring a Good Latch

As we mentioned in the last week’s article, breastfeeding is a special bond between mother and child that predates even the emergence of the words “mother” and “child.” While breastfeeding is a natural part of human development, the process can still require some work.

It can cause anxiety when difficulties arise, and you may find yourself thinking, “This is how it’s been done since the beginning of time, what am I missing here? Am I doing something wrong?”

Often, you aren’t. Take a deep breath and remember that newborns have an instinct for breastfeeding, but they may require help along the way.

In this article, we’ll discuss some tips and tricks to help you and your newborn get off to a smooth start. You’ll likely receive information about breastfeeding in the hospital, and there are lactation specialists that are available if difficulties continue.

Finally, keep in mind that your health care provider is a critical source of information.

This article simply gathers together the best practices and recommendations from other parents in one convenient location. We hope it will help guide you along the way!

Breastfeeding Basics: Latching On

Your first time breastfeeding will likely take place in the hospital, and many times a lactation consultant will be brought in to help.

You’ve probably heard about the importance of “latching on,” or perhaps you are all-too-familiar with the difficulties of latching on.

Latching on means that your baby is in the proper position, such that when they are sucking (which they will do instinctively) they are receiving milk from the nipple.

Holding Techniques

There are several holding techniques that can be helpful with latching on.

  • The “C” Hold – most common. Place your breast in the palm of your hand with thumb on top of the breast. Cup your fingers around the bottom of the breast, and your hand should look like it is in the shape of a C
  • The “U” Hold – this is essentially the C hold but rotated to resemble a letter U, this gives better bottom support.
  • The “V” Hold – often used by women with smaller breasts or large hands, this technique involves placing your thumb and index finger on the top of the breast above the areola, and the rest of your finger (middle, ring, and pinky) on the bottom side, below the areola. Your nipple will be guided by the space between your index finger at the top and the middle finger below. Be sure you have adequate space between these fingers as it is not helpful to have the fingers too close to the areola.

Ensuring a Good Latch

After figuring out the hold you’d like to try, it’s time to give it a go. There are numerous reasons why a baby may not be latching on immediately, so we’ve listed out some common techniques to ensure a good latch.

The American Pregnancy Association recommends the following techniques:

  • Your baby should be tummy-to-tummy with you
  • Bring your baby to you, and don’t strain your neck or shoulders by leaning towards them
  • Keeping your baby’s ear, shoulder, and neck in alignment to help with their swallowing (using a breastfeeding pillow or equivalent will help you get your baby in the right position).
  • Your baby’s nose should be opposite to the nipple
  • Some mothers will need to hold the breast in a certain way and guide it to the baby’s mouth, especially in the beginning. The most common holding technique is the “C” hold.
  • You should aim the nipple towards the baby’s upper lip and not the middle of the mouth
  • Your baby’s head should be tilted slightly up (do not have their chin to chest)
  • Wait for your baby to open their mouth wide. If they do not open their mouth, back up and try again but don’t force it if your baby has not yet opened their mouth

Don’t blink, or you’ll miss it, the latch is coming up!

  • When your baby opens their mouth wide with the chin dropped and tongue down, they should latch on to the nipple
  • You should try to get as much of the lower part of the areola in the baby’s mouth as possible
  • You’ll know the position is correct if your baby’s chin is indenting the lower portion of your breast.
  • Check for fish lips: Your baby’s lips should be flattened out like a fish, if they are not, it is recommended to use one finger to gently pull the lips into the proper position

How You’ll Know the Latch is Good

It can be difficult for new mothers to tell whether or not the latch is solid. For this reason, the American Pregnancy Association has several guidelines for ensuring a good latch:

  • Check by pulling down your baby’s bottom lip; their tongue should be visible
  • Ears wiggle
  • Circular jaw movement rather than rapid chin movement
  • Cheeks are rounded
  • There is no clicking or smacking noise
  • You can hear swallowing
  • When your baby comes off the breast, the nipple is not flattened or misshaped
  • Any discomfort ends quickly after getting the baby latched on
  • Your baby finishes the feeding with signs of satiety/satisfaction. These signs include: the baby looks relaxed, “falls” off the breast, has open hands, or falls asleep.

Breastfeeding Positions

There are several common breastfeeding positions. We’ll cover five of the more common positions below. Most mothers recommend trying these out until you find one that works best for you and your little one.

1. Cradle Hold

Your baby should be held in the arm that’s one the same side, which you will be breastfeeding on. Your baby’s head should rest in the crook of your elbow and your forearm and hand will support the rest of the body

2. Crossover Hold

Hold your baby’s head in the arm opposite to the side you’ll be breastfeeding. Your forearm should run along your baby’s back, and you’ll support your baby’s head with your thumb and forefinger, behind the ears.

3. Football Hold

In this position, your baby will be held in the arm on the same side as the breast you are nursing on. Hold your baby’s head in your hand with their back along your forearm.

However, in this position, the baby’s body will run along your side, with their legs and feet tucked up under your arm.

4. Laid-back Position (Biological Nurturing)

Position yourself in a comfortable reclining posture, with good pillows for back support. Your baby will rest on one side of your chest, with their stomach down.

Gravity will assist in holding them in place and helping them to mold to your body. It is important to support your baby’s feet in this position.

5. Side-lying Position

As implied by the name, this position involves lying down on your side with your baby facing you. Your baby should be resting on/along your arm (the one that is on the same side you are nursing on). Your baby’s back may run along your forearm, and a pillow can help to keep them in place.

When in Doubt, Seek Help

There is a wealth of information available to help as you navigate the first weeks and months of breastfeeding.

Remember to contact your health care provider or lactation consultant if problems persist. If you have tips or tricks for breastfeeding, latching on, or a useful holding position, please share with the community in the comments below!