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Positioning and attachment

Positioning and attachment means the way in which you hold your baby while you are breastfeeding. 

Holding your baby in a position so that she is well supported means that she will be able to take a large amount of breast tissue into her mouth when she attaches, or ‘latches on’ to the breast. This helps the milk to flow and to make breastfeeding more comfortable for you.

Sometimes finding the most comfortable and effective position for you can take a little time and practice. For others it can be more instinctive. Neither of these experiences means that you are doing it ‘wrong’. 

Seeking support from trained professionals if you experience discomfort, or you are worried about how much milk baby is getting will usually involve an assessment of positioning and attachment as small changes can make a big difference to your breastfeeding experience.

Traditionally women have been supported to breastfeed following principles of positioning and attachment, which we outline below. Recent research has shown that ‘laid back’ breastfeeding may help mothers to follow these principles more instinctively.  This is known as ‘biological nurturing’. 

Positioning

There are many different positions for feeding your baby, but they all follow these main principles:

Start out by making sure that you are comfortable and well supported. Use cushions or pillows as you need to. You can breastfeed in almost any position!

To give you a few ideas some of the most traditional positions are shown below.

Attachment

Whatever position you choose, following these principles of attachment will help you have trouble-free breastfeeding:

Watch this video for a demonstration of positioning and attachment.

Note that the video talks about lips being ‘flanged’ as a sign the baby is well attached.  The bottom lip maybe flanged back, but if the top lip is flanged this can actually be a sign that baby is not opening their mouth very wide.

Signs of optimal attachment

Wide open mouth, more areola above the top lip than below the bottom
lip (if areola is seen), rounded cheeks, chin indenting the breast, rapid
sucks initially turning to slow deep sucks with swallows, contented baby
who stays on the breast, no pain for the mother.

Signs for you

Signs for someone else

Biological Nurturing

The biological nurturing approach is the result of research closely observing maternal breastfeeding behaviours. It is also known as ‘laid back’ breastfeeding because the idea is that mothers lie in a semi-reclined position (as if lying with your feet up on the sofa, supported by cushions). Baby then lies on top of mum, and together mum and baby find the best position for breastfeeding.

The research suggests that with the baby in this position, their natural reflexes allow them to find the breast and attach by themselves. At the moment the research looks promising, but it is too early to say for definite whether this or the more traditional approach is ‘best’ for supporting breastfeeding mothers.

Ultimately, you and your supporters will help you find the best ‘method’ of breastfeeding for you. If having your feet up sounds appealing to you, then you might want to look at the biological nurturing web page that has been created by the lead researcher. This includes a great video of a mother feeding her young baby and interacting with her older daughter.