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’.
There are many different positions for feeding your baby, but they all follow these main principles:
- You hold your baby close to your body.
- Your baby’s head and body should be in a straight line.
- Baby’s neck, shoulders and back are supported.
- Baby is able to extend their head to the breast
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.
Rugby ball or under arm
Whatever position you choose, following these principles of attachment will help you have trouble-free breastfeeding:
- Allow baby to tip his head back and brush his lips against your breast. This will trigger the ‘gape reflex’. Baby’s bottom jaw will drop and his tongue moves down and forwards.
- Open wide! Baby needs to have a wide open mouth to get a large mouthful of breast. You need to quickly move baby onto your breast as he drops his lower jaw.
- Chin up! Baby should have his chin against the bottom of your breast.
- Baby’s bottom lip will touch your breast away from your nipple
- Your nipple will be able to go right to the back and top of baby’s mouth
- Nose Clear! Baby’s nose should be free.
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
- It shouldn’t hurt.
- If you can see any of the dark area around the nipple then you should see more above the baby’s top lip than below his bottom lip.
- Your baby’s sucking rhythm will change, from short sucks to slow deep sucks.
- Your baby will pause from time to time, and start sucking again without prompting.
- Your baby will be relaxed while he is feeding.
- Your baby will let go of the breast by himself when he has finished the feed.
- Your nipple should be the same shape after the feed as it was before the feed started.
Signs for someone else
- Baby’s mouth is open wide
- Baby’s nose is free of the breast
- Baby’s chin is indenting the breast
- Baby’s cheeks are round and full
- Baby’s head is tipped back