Every year, August 1-7 is celebrated as World Breastfeeding Week to encourage breastfeeding. According to the UN, “It commemorates the Innocenti Declaration signed in August 1990 by government policymakers, WHO, UNICEF, and other organisations to protect, promote, and support breastfeeding. Breastfeeding is the best way to provide infants with the nutrients they need. WHO recommends exclusive breastfeeding starting within one hour after birth, until a baby is six months old. Nutritious complementary foods should then be added while continuing to breastfeed for up to two years or beyond.”
According to Unicef India, “In India, 1.2 million under-fives die every year (SRS 2013), and half of these deaths occur in the first 28 days of life, a time referred to as the neonatal period. Global evidence shows that children who are exclusively breastfed are 14 times more likely to survive the first six months of life than non-breastfed children.” Therefore, supporting mothers to breastfeed their children becomes crucial.
Breastfeeding is natural but can be challenging, especially in the initial few weeks after birth. A young mother may find it frustrating, but understanding breastfeeding positions may help her find comfort in the way she breastfeeds her baby. Here are some pointers that may help:
Basic points for every breastfeeding position
- Wash your hands well before feeding
- Give proper support to your body
- Hold your baby comfortably
- Give proper support to the breast
Getting baby to latch onto the breast
It is important to notice and take steps to ensure proper latching and positioning of the baby. Steps include sitting and lying comfortably with support to the neck and back. Place a pillow under the baby’s body to bring him/her to the level of your breast. Your baby’s abdomen must face your abdomen. Gently massage your breast. With your fingertips, massage from your chest wall towards your nipple in a circular motion. This encourages milk flow. You may need to continue this action during the feeding if your milk flows slowly.
Support your breast with four fingers underneath and your thumb above your nipple. Make sure your fingers are well away from your nipple and your baby’s mouth. Stroke your baby’s lips gently with your finger or nipple. When your baby’s mouth is open wide enough, quickly bring your baby to your breast, placing your entire nipple and as much of the coloured area around your nipple (areola) as possible into your baby’s mouth.
More areola should be visible above your baby’s upper lip than below the lower lip. Your baby’s tongue should be between his/her lower gum and your breast. Ensure your baby’s mouth is correctly positioned around your nipple (latched). Your baby’s lips should create a seal on your breast and be turned out. It is common for your baby to suck for about two-three minutes in order to start the flow of breast milk. Signs that your baby has successfully latched on to your nipple include:
- Quietly tugging or quietly sucking without causing you pain
- Swallowing heard between every three-four sucks
- Muscle movement above and in front of his/her ears with sucking
Signs that your baby has not successfully latched on to nipple include:
- Sucking sounds or smacking sounds from your baby while nursing
- Nipple pain
Two natural hand positions
The scissor grasp is the placement of the thumb and index finger above the areola and the other three fingers below the breast for support, thus allowing some compression of the areola. Care should be taken that the hand is not in the infant’s way of getting sufficient areola into the mouth. This grip has been used for centuries and was shown in sketches and paintings even before the Christian era. It may work better than the palmar grasp if the hand is large or the breast small.
The palmar grasp is the placement of all the fingers under the breast and only the thumb above. This has been called the C-hold, but is actually a V-hold, depending on the size of the breast and the size of the hand. Here are some comfortable breastfeeding positions:
- This is done in a sitting position
- Hold the baby horizontally facing the mother
- When nursing from the right breast, use the right arm to hold the baby
- Let the baby’s head rest on your forearm while supporting his back with the same forearm and holding his bottom with the hand
- Support the breast with the left hand
- Hold your baby along the area opposite from the breast you are using
- Support your baby’s head at the base of his/her neck with the palm of your hand
The “football hold” is a popular but poorly named position in which an infant is held close to the mother’s body with the feet to her side. The head and face are squarely in front of the breast and steadied by the mother’s arm and hand on that side. Cupping the breast and the jaw in one hand facilitates the infant’s seal around the breast with the mouth. This position is also called the “dancer hold”.
One of the most valuable suggestions is the use of a sling or pleat-seat which holds the infant in a flexed position that facilitates infant suckling, leaving the mother’s hands free to support her breast and the infant. Holding an infant in a flexed position that mimics the fetal position relaxes an infant who is hypertonic or arching away from the breast.
Side lying position
Lay your baby next to you on the bed, so his/her mouth is opposite your nipple, and place a small rolled blanket, towel, or soft cloth behind your baby’s back. Support the base of the baby’s head between your thumb and forefinger.
Pull your baby onto your breast when his/her mouth is open wide, far enough onto your breast so that his/her nose, cheeks, and chin all are touching your breast. If you need to switch breasts, hold your baby close to your body and roll onto your back, then to the other side.
Laidback hold (Straddle Hold)
Dr Shilpa Agrawal is a high-risk pregnancy and foetal medicine specialist at Jaslok Hospital and Research Centre, Mumbai.
(Disclaimer: The views and opinions expressed in this article are those of the author and do not necessarily reflect the views of YourStory.)