When using the cradle hold (the baby's head in the crook of your arm),
place the baby so that he is completely on his side. There should be an
imaginary straight line from his ear to his shoulder to his hip. You
should not be able to see his navel if he is lying fully on his side.
This position keeps him from having to turn his head to reach your
breast; thus making swallowing more difficult and perhaps causing
nipple soreness. His lower arm should be tucked around your side. His
upper arm should be along his side. Use a bed pillow or a nursing pillow
underneath the baby to raise him to breast level. Do not bend over to
reach him. Even though you may start out with your baby positioned
well, he may begin to roll over onto his back as the feeding
progresses. A rolled-up blanket/towel behind him should prevent this.|
When using the football or clutch hold, position the baby at your side
with your forearm along his back and your hand cradling the back of his
neck. You will want to place a pillow at your elbow where the baby's
bottom will rest. Pull the baby in closely. Use the pillow under baby's
bottom to support your arm as well. You may also find that a pillow or
rolled up blanket/towel under your hand/wrist at the baby's head
prevents you from tiring so easily.
Another position that allows for good head control like the football
hold is the transitional hold or cross-cradle hold. With this position,
lay the baby across the front of your body on his side as you would
with the traditional cradle hold. Support your breast with the hand
that is on the same side as the breast you will be offering the baby.
With the opposite arm, reach around the back of the baby's back and
cradle the baby's neck with your hand.
You will want to support your breast throughout the entire feeding for
the first few weeks. If you are large breasted you may want to continue
to do this for as long as you breastfeed. Larger breasted mothers often
find that a rolled-up blanket or towel placed under their breasts makes
latch-on easier for the baby as well. Support your breast using a
C-hold (4 fingers underneath way back against the chest wall and thumb
on top away from the areola).
Begin by hand expressing a little breastmilk onto your nipple. Line
your baby up so that his nose is at the level of your nipple. Lightly
tickle your baby's top lip with the tip of your nipple in an up and
down motion. This will cause baby to tip his head slightly back making
it more likely that the chin plants first and more of the lower breast
tissue is taken into the mouth. WAIT for baby to open wide - as wide as
he does when he yawns. For some babies this may take time, so be
patient! Do not allow the baby to chew his way onto the nipple.
When the baby opens as wide as a yawn, QUICKLY boost him onto your
breast. He should take an inch to an inch and a half of your breast
tissue into his mouth. Once he is latched-on you can help him take more
of your breast into his mouth by pulling down on his chin. He should be
pulled in so close that his chin is touching your breast. His nose may
also touch it. Do not be afraid that he cannot breathe in this
position. Babies' nostrils flare, enabling them to breathe out of the
corner of their noses during nursing. If the baby's nose seems to be
blocked by your breast, change your positioning by pulling the baby's
legs and body in closer or lift your breast a bit more rather than
compressing the areola with your thumb. Doing so can inhibit the flow
of your milk.
It is normal to experience some discomfort the first few seconds of
nursing as your nipple tissue is stretched and elongated far back into
your baby's mouth. This temporary tenderness usually diminishes once
your milk lets down and completely disappears within a few days. Aside
from this normal tenderness, breastfeeding should NOT hurt. Sore
nipples usually indicate that the baby needs to take more of the breast
tissue into his mouth where it cannot be gummed or chewed. If this
initial discomfort does not subside within the first minute or so of a
feeding, break the latch by inserting your finger in the corner of
baby's mouth or by pulling down on baby's chin, and begin again. Do
this as many times as you need to for the latch-on to feel comfortable.
Allowing your baby to stay on the breast when he is not latched-on
correctly will cause nipple soreness and possibly prevent your baby
from receiving a sufficient amount of milk. Some babies will start out
with a good, deep latch and then slip down onto the nipple as the
feeding progresses. Be aware of this and break the suction and relatch
your baby is needed.
SIGNS OF A GOOD LATCH-ON
- If using the cradle hold, cross cradle/transitional hold, or lying
side-by-side, the baby should be facing you so that he does not have to
turn his head. If using the football hold, the baby's mouth should be
directly in front of or slightly below your nipple.
- The baby should take at least an inch of your areola into his mouth.
- The baby's chin and nose should be touching your breast.
- The baby's cheeks are nicely rounded when suckling.
- The baby's top and bottom lips should be flanged out -
like a fish's lips or a rose bud. If they are not, use your finger to
manually flip them out. If the baby sucks in either of his lips during
the feeding it can cause nipple soreness.
- The baby's tongue is down, cupping your breast. If
breastfeeding is going well and you are comfortable there is no reason
to check the position of the tongue. If nursing is uncomfortable and
the tongue cannot be seen, it may indicate that the baby is using it
improperly. If this is a possibility, consult a lactation consultant or
La Leche League leader in your area.
- Your nipple looks nicely rounded immediately after your
baby releases it. There should not be any creasing. The nipple should
not look pointed, mashed, or formed in any way.
WARNING SIGNS THAT LATCH ON IS PROBABLY FAULTY AND COULD USE SOME IMPROVEMENT
- Your nipples are sore during the entire feeding or become sore as the feeding continues.
- You can hear clicking or smacking noises as the baby suckles.
- The baby is having trouble latching on and is coming off the breast repeatedly after only a few sucks.
- The baby falls asleep after only a VERY few minutes of nursing.
- The baby's cheeks are dimpling in with each suck.
- Your nipples look pointed, creased, mashed, etc. when released from your baby's mouth.
- The baby has too few wet diapers and stools (see "Is My Baby Getting Enough?").
- The baby acts hungry all the time by being constantly fussy and by constantly sucking on his hands.
- Feedings are routinely taking more than 30 minutes. While
length of feeding may not indicate a problem at all, sometimes babies
who routinely need this long or longer to feed are not latched deeply
enough to transfer milk effectively.
Breastfeeding is not supposed to hurt! If after paying close
attention to positioning and latch-on for 48 hours, your nipples are no
better or are worse, you should consult a lactation consultant or La Leche League leader for one-on-one support. In the meantime, following the measures listed in "Treatment Measures for Sore, Cracked, and Bleeding Nipples" may make you more comfortable.
Written by Becky Flora, BSed, IBCLC
Last revision: February, 2, 2001
- La Leche League's, "The Breastfeeding Answer Book" (1997) by Nancy Mohrbacher, IBCLC and Julie Stock, BA, IBCLC
- "Guide for the Breastfeeding Mother" (1996) by Edie Armstrong, BSN, IBCLC
More info at other sites:
Color images of correct latch-on