Just because breastfeeding is natural doesn’t mean it’ll be second nature. Sometimes it takes time, practice and a whole lot of trial and error to get into a breastfeeding groove. So be patient and persistent. To help get there, snuggle baby skin-to-skin within the first hour after birth, says Natasha K. Sriraman, MD, MPH, FAAP, FABM, associate professor of pediatrics at Children’s Hospital of the King’s Daughter in Norfolk, Virginia. “This is true whether you give birth vaginally or via c-section.” Skin-to-skin contact stimulates your milk-producing hormone, which, in case you were wondering, is called prolactin. Plus, the smell, feel and warmth between you and your newborn encourages baby to initiate nursing more successfully, Sriraman says.
A healthy newborn’s instinct to breastfeed peaks about 20 to 30 minutes after he or she’s born, so you want to have baby right there next to you, ready to drink up your colostrum—that’s the nutrient-packed early milk you express after delivering. But being physically close to baby is important beyond those first few hours too. The American Academy of Pediatrics recommends that mom and baby share a room in the hospital, instead of having baby sleep in the hospital’s nursery. This makes nursing on demand easier for you; the more you breastfeed, the better it is for your milk supply.
While you’re in the hospital, take full advantage of the nurses and lactation consultants who can help you and baby perfect the latch and find breastfeeding latching positions that work best for you both. “Your baby’s latch depends on many factors, such as the size of your breasts and your own comfort level,” Sriraman says. “The goal is to have baby’s mouth wide open, chin dropped and touching your breast, tongue down, with her lips flanged—not puckered in—on the areola.” Luckily, you can achieve the ideal breastfeeding latch in many types of breastfeeding holds, so experiment and find the one or ones you like the most.
8 TYPES OF BREASTFEEDING POSITIONS TO TRY
There’s no right or wrong way to go about breastfeeding baby. Try one or all of these nursing positions, and remember that “the only right type of breastfeeding position is a comfortable one that works best for mom and baby,” Sriraman says. And keep in mind that what might work for you today can change down the road as baby grows and you both get more comfortable with the whole feeding thing.
“This is the position that most moms prefer because baby is draped across your body and you can easily see what he’s doing when latching,” says Stephanie Nguyen, RN, IBCLC, a board-certified lactation consultant in Scottsdale, Arizona. It’s also the easiest nursing-in-public position. To use the cross-cradle position, bring baby across your body, tummy to tummy, so if baby is nursing on your left side, you hold baby—supporting his neck—with your right arm and support the breast with your left hand. Lots of moms use a breastfeeding pillow when nursing in this position, since it can make it even easier and more comfortable. FYI: This is also a favorite position for bottle-feeding.
This nursing position is very similar to the cross-cradle, but in this one you support baby with the arm on the same side as the breast she’s feeding from, not the opposite arm. This position is also very popular during the first few weeks of nursing when you’re getting comfortable with your new job. Like with cross-cradle, a breastfeeding pillow can help lift baby and support your elbows.
Also sometimes called clutch hold, this position is often the first nursing position that moms learn. With the football hold, baby is tucked under your arm off to the side (yep like a football) and held with one arm while you support your breast with the other arm. If you’re holding baby on the right side, baby will latch onto your right breast while you support it with your left hand. “This position is great for c-section moms because there’s less rubbing on the incision,” Nguyen says. “It’s also good for moms who are struggling with a deep latch.” Like cross-cradle, a Boppy or other breastfeeding pillow can help you achieve this position more comfortably.
“Many moms and babies love the laid-back position because it’s so natural for baby and relaxing for mom,” Nguyen says. To do this one, you recline back about 45 degrees wherever you like to nurse—on the couch, in bed, on a recliner—and baby lies face down on top of your breast with his arms hugging your breast on both sides.
For this in-bed breastfeeding position, lie down on your side with baby facing you. (You can put a breastfeeding pillow or a roll-up towel behind baby to support her back.) Baby nurses from the breast that’s resting on the bed. “Some moms may find it easiest to latch the baby while sitting up and then slowly lie down until they get the hang of this position,” Nguyen says. This is another good position for moms who had a c-section or for moms who just want to rest their tired bodies while baby feeds.
To breastfeed in this position, sometimes called the upright football or koala hold, have baby sit upright, facing you and straddling your knee. You’ll support baby with the arm on the same side as baby is feeding and support your breast with the opposite hand, like in the football hold.
Double-cradle hold or double-football hold
Got twins? You’ve got a few options. The double-cradle position allows moms of multiples to nurse in tandem, often with a breastfeeding pillow under both babies. Each baby lays in the crook of each elbow, crisscrossing each other in your lap. With the double-football hold, your babies’ bodies rest on pillows along your sides and under your arms. (You can also hold one baby in a cradle and one in football.) “Simultaneous breastfeeding can be difficult and stressful though,” Sriraman says. “When you’re just starting out, try breastfeeding each baby separately before trying to attempt two at time.”
GOOD POSITIONS FOR BREASTFEEDING PROBLEMS
While the cross-cradle hold may be your first go-to nursing position, if baby is stuffy or spitting up, a new breastfeeding style might be in order. Here are several positions to consider if your breastfeeding situation changes:
Breastfeeding positions for reflux
For babies with reflux, upright or semi-upright positions are best, like the koala hold or laid-back position, since gravity will help with digestion, Sriraman says. “If baby is reluctant to nurse because of reflux, try standing or walking while breastfeeding,” Nguyen says. “The gentle movements can help calm baby and encourage eating.” It’s also important to keep baby upright for 15 to 20 minutes after a feeding, either holding him over your shoulder or upright in an infant carrier. “After a feeding, it’s best to avoid seats or swings that place baby at a 45-degree angle,” Nguyen says. “This position actually puts pressure on the esophageal sphincter, making reflux worse.”
Breastfeeding positions for gas
Positions that help babies who have reflux also work well when baby is gassy. “Because milk isn’t flowing downward with gravity into the baby’s mouth, she can control the milk flow better in this position, which helps avoid gas,” Nguyen says. If baby is experiencing a lot of painful gas, check on her latch. “If she’s gulping or taking in lots of air while nursing, she’s going to be gassy, no matter what position you feed in,” Nguyen says.
Breastfeeding positions for stuffy nose
Having a cold, complete with clogged nose, can get in the way of a successful nursing session. To help baby when he’s stuffed up, try nursing in an upright or laid-back position. “Have you ever noticed when you have a stuffy nose, it gets worse when you lie down? Same with babies,” Nguyen says. You can also try nursing in a steamy bathroom to help loosen congestion.
Breastfeeding positions for an overactive letdown
When you have an overactive letdown, your breast milk comes out rather forcefully and in large quantities, which can fill baby’s belly up too fast and lead to gas and spitting up. To help work against gravity, you can try the laid-back breastfeeding position. Plus, with this hold, it’s easier for baby to back off your breast and away from the milk stream when needed.
Breastfeeding positions for a difficult latch
If baby is having a hard time mastering the latch, try different positions to see what works. “Sometimes cross-cradle can be helpful because mom can see more of what is going on during the latching process, but many moms find that babies do well nursing skin-to-skin in a laid-back position,” Nguyen says.
SWITCHING SIDES WHILE BREASTFEEDING
Now that you’ve zeroed in on the breastfeeding positions that work for you and baby, you’ve got to learn how to do it on both sides. Use our guide:
How to make the switch
If baby doesn’t break his latch by himself, help by gently sliding your finger into the corner of his mouth, between his jaws. He’ll open his mouth, breaking suction and freeing your nipple. “Once baby has had a satisfactory nursing session on the first side, it’s a good idea to take a minute to burp him before offering the other side,” says Kathleen F. McCue, DNP, FNP-BC, IBCLC-RLC, a nurse practitioner and lactation consultant in Bethesda, Maryland.
When to change sides
“There’s no set amount of time that makes up a normal nursing session, but seeing active suck/swallow patterns from baby will let you know that she’s still receiving milk,” McCue says. Once that active pattern has stopped, you can move over to the second side. Most babies need to nurse from both sides to get enough milk. However, some babies will only need to eat from one side at a feeding. “Either option is normal as long as baby is gaining weight, producing both wet and poopy diapers, and doesn’t flat-out refuse breast number two,” McCue says.
What if one breast is preferred?
“Many women have one breast that has a faster flow of milk, which can make baby favor that side,” McCue says. Also, if you’re more comfortable with your newborn in, say, the cross-cradle, feeding from your left breast, baby may start to prefer that as well. “In most cases, there’s nothing that needs to be done about the preference. But if baby begins to refuse a side, you’ll need to focus on maintaining the milk supply in that breast via hand-expression or pumping, McCue says. You’ll also need to try gentle strategies to bring baby back to the other breast. One way is to offer your (full) neglected breast when baby is lightly sleeping or just waking up, or when she's in the sling and you're moving.
GET MORE BREASTFEEDING HELP
As we’ve said, breastfeeding isn’t a one-and-done process. It can take time for both you and baby to get adjusted, and problems can come up right from the start or any time along the way for that matter. Whether you’re dealing with sore nipples or having trouble finding a comfortable position, here are a few more helpful tips to get you over any challenges.
Find a support system
Looking for a local lactation consultant and/or breastfeeding-friendly pediatrician is a great place to start. “Mother-to-mother groups like La Leche League can provide excellent support for a new mom and help her feel more comfortable with normal breastfeeding behaviors,” McCue says. One thing to remember is that breastfeeding advice varies greatly, so if you aren’t getting the answers you need, don’t get defeated. Just move on and try getting another opinion.
Get a nursing pillow
“The Boppy—or any breastfeeding pillow—can be helpful when nursing in cross-cradle hold or football hold,” Nguyen says. A pillow supports baby and gives your tired arms a break. (When nursing in football hold, it’s actually best to turn the Boppy to your side.) Some brands like the Boppy Nursing Pillow or My Brest Friend pillow have a firm top and a strap that can secure the pillow around your waist. (Avoid a soft sleeping or sofa pillow which can put baby at risk of suffocation.)
Use a nipple cream
A poor latch is often to blame for many a sore nipple, so to truly fix the problem, you’ll want to start by working on that latch. But to soothe already-sore nipples, try a pure lanolin product, like Lansinoh. It’s safe to be in baby’s mouth (key) and contains no allergens or additives, so it’s safe for your skin too.
Try a nipple shield
These flexible silicone covers fit over the nipple and areola and can help baby if he or she is having trouble latching. To work effectively, nipple shields need to be sized properly for both your nipple as well as baby’s mouth, and they need to be attached so they draw in a lot of your breast. Since baby may get less milk if the shields are used incorrectly it’s best to talk with an International Board Certified Lactation Consultant (IBCLC), so she can help get you set up and make sure you’re using them the right way.
Experts: Natasha K. Sriraman, MD, MPH, FAAP, FABM, associate professor of pediatrics at Children’s Hospital of the King’s Daughter in Norfolk, Virginia; Stephanie Nguyen, RN, IBCLC, a board-certified lactation consultant and founder of Modern Milk, a breastfeeding clinic and prenatal/postnatal education center in Scottsdale, Arizona; Kathleen F. McCue, DNP, FNP-BC, IBCLC-RLC, nurse practitioner and lactation consultant, owner of Metropolitan Breastfeeding in Bethesda, Maryland.