What is important when latching and positioning your baby?
Successful breastfeeding depends on two key elements namely how the baby latches on your breast and the position of your baby. Breastfeeding is easier when you as the mother answer the baby’s request instead of waiting for the baby’s demands.
Your baby needs to be calm when you feed, start the feed before your baby starts to cry. A crying baby struggles to latch and makes chopping movements instead of sucking movements on the breast.
Finding a comfortable position to feed in, and good back support is essential. The position you choose to feed in must also be comfortable for your baby.
Familiarize yourself with the feeding cues of a baby. This will help you to understand when it is time to feed your baby.
The early feeding cues are:
Rooting: your baby will turn the face towards the breast when you stroke the baby’s cheek
Eye movements: the eyes will start to move even if the baby is still asleep
Hand-to-mouth movements: the baby will suck on his/her hand or try to suck on something touching the mouth
Hunger builds up: tongue and licking movements will be visible
More obvious feeding cues are:
Rooting to mother’s chest, whimpering or squeaking
The baby’s mouth and body tense and the baby starts to breath faster as the hungry builds up
Crying is a late sign of hungry, calm baby down first before attempting to feed your baby
The following are very important when holding your baby to feed:
Unwrap your baby and if your baby is fussy during a feed you can also undress your baby. Remember that your body temperature can rise or fall according to your baby’s needs so your body will keep your baby warm.
The baby’s ear, shoulder and hip must be in a straight line and when you take your baby to the breast allows the baby’s head to tilt slightly back like sniffing the air. You can compare this to when you drink out of a glass, you face forward and tilt your head slightly when you take a sip out of the glass.
Your nipple must be above the baby’s top lip, nipple to the nose.
The baby’s tongue must be down, the mouth wide open and the lips curl out and the chin touches the breast first and sinks into the mother’s breast. You can compare this with what your mouth will do if you take a deep bite out of an apple.
The more breast on the tongue, the more milk can be removed. The tongue is making movements almost like waves and pressing the breast against the hard palate.
When holding your baby, place the heel of your hand on the baby's shoulder blades, supporting the baby’s neck and fingers, not above the baby's ears.
Steps to remember:
Open: the mouth must be wide open and the tongue must be down
Angle: the baby’s nose to nipple, the head slightly tilted back, chin first to
the breast, shoulders and hips pulled in close to the mother’s body
Oomph: push on the baby’s shoulders to latch on
What to avoid:
There are however a few things to avoid when latching your baby.
Avoid holding your hand at the back of your baby’s head. If you put your hand on the back of your baby’s head, your baby will tend to pull back from the breast.
Avoid your baby’s feet to push against hard surfaces
Avoid leaving open spaces between mother and baby
Let us have a look into a few more important things for feeding your baby before we discuss the different positions you can feed your baby in.
The first feed must be as soon as possible after the baby is born and remember about the skin-skin.
Frequent unrestricted feeds; in the beginning, the baby may feed 8 - 10 times in 24 hours. This will prevent the breast from getting engorged, stimulate your milk production and lower the risk of low blood sugar levels, baby jaundice and dehydration in your baby.
Nurse often and long enough to establish a good flow of milk, do not rush the feed. A letdown can be described as a tingly feeling in the breast and you can experience 9 letdowns in one feed. It is also possible that you will not feel the letdowns, especially later in your breastfeeding journey. Do not watch the clock and let your baby guide you and will stop drinking when they have enough. Babies do not drink at the same pace, some will drink slower than others. You can compare it to adults eating, some will finish a plate of food quicker than others around the table.
Your baby will take in different volumes at each feed and also different amounts of feeds per day and sometimes feeds will be close together and sometimes long intervals apart. You can compare it to your eating pattern, some days you eat small amounts far apart and on another day you will eat constantly. Your baby will do the same.
Learn the difference between nutritional and non-nutritional sucking. With nutritional sucking, you will see that the face muscles in front of the baby’s ears are moving, see jaw movements and hear/see the baby swallowing. Your breast will also make small movements. Non-nutritional sucking the baby is using your breast as a soother and small chopping movements will be felt.
Hold your breast in a supportive “C” grasp, you may lift the breast slightly.
Stimulate the rooting reflex by stroking the baby's cheek with your nipple and above the top lip. This will ensure that the baby will open his/her mouth wide. When the mouth is wide open, place nipples and areola on the tongue. Make sure that the baby makes a deep latch (edge of the nipple almost up to where the hard and soft palate of the baby meets).
Lips need to be turned out and the baby needs to draw the nipple and areola into the mouth and form a good seal around the breast, with no open spaces.
You need to feel rhythmic up and down pressure of the baby’s tongue.
Break the suction before you take the baby off the breast if you need to. Put your small finger in the corner of the baby’s lips. Your nipple will get damaged if you remove the baby from the breast without breaking the suction.
Let's look closer at the positions in which you can feed your baby. You as mom and baby need to find a position which is working and comfortable for you, so each mom and baby will be different. Keep all the information mentioned above in mind when you are latching your baby.
Cradle position:
Your baby’s head rests on your arm at the bend of your elbow. Some mothers find that they do not have the control over the baby they would like to have. With this position, you will feed on the breast on the same side on which arm the baby’s head is; for example, right arm, right breast.
Cross cradle position:
With this position you support your breast with the hand on the same side; for example, left breast left hand. You use the opposite hand to hold your baby. Open your hand and let your baby’s shoulder and neck rest on the hand palm. Your forearm will support the baby’s back. Cross the baby over in front of your body. I can describe it as follows as example; support your left breast and hold your baby with your right hand and arm and bring your baby to the left breast. You will have a better view of your baby and the breast.
Side-lying position:
You will lie on your side with your back and head support. You can also put a pillow also between your legs from the knees down to the ankles. The baby lay flat on the bed and also on his/her side, keeping in mind everything for latching. You can support the baby’s back with a rolled-up receiving blanket. You can rest and even fall asleep when feeding in this position. Your baby will come off the breast if you do fall asleep.
Football position:
This is a nice position to use if you had a cesarean section and do not want the baby across your lap. The baby’s neck and shoulder will rest on your hand and the body supported by your forearm like with a cross-cradle hold. The baby is at your side. The baby’s tummy must still be turned towards the mother’s body, tummy against mommy.
Laid back position:
You will lean back, not totally flat, but comfortably leaning back so that when you put your baby on your chest, gravity will keep your baby in position with his body on yours. Support your head and shoulders. The baby’s whole front touches your whole front. This position is recommended if you have a strong letdown and milk flow.
You can try the different positions during the pregnancy and get familiar with how to hold a baby, you can use a doll or even a soft toy.
For more information on breastfeeding preparation classes or a breastfeeding consultation contact Sr Elna 072 124 7455.
REFERENCES:
Breastfeeding and Human Lactation; Jan Riordan and Karen Wambach;
Breastfeeding Made Simple; Nancy Mohrbacher and Kathleen Kendall-Tackett
Born to breastfeed, born to be breastfed; Hettie Grove
Borsvoed jou baba; Marie-Louise Steyn
Hold your baby; Jill Bergman
The womanly art of breastfeeding; Diane Wiessinger, Diana West, Teresa Pitman