The art of breastfeeding (Part 2)

Last month, I wrote an article about breastfeeding and how it is not as easy as we may be thinking. I forgot to mention the fact that when babies are kept skin to skin in the first hour after birth, most healthy babies demonstrate instinctive behaviors.

They slowly push their way up to the breast, open their mouths, drop their tongues, and latch on the nipple on their own or with just a little guidance. I have mentioned some breastfeeding positions. In this follow up article, I am going to explain each one of them briefly and when they can be used.

The illustration for this can be found in the above picture while more visual details can be easily looked up online.

Let’s start with the cradle hold, which is the classic breastfeeding position most of us picture when we think about breastfeeding. The mother needs to sit upright, preferably in a chair with armrests.

The baby is positioned on his side, the head and neck lying along the mother’s forearm and the baby’s body against the mother’s stomach.

Although this position is the most common, it is not always comfortable with a newborn because it doesn’t give the baby as much support as some other holds. 

The cross-cradle hold is ideal for newborns, suitable for small babies and those with latching difficulties. Like the cradle hold, the mother sits upright in a comfortable chair with armrests. Then she brings the baby across the front of her body, tummy to tummy, and holds the baby in the crook of the arm opposite the breast she is feeding on (left arm for right breast, right arm for left breast).

The open hand supports the baby’s head, while the other hand supports the breast from the underside. The mother has more control over the baby’s positioning.  

Another breastfeeding position is the clutch or rugby ball (or football if you’re from the USA) hold. This position is another helpful early breastfeeding position. It supports the baby well and gives the mother plenty of control and a good view of the baby’s face. It might be the right choice for a mother recovering from a Cesarean section or for mothers with large breasts as well.

The baby is positioned at the mother’s side, with the baby’s body and feet tucked under the mother’s arm, and with that same arm’s hand, the baby’s head is held and faced toward the mother’s breast.

The baby’s back rests on the mother’s forearm. The other hand supports the breast. This hold is used for breastfeeding twins too. For this hold, use a chair with broad, low arms. 

The side-lying hold may be another preferred choice for a mother who had a Cesarean section or is tired but able to stay awake throughout the feed. This position is ideal for relaxed night feeds and breastfeeding in bed or on the sofa.

The mother and baby lie on the side next to one another, belly to belly. The mother faces her baby toward her breast while supporting it with one hand. The other hand supports the breast. Once the baby latches on, the mother uses one arm to support her head and the other to help support the baby and bring him or her close. 

The upright or koala hold is a convenient way to breastfeed an older baby who can sit unaided but can also be used with a newborn if given plenty of support. It is often the most comfortable breastfeeding position for babies who suffer from reflux or ear infections, and it can work for babies with a low muscle tone.

The baby sits on the mother’s lap, with his spine and head upright as he feeds. The mother supports the baby with the arm on the side the baby is feeding on. The opposite hand supports the breast.  

With any breastfeeding position or hold, both the mother and baby need to be comfortable. The mother does not bend over or lean forward to reach the baby. Bring the baby close to the breast instead.

Also, check if your baby’s head, shoulders, and hips are in line, not twisted or turned. The baby is directly facing the breast with feet, bottom, and shoulders pulled in close. The baby’s head is free to tilt back a bit, and he/she comes to the breast chin first. For extra support, in any breastfeeding position, use a pillow or a blanket under your arm as needed. 

Encourage your baby to feed at least eight to ten times in 24 hours. If your baby is too sleepy, you need to wake him up so that he does not go hungry. It is advised that babies breastfeed at least every three hours.

Newborns can feed for up to 20 minutes on each breast. As babies grow old, they become more efficient and may take five to ten minutes on each breast. Also note that the more you breastfeed, the more breastmilk you will produce.

In the first few weeks after delivery, you may feel that you are doing nothing but feeding, but things will settle down as your baby grows, and your milk production adjusts.

Remember that the cross-cradle and the clutch holds are great during the first few weeks of breastfeeding.

The cradle and the side-lying positions are more effective a few weeks after birth when both you and your baby are more experienced breastfeeders.

The writer is a Rwandan medical doctor.

The views expressed in this  article are of the author.

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