Wednesday, October 23, 2013

Breastfeeding Secrets Revealed: Position, Hold and Proper Latch

     New moms have told me that they wish they had been given more information on positioning and latch as well as the various holds associated with breastfeeding.  So I have decided to reveal these breastfeeding "secrets" here. 
1.  What is the secret to preparing for breastfeeding?
Holding the breast properly!  The c-hold is the proper way to support the breast when learning to breastfeed and should be practiced by expectant and new mothers because almost every new mom does it incorrectly.  How?  Moms tend to place the thumb on top (correct) but place the bottom fingers in the wrong place.  The bottom fingers need to be near the chest wall.  The index finger usually ends up on the bottom of the areola preventing baby from getting a deep latch.  Whether you are already breastfeeding or still expecting, check your c-hold in a mirror to make sure your fingers are out of the way. Also make sure the flap of your nursing bra is not in the way.  Remember, a new baby cannot support the weight of their own head, let alone your breast so support your breast properly and without hindering the latch.  If you are expectant mom, it is not proper to prepare for breastfeeding by toughening nipples, an antiquated practice that breaks down the keratin layer of the skin and is not helpful.  It is helpful to test nipples for inversion by placing the fingers 1" behind the nipple and gently pinching to see if the nipple inverts, goes flat or protrudes normally.  If it does not, consider using a breast pump to draw out nipples just prior to feeding.  A nipple shield is a last resort as it can cause a decrease in milk supply.
2.  What is the secret of a good latch? 
We will discuss proper body position in a few moments, but here are the basics of a good deep latch.
          1.  Support the breast in the c-hold discussed earlier.
          2.  Line the baby's nose up with your nipple.
          3.  Use your nipple to tickle the baby's lower lip in a downward motion to elicit the open mouth reflex.
          4.  Wait for a yawn or cry-wide mouth.
          5.  Swoop the baby's entire body towards you.
          6.  Bring the baby's bottom in closer to you.  This will dig in the chin and tilt the head slightly.
          7.  Support the breast for a newborn the entire feeding, but don't forget to relax your shoulders and make sure you have support for your arm as newborns can take 45 minutes to get in 20 minutes of swallowing.


3.  What position is the best to learn to breastfeed? 
The cross-cradle hold gives you the most control, but depending on whether you had a c-section, the football hold may be best for you.  We will address the football hold a little later.  In a proper cross-cradle hold you will hold the baby at the nape of the neck with the hand opposite the breast you are using.  Use a proper c-hold on the breast.  Sit back in the chair, put your feet up on a stationary footrest.  This brings your knees above your hips helping to keep you from the temptation of bringing the breast to the baby.  Always bring the baby to the breast.  Otherwise you end up with a sore back from improperly leaning into the baby.  Latching on in the cross-cradle or any position should be done in a one (1) two (2) motion.  Practice the proper latch techniques previously discussed. 1. Swoop the baby in as soon as you see a yawn or cry-wide mouth.  2.  Pull your elbow towards your ribs bringing the baby's bottom with it.  This draws the baby's bottom close helping him dig in his chin and tilt his head back keeping you from the temptation of pushing the breast tissue away with your thumb.  You shouldn't push down with your thumb as it raises the nipple toward the roof of his mouth causing nipple irritation.  When using a pillow, remember that it is there to support you while supporting the baby.  It is not meant to support the baby without your help, but a nursing pillow is an effective tool to keep mom in the proper position and save her from backache. 


4.  What is the secret to a good football hold? 
Much like the cross cradle hold, mom holds the nape of the baby's neck with her hand, but this time, the same hand on the same side as the breast she is using. Use the c-hold and ensure that the bottom fingers are well below the areola.  Support the breast with your hand or a rolled up burp rag during the entire feeding for a newborn who cannot support the weight of his own head.  Remember that your hand should be on the nape of the neck and not higher on the head for several reasons. One being that baby's tend to arch their back when you touch the top of their head. Sit back in the chair, put your feet up and have a pillow on that side of your lap for support. Your baby should be tucked under your arm like a football. His legs should be in a fetal position or and older baby might have them raised up resting his bottom and legs on the back of the chair. done in a one (1) two (2) motion. Practice the proper latch techniques and the swoop and tuck motion previously discussed.   Nursing pillows are essential in this position unless you have a very wide soft armrest on your chair.


5.  What is the secret to when the cradle hold should be used?
It is best to use the cross-cradle hold instead of the cradle hold when you are first learning to breastfeed because you have more control over the position of the baby's head with your hand than you do in the crook of the elbow.  But many moms are very comfortable in this position so moving to this position after the initial latch on as long as you support the breast for the newborn with a rolled up burp cloth is easy to accomplish.  Or once the baby has more control over his head or you are a smaller busted mom, you can use the cradle hold comfortably.  Just remember the latch positioning discussed previously.  Baby's nose should be on target with the nipple.  He should be tummy to tummy with mom.  His ears, shoulders and hips should be in a straight line as it is hard to swallow with your head turned.  Also remember to bring baby to the breast and not the other way around and to relax your shoulders and use something to support your arm.
6.  Do I need to learn to nurse lying down?
Is it important to learn the side-lying position?  In a word, YES!  The side lying position can be the answer for a stressed sleep-deprived mom or a mom who wants to increase her milk supply!  The proper technique for the side lying position is to have a pillow or two under your head and a pillow between your knees to stabilize your hips.  Baby's nose is on target with the nipple and the baby is drawn close with moms arm that is under her.  The bicep of this arm is partially used to support the breast for a larger busted mom as well.  Remember in all holds baby is tummy to tummy with you and not lying on his back with his head turned trying to swallow.  The side-lying position is perfect for co-sleeping at night or catching a nap with baby.  Taking your baby to bed with you if you perceive a dip in milk supply is a great way to get a boost as well.  If you are uncomfortable keeping the baby in bed with you all night, you can still hear the early feeding cues and nurse lying down with a co-sleeper bassinet that keeps baby within arm's reach.
     Breastfeeding should not hurt!  If you have had previous trauma and are correcting an improper latch, there can be discomfort for the first 30-60 seconds, but then it should subside.  If it does not, break the suction by inserting a clean finger passed the gums and turning.  Then start the latch again from the beginning.  Don't let your toes curl and your teeth clench because you are a good mama.  The milk sinuses where the milk pools are located approximately one inch behind the nipple and not on the nipple for a reason.  The nerve ending are on the nipple.  Pain is telling you that your latch is incorrect.  Once the baby is in proper position with a deep latch, he will get more milk and you will have a more comfortable rewarding breastfeeding experience. 
     For more answers to breastfeeding questions visit our breastfeeding tips page or give us a call at 254-728-3627 9-5 M-F CST.