What is the best position to breastfeed? This is one of the most common doubts among first-time mothers. When the World Breastfeeding Week begins, experts believe that it is not a matter of correct or incorrect postures to hold the baby, but of prioritizing comfort to achieve the relaxation of the mother and favor the production of breast milk.
To facilitate successful breastfeeding, there are multiple possibilities that adapt to specific situations of the mother: difficulties with the baby’s grip, premature or cesarean deliveries, mastitis, babies with reflux, ear infections or twin births.
With the aim of the World Maternal Breastfeeding Week, which is celebrated until August 7, some of the preferred positions of mothers are collected at the time of breastfeeding and highlights the main considerations of experts in this field so that breastfeeding is satisfactory and fruitful.
According to the National Health Survey of 2017, in the last 20 years there has been an increase in breastfeeding, both in frequency and in duration. At 6 months almost 40% of the women continue with exclusive breastfeeding.
The WHO and the Spanish Association of Pediatrics recommend maintaining breastfeeding until 2 years, being exclusive during the first six months, and including a complementary feeding thereafter.
The comfort first
There is no right or wrong position to hold and feed the baby. This is highlighted by the company specializing in breastfeeding Medela, who insists that what should prevail is the comfort of the mother and baby during the lactation session.
In this line, the neonatologist of the Hospital Nuestra Señora del Rosario, Dr. Leticia Ruiz, states that, “although there are many positions for breastfeeding, the most important thing is that both the mother and the child are comfortable.”
According to the specialist, comfort is given by two things: first, the mother must have her back reclined and her feet supported, and second, the child has to keep the cervicals aligned with the back.
Although any position is adequate, the neonatologist recommends adapting to situations. For example, in the first week of postpartum, the lower abdomen may be more painful (especially after cesarean section) and recommends using a pillow or a breastfeeding cushion to elevate the baby.
“You also have to change positions as the baby is gaining weight and height.” However, according to Dr. Ruiz, generally the preferred position among mothers is sitting, sticking abdomen with abdomen and the baby held in arms.
It has been proven that the skin-to-skin contact of the baby with the mother causes an increase in the levels of oxytocin , a hormone that participates in the release of breast milk. Stress hinders the production of oxytocin, so the comfort and relaxation of mothers are essential to promote the flow of milk.
1. Lying position recumbent or lying down
It is the position of biological lactation and is usually the first choice of mothers, as confirmed by Leticia Ruiz. To be more relaxed and able to see the baby, the mother can use pillows and cushions. In this way, you can remain reclining instead of lying down.
It is very useful if the mother has a milk drop or large breasts, or if the baby does not like to touch his head while feeding. In addition, skin-to-skin contact stimulates the baby’s feeding instincts and gravity allows him to hold on well. It is the usual position immediately after giving birth , because if the mother places the baby on his gut, he will crawl instinctively until he clings to his chest.
2. Cradle position
The classic position and the most popular, although it does not always provide as much support to the baby as the rest of postures. The mother sits upright and the baby has the head and neck placed on the forearm of the mother and the body in the stomach.
If the mother is placed a cushion on the shoulders or back will avoid tensions, and if you choose to use a breastfeeding cushion should take into account that their breasts must be at the height of the baby to avoid being too high and eliminate the sore nipples and tight grip.
3. Cross cradle position
This position is similar to the previous one, but in this case the baby rests on the opposite forearm. It is very useful if there are difficulties with the grip of the baby, because the mother has more control over its placement and can use the free hand to hold the baby at neck height and tilt the head.
The grip is one of the most important aspects for a good start that facilitates a satisfactory breastfeeding, since a poor grip influences the development of the baby and can damage the nipples and cause pain. For a good grip, the mother should direct the nipple towards the baby’s palate.
This position is highly recommended for newborn babies , although it is important to keep in mind that during the first days the mother should not hold the baby. Tilting the baby’s chin against the chest causes a superficial grip that could cause sore nipples. Begins to be appropriate when the baby is bigger.
4. Rugby ball position
Also known as auxiliary or coupling position. The mother is seated and the baby is lying on his side, resting on his forearm and with his feet towards the backrest. E l body of the baby’s back and head remains centered on the midline of the abdomen of the mother.
It is one of the preferred options for mothers of premature babies , twins or those mothers who have given birth by cesarean, because they do not support the baby on the wound. It offers security to the baby and the mother because both look at each other, which in turn serves to reinforce the maternal-filial bond.
5. Double rugby ball position
In the case of twins, it is common for mothers to need help to place the second baby when the first one is already hooked. It is ideal for twins, and is similar to the previous position but needs a double breastfeeding pillow. This supplement provides extra support so that the mother can breastfeed both babies at the same time while keeping her hands relatively free and without putting pressure on her gut (fundamental after caesarean section).
However, it is important to bear in mind that “normally, all babies have a predilection for one of the two breasts for a postural issue,” explains the neonatologist. With the twins, this position is recommended if it is possible to hook the two babies at once, but if one is very nervous or has low weight, it will be preferable to feed him first.
6. Position lying on its side
The mother and the baby are lying next to each other, belly to belly. It is ideal for nocturnal shots, for mothers who have stitches of caesarean section and can facilitate breastfeeding to babies with short frenulum or ankyloglossia.
Dr. Leticia Ruiz emphasizes that the mother must be aware of the risk of crushing that exists in this position in the event that the mother falls asleep, or the fact that the baby falls asleep and stops sucking.
7. Position lying down after caesarean section
It is complementary to the previous one. The mother is lying down and has the baby’s body on her shoulder. In this position it is avoided to support the weight of the baby on the wound.
8. Koala position
The baby is sitting astride the mother’s thighs or hips. Both your head and your spine should be kept vertical during the lactation session.
It is usually the most comfortable position for babies who have reflux or have ear infections. It is also beneficial for babies with ankyloglossia or low muscle tone.
9. P osition on all fours
It is very useful in cases of mastitis , although it may not be the most comfortable position and it is advisable to resort to it only for short periods of time. The baby is lying down and the mother crouches down, leaving the nipple suspended over her mouth.
10. With baby carriers
The mother should see the face of the baby and check that her chin is not pressed against her breast, so it is best when the infant is able to hold the head by itself.
It is very practical to breastfeed outside the home, if the baby does not like to be knocked over or fed frequently.
11. Ballerina hand position
It is especially indicated for babies with a low muscle tone, such as those born prematurely, with Down syndrome, or those who have difficulty keeping their hands. This position offers great support and allows the mother to see how the baby is positioned.
The mother should hold the breast underneath with her hand with three U-shaped fingers, and grasp the baby’s jaw with the thumb and forefinger on her cheeks.
Before beginning the feeding, the mother should make sure that she has everything necessary at her disposal (drink, a snack, etc.) and be comfortable. The shot will be finished when the baby has ingested enough, that is, when he stops sucking. According to the neonatologist, he will get angry and let go, or he will fall asleep.
A posture that is contraindicated if you breastfeed is for children to sleep on their stomachs. “This position is associated with the sudden death of the infant , and the mother must be alert in case the baby turns around when the shot is finished,” says Dr. Ruiz.
If the grip is not correct, the main symptom is pain. “The first days, the coupling produces pain, but the discomforts disappear with the suction,” says the doctor of the Hospital Nuestra Señora del Rosario. If the pain remains, it can cause pain, cracks or wounds.
Poor grip influences the development of the baby and can damage the nipples and cause pain
Breastfeeding is on demand , and the frequency and duration of feeding is very variable. The main question for mothers who breastfeed is that they do not know what the baby is eating. To relieve first-time mothers, Leticia Ruiz recommends frequent hooking of the baby, which in turn stimulates milk production.
It must be remembered that breastfeeding has important benefits. The most immediate for the mother are: the return to the basal situation of the uterus, the recovery of a normal weight, the maternal-filial psychological bond and the prevention of uterine and breast cancer .