Breastfeeding: The Basics of Positioning
The first breastfeeding may occur while you're reclining or sitting in your hospital bed or sitting in a chair in your room. The reclining position will be discussed a little later. If you sit up in bed, elevate the head of your bed as much as possible. You will probably need to tuck some pillows behind you to keep your back straight. If you sit up in a chair, select one with ample back and arm support and an appropriate height. It shouldn't be so low that your knees point up nor so high that your feet can't reach the ground. If necessary, tuck one or more pillows behind your back to help you sit upright. A rocker sounds enticing but it's preferable not to have movement while you and your baby are learning.
A pillow placed on your lap will help elevate your baby to the level of your breast. If no pillow is available, crossing your leg on the side you are nursing will bring your baby closer to your breast. A lap pillow is essential for women who deliver by C-section to keep the baby's weight from pressing against their incision. A footstool beneath your feet will also decrease the distance between your lap and your breast and make your back more comfortable. These simple measures can reduce neck, shoulder, and back strain. Some women purchase and use a special nursing pillow to make breastfeeding more comfortable and may even bring their pillow on outings.
Sitting upright is important, both for your comfort and to help your baby attach to your breast correctly. Leaning forward or backward changes the position of your breasts in relation to the baby and makes it more difficult for your baby to grasp the breast correctly. When you breastfeed, you always want to bring the baby to your breast, not your breast to the baby. When your breast has to be pulled to reach your baby, it is more easily dislodged from the infant's mouth during feeding. If your breasts are very large, you may want to roll up a diaper or receiving blanket and put it under your breast to elevate it.
Positioning Your Baby
No matter which breastfeeding position you use, a few basic principles apply. Your baby should be well supported throughout the feeding to help her relax and to provide her with a sense of security. You can use pillows, cushions, or your arm to maintain good support for her head, neck, shoulders, back, and bottom. Your baby's head, neck, back, and hips should remain in alignment. Her body should not be flexed or curved when positioning her to feed. When first learning to nurse, you'll want to keep her hands out of the way so they don't wind up in her mouth or next to your nipple. You can do this by swaddling your baby in a blanket. Or, you may be able to hold her arms against her body as you position her to nurse.
Supporting Your Breast
During pregnancy, most women experience remarkable breast enlargement as a result of the development of the milk glands and ducts. When abundant milk production begins, the breasts get even heavier. A newborn infant can't be expected to keep the breast correctly positioned in her mouth during nursing unless you support your heavy breast from beneath. Use the hand opposite from your arm that is supporting the baby to cup your breast so you can present the nipple to your baby. Place four fingers underneath your breast and your thumb on top-the C-hold-to gently support your breast. The placement of your fingers on your breast is very important. They should be well behind the areola, far back from the nipple, so that they don't get in the way of the baby's mouth. Some women successfully use a "scissor" hold, or V-hold, to support the breast between their index and middle fingers. However, it is difficult with this hold to splay the fingers far enough apart to keep them behind the areola. The C-hold not only provides better breast support, but it makes it easier for the baby to grasp sufficient breast without impediment. Eventually, most babies learn to breastfeed without requiring the breast to be supported throughout the feeding. In the beginning, however, breast support will be a big help to your baby.
From Dr. Mom's Guide to Breastfeeding by Marianne R. Neifert. Copyright © 1998 by Marianne R. Neifert. Used by arrangement with Plume, a member of Penguin Group (USA) Inc.
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