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Breastfeeding: The Basics of Positioning

Specific Nursing Positions
You can choose from several popular breastfeeding positions and will probably find that certain ones work better under certain circumstances. Because the maximum pressure on the nipple and areola is different for each position, varying the position you use can help prevent nipple soreness. Make an effort to learn at least two positions before you leave the hospital.

Cradle Hold
The traditional nursing position used most often and depicted in historical artwork is known as the cradle hold. The baby is supported with your arm beneath her back and with her head resting in the crook of your elbow or on your forearm. Your hand can cup the baby's bottom or thigh, and you may be able to hold her uppermost arm against her body using your thumb. With your upper arm held against your side, rotate your forearm so your baby's whole body turns toward you. A common error is to lay the baby on her back and stimulate her cheek with your nipple so her head will turn toward the breast. This technique is highly unsuitable-you wouldn't want to drink with your head turned to one side! Instead, your baby should be rotated to face your breast so that the two of you are chest-to-chest. Her mouth should be lined up with your nipple so she can attach readily. Your baby's lower arm can be tucked around your waist or under your breast.

Cross-Cradle Hold. The cross-cradle hold is similar to the cradle hold, except your arms are switched in their roles. With the cross-cradle hold, the baby is supported by the arm and hand opposite the breast being used, while the breast is supported by the hand on the same side. This position gives the mother more control of the baby's head, which rests between her thumb and fingers instead of on her arm. Rotate your baby's body on your arm so her chest and tummy are facing you. The cross-cradle hold is an excellent position for babies having trouble latching on and for small babies. Your hand supporting the baby's head can quickly guide the infant to your breast.

Football Hold
The football hold, also known as the clutch hold, is used to position the baby to nurse on the same side as the supporting arm. The position is a popular choice for mothers who have had a cesarean birth, as it keeps the baby's weight off the mother's incision. Begin by sitting your baby up at your side, facing you with her head near your breast. Tuck her body under your arm against your side, like a football, with her feet pointing toward your back. If you are seated in a chair, the baby's body can be flexed at the hips, with her bottom at the back of the chair and her legs pointed up. Her shoulders, neck, and head are supported by your hand and fingers, while her upper back rests against your forearm. Typically a pillow is placed beneath the arm supporting the baby to elevate her to the level of the breast and to provide comfortable support for the mother's elbow. The football hold is another popular position for small babies or those having trouble latching on. It also works well for women with large breasts or flat nipples. The position allows a mother to see her nipple and the baby's mouth and to control the baby's head. It is important not to apply too much pressure to the baby's head, however, as this can cause the infant to arch her head against your hand.

Reclining Position
It is not necessary to get into a sitting position in order to nurse your baby. Women who have a cesarean birth often prefer to nurse while lying down to avoid pressure against their incision. Other women may not feel well enough to sit upright for long. At home, you may want to nurse your baby while lying in bed at night or while napping during the day. To nurse while lying down, roll onto one side and have a helper place several pillows against your back. You'll probably want a pillow under your head, and some women like to have a pillow placed between their knees. Try to keep your back and hips in a straight line. Place your lower arm around your baby and draw her close to you so that your bodies are touching. Your baby should be on her side facing your breast, with her mouth lined up with the nipple. Use your opposite hand to support your breast.

It is actually possible to nurse from either breast in the reclining position without turning over. Place the baby on the bed next to you to nurse from the lower breast. Or, elevate the baby on a pillow to bring him to the level of the upper breast. You will want to have several other pillows handy to help you get into optimal position. Placing a pillow against the baby's back will keep him from rolling over if you want to remove your lower arm and put it under your head.

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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