NOTES FOR POSITIONING & LATCHING BREAK-OUT GROUPS

Introduction Introduce yourself # of kids and your breastfeeding experience Explain that breastfeeding is an ACQUIRED skill and not instinctual for the mother. Mothers need to know that breastfeeding is natural but mastery comes from practice.

Positioning Positioning is how mothers hold the baby when breastfeeding Mothers will be breastfeeding every 2 to 3 hours in the first weeks of life It is important that mother and the baby be comfortable at ALL times

Positioning The preferred method of teaching is to demonstrate with a doll what they should do Then ask them to repeat with their own baby We want to avoid touching the mother’s breasts during the instruction

Positioning For all breastfeeding positions: Breast must be easy to get to Mother needs to be comfortable Back straight & arms supported (use pillows under your elbow and at your back) Knees level with hips when sitting (footstool or directories to elevate your feet) Remove extra clothing (for more skin-to-skin contact)

Positioning Remind mothers to bring baby to breast instead of breast to baby (“Mohammed to the mountain and not the mountain to Mohammed”) If you bring breast to baby, you end up being hunched over & your back will be sore Baby’s head, chest & knees face same direction (do the drinking water demo)

Positioning 4 common positions Cradle Hold (traditional) Cross-Cradle Hold (transitional) Clutch Hold (football) Side-lying Hold

Cradle Hold Breastfeeding position used most often. The head is supported in mother’s elbow. Make them do it and show them where mothers might get stiff (shoulder etc)

Cross-Cradle Hold Helpful in early weeks of breastfeeding Note - Helpful that you wear the breast bikini when demonstrating this hold Helpful in early weeks of breastfeeding When baby’s neck needs more support When breast needs more support “Joystick – more manueverability” Move to cradle hold after baby has latched on

Clutch Hold (football) Good choice: after c-section premature infants mothers with large breasts most newborns Twins/ tandem nursing Mothers can see baby’s mouth open wide & help them latch

Side-lying Hold When mothers want to rest Avoid breastfeeding in waterbeds or with fluffy blankets/comforters Use lots of pillows Can start in cradle hold at side of bed & slowly lower yourself & baby to a lying down position SHOW how to transition from one side to other

Latch-On Way the baby attaches to the breast Correct latch-on is important to: Make sure baby gets enough milk Avoid sore nipples Get the breast to make more milk NOTE: Wear your breast bikinis to show how to latch. Though the steps we are about to explain seem long, it actually happens fast

Steps to a Successful Latch “Ridge” the breast (sandwich) Bring baby’s nose toward nipple Tummy to tummy, chin to chest, nipple to nose Lower lip touches breast first Mouth takes in the underside of the areola & breast “Breastfeeding” not “Nipple feeding” At least 1 inch radius of the areola should be in baby’s mouth Fix latch, if needed

Steps to a Successful Latch Remind them that nipples do not need to be cleaned before a feed. Teach how to unlatch correctly. Do hand over nose demo to show you cannot suffocate & say that babies will not choose food over air.

Latch-On After demonstrating/teaching the latch, the best position when observing the mother repeat what you taught is to stand behind them This way, you have the same viewpoint as the mother and you can see what they see

Signs of a Good Latch Lack of constant pain Lips curled outward Mother is relaxed Chin touching the breast Cheeks rounded Nipple may come out longer, not pinched or discolored Lips curled outward Lower lip should not be pursed inward Nostrils barely touch breast but nose rests on breast Baby’s swallows can be heard BUT sucking should not be heard Breasts are softer & feel lighter after feeding

A Good Latch END OF NOTES ©B. Wilson-Clay/Kay Hoover, The Breastfeeding Atlas, used with permission.