1. In The name of God

2. Breastfeeding Positions Dr Farideh Akhlaghi Associate Professor of Obstetrics&Gynecology

3. Breastfeeding Positions Mother comfortable Infant head in straight line with body Tummy-to-tummy or chest-to-chest Copyright © 2003, Rev 2005 American Academy of Pediatrics Photo © Ruth A. Lawrence, MD, FAAP

4. Latch Stimulate rooting reflex. Take sufficient areola into mouth. Flange lips around the breast— “fish lips.” Have wide angle at corner of mouth.

5. Latching On The best way to ensure successful breastfeeding is getting baby to latch on well. A baby who latches on well gets milk successfully. A baby who latches on poorly has difficulty getting milk. A poor latch may also cause the mother nipple pain and trauma. If a baby is not latched well, and not receiving milk well, she will often stay on the breast for long periods, thus increasing the mother's pain from the improper latch.

6. Steps to a Successful Latch Get comfortable, position baby at the breast, and relax. Place four fingers under breast and thumb on top, well back from nipple and areola. Lightly tickle baby's lower lip with nipple. Have patience. Wait for her to open up her mouth wide, as if yawning, then quickly pull her towards you onto the nipple. Several tries may be necessary.

7. If baby is positioned correctly, her/his nose will be resting on top of the breast and not buried in breast tissue. Do not press down on the breast to create breathing space. Even if her/his nose is pressed slightly against the breast, her/his nostrils should flare out at the sides allowing to breathe.

8. If it is correct her mouth will be open wide with flanged ("turned back") lips. Her tongue will be covering the lower gum, perhaps extending to her lower lip. Her chin will pressed into your breast with her nose resting on top. If the latch isn't right (the baby has only part of the nipple in her mouth) you are likely to experience nipple pain Check the latch

9. Signs of a Good Latch Lack of constant pain Chin touching the breast Cheeks rounded Nipple may come out longer, not pinched or discolored Lips curled outward Nostrils rarely touch breast Baby’s swallows can be heard Breasts are softer & feel lighter after feeding

11. Listen for swallowing. If baby is feeding well, we will see a suck- swallow motion with pauses in between. The jaw movement goes past the ears, sometimes even making the ears wiggle. If baby starts wiggling around during the feed she/he may need to burp.

12. Remember Bring the baby to the breast, NOT the breast to the baby Breastfeeding” not “Nipple feeding” Don't let her latch onto the nipple, get as much of the areola into the mouth as possible.

13. Copyright © 2003, Rev 2005 American Academy of Pediatrics

14. Positioning For all breastfeeding positions: –Breast must be easy to get to –Mother needs to be comfortable –Back straight & arms supported –Knees level with hips when sitting –Remove extra clothing

15. Positioning Hold baby with her palm facing ceiling Bring baby to breast Baby’s head, chest & knees face same direction

18. Making Enough Milk Breastfeed within the 1 st hour after birth Breastfeed often (8-12 + times in 24 hrs.) Stimulate both breasts EXCLUSIVELY breastfeed Avoid pacifiers and artificial nipples Obtain breastfeeding help when necessary, at least by day 3

19. Thanks for your attention