Breastfeeding is a beautiful and natural way to nourish your baby, but it can also come with its challenges, especially in the beginning. One of the key factors that can make or break your breastfeeding journey is proper positioning and attachment. Getting these two aspects right can ensure a comfortable and effective feeding experience for both you and your baby.

Positioning and attachment for effective breastfeeding.

What is Positioning and Attachment?

When you begin to learn about breastfeeding your baby, it might feel like you’re discovering a whole new vocabulary that needs to be understood. Positioning and attachment are the cornerstones of breastfeeding. Put simply, positioning is how you position yourself and your baby to facilitate them to breastfeed. Attachment is about how your baby actually takes the breast into their mouth.

Why are Proper Positioning and Attachment Important?

Positioning and attachment are vital for effective breastfeeding. If the positioning is poor, then the attachment will also be poor. This can then lead to painful breastfeeding and a whole host of other complications for both you and your baby. Proper positioning and attachment are crucial for successful breastfeeding for several reasons:

1. Comfort: The right positioning can help prevent sore nipples, breast engorgement, and other discomforts associated with breastfeeding.
2. Milk Transfer: When your baby is properly attached to your breast, they can effectively extract milk, ensuring they are well-fed and promoting good milk supply for you.
3. Preventing Issues: Poor attachment can lead to many issues such as –

   

   low milk supply, slow weight gain in your baby, and even mastitis for you.

Principles for positioning

The CHINS analogy is a commonly used analogy for helping new Mum’s to learn the principles for good positioning. Where your baby’s chin is positioned is pivotal to them establishing a deep attachment. It is the lower jaw and the tongue that do all the movement at the breast to move the milk from Mum to baby.

• Close – hold your baby really close to your body so that their chin is already in contact with your breast, just below the nipple. This helps them to orientate themselves and sense that the breast and nipple are near
• Head free – Hold your baby so that your hand is behind their shoulders not behind their head. They need to be able to freely tilt their head back as they open their mouth wide to reach for the breast.
• In line – make sure your baby’s head, neck, shoulders and hips are all in alignment with each other. If your baby is laid on their back with their head twisted to look over their shoulder, this will not be a comfortable drinking position. (Try it yourself next time you have a drink!). Their body needs to all be facing in the same direction so that they can drink and digest comfortably.
• Nipple pointing up the nose – If you begin with their chin touching the breast just below the nipple, the nipple will be pointing up their nose. As they then tilt their head back and open their mouth wide, the top lip will be nearer to the nipple and the lower jaw will gape down well below the nipple.
• Sustainable – This should be your first priority for every feed really. Think about how you are sitting, have you got good back support? Do you need any cushions to support you? Have you got a drink near to hand? You want to ensure that you can be comfortable for the duration of the feed.

Principles for attachment

Once you have positioned your baby with their chin against the breast and the nipple pointing up their nose, you need to wait for them to tilt their head and gape their mouth open in search of the breast. When they do this, the next step is to swiftly apply pressure behind their shoulders to move them even closer to your body so that their chin buries into your breast. They should then feel the breast and nipple and begin to suckle to draw the breast into their mouth. Initially, the first few sucks can feel uncomfortable, this is because they are drawing the breast into their mouth and the nipple is moving along the hard palate all the way to their soft palate at the back.

Achieving a proper latch is crucial; with a good position and deep attachment, the nipple remains at the soft palate during feeding, ensuring comfort. If the latch isn’t deep enough, the nipple doesn’t reach far back and gets compressed between the baby’s tongue and hard palate, causing you pain. In such cases, the nipple may appear misshapen or blanched upon detachment from the breast.

Signs that your baby is attaching well

• Feeding is pain free – after the initial 10-20 seconds of the nipple being drawn in, feeding should be totally comfortable. It can feel like a strong tugging sensation but should not feel painful in any way.
• Frequency of feeds – Baby should be feeding at least 8-12 times per 24 hours.
• Duration of feeds – Feeds are between 5 -40 minutes long
• How baby is during and between feeds – Baby is generally calm during feeds and will settle in between feeds (this may only be in your arms though, remember they are hardwired to want to be close to you!)
• They are drinking well – The suckling of effective feeds tends to follow this pattern – rapid sucks at the start of a feed as they draw the breast into their mouth and stimulate the milk flow. Once the milk starts flowing, you should notice slower and longer jaw movements. If you listen carefully you will also hear them swallowing, this can often be a quiet ‘kuh’ noise. As the feed comes to an end, they will slow their jaw movement again and sometimes do some fluttery movements. It is best to let baby feed until they naturally release the breast to ensure they have had a full feed.
• Wet nappies – Baby is weeing at least 7x per 24 hours once over a week old.
• Dirty nappies – Baby is pooing a minimum of 2-3 x per day in the first 6 weeks. (After this they may develop their individual pooing pattern but always consider if lack of poo could be a sign that they are not getting enough).
• Baby’s wellbeing – Baby has normal skin colour and tone and is waking regularly for feeds.

Having challenges with breastfeeding? Don’t struggle on alone, reach out for support here Book Breastfeeding Support

Liz Farrant, July 2024