Benefits Of Different Breastfeeding Positions

Introduction

Breastfeeding is the best for babies. This is the basis for the recommendation by the World Health Organisation that babies feed on only breast milk for the first 6 months of life and then continue up to 2 years and beyond.¹

However, a significant proportion of mothers don't seem to get it right with their newborns when it comes to breastfeeding techniques (BFT). Poor positioning can lead to ineffective breastfeeding techniques.² This has led to mothers having nipple injuries, babies not gaining weight appropriately and overall, a shortening of the duration of breastfeeding.³

An understanding of the various breastfeeding positions and the conditions in which they could be used could give more satisfaction to both mother and baby with the whole process.

Overview

Breastfeeding requires time, effort and support as it is best initiated within one hour of delivery and needs to be continued as frequently as the baby demands it.¹ 

Several methods of breastfeeding suit various conditions a mother-baby may find themselves in these special situations could affect the mother, the baby, or both of them. They include delivery by Cesarean section, having large breasts, breastfeeding a small or preterm infant, or an infant with special conditions such as Down's syndrome, breastfeeding twins or just breastfeeding while lying down in conditions where the mother needs some rest. Moreover, some positions suit there breastfeeding from engorged breasts.^4,6

There are several different positions for breastfeeding and some of them include the cradle position, cross cradle position, football position, the side-lying position and the rugby position.^4,6

Take a look below to find some of these positions and the benefits of each one.

Cradle hold position

Description and technique 

This is the most commonly used position by breastfeeders. It is relatively easy to adopt and enjoyed in many situations.

It is also known as the "Madonna hold".⁶

It is carried out with the mother sitting upright in a chair. 

The baby is held in the arm of the mother on the same side as the breast which it is to be nursed at. The baby faces the mother with stomach to stomach contact between the pair. The head of the baby lies in the crook of the elbow joint while the palm supports the buttocks. His or her arm is kept around the mother's body.

With the baby lying in position on the mother's body, the baby is then taken to the breast.^4,6

Benefits

1. There is an optimal latch and milk transfer
2. It is comfortable for both mother and baby
3. It enhances bonding and eye contact
4. It is easily adopted by older babies who can control their necks⁷

Tips for successful cradle hold positions 

• The mother should be seated comfortably in a chair and can support her back by using pillows^4,7
• In help lift the baby to the mother, a breastfeeding pillow can be used or the mother can cross her legs. Breastfeeding pillows have maternal discomfort during breastfeeding⁷
• The mother can support her legs using a footstool
• Also, the mother should not bend over to reach the baby as this can cause back pain over time
• The baby's ear, shoulder and hip should be in a straight line^4,7

Cross cradle position

Description and technique 

This can be described as the " opposite " of the cradle hold position.⁴ It is also known as the cross-over position.⁷ The head of the baby lies in the hand of the mother and not in the crook of her arm as in the cradle hold position. The baby is supported with the opposite arm to the side of the breast to be sucked while it faces the mother with its body lying on the mother's body and with the legs tucked under the mother's arm.^4,7

Benefits

1. The cradle hold position is ideal for breastfeeding small or premature babies as the head can be easily controlled in this position
2. The mother has complete control of the baby's head with her hand which she uses to guide latching of the baby to the breast. Therefore, it is good for learning positioning for a newborn and a new mother^4,7

Tips for successful cross-cradle hold position

• Mother should sit upright comfortably in a chair
• The use of nursing pillows would give extra support and prevent body pains⁸
• The baby's ear, shoulder and hip should be in a straight line^4,7

Football hold position

Description and technique 

This is also known as the Clutch hold, or the Rugby hold. This is because the manner in which the mother holds the baby is similar to the way a player holds a football or Rugby ball.

While the mother is turned to one side, the baby is held along the mother's forearm supporting the face and neck to face the mother while its legs are tucked under her arms.^4,7

Benefits

1. It is perfect for mothers who have a Caesarean section as the baby does not lie on the mother's stomach
2. It is suitable for mothers with engorged breasts, large breasts, or sore nipples as it encourages emptying of the bottom ducts thereby preventing plugging of the ducts. It is also great for mothers with a forceful milk ejection reflex
3. The baby's head can easily be controlled and positioned so it also works well for those with small, or premature babies
4. It guarantees easy access to the breast
5. It works well when the mother wants to check your baby's latch-on or you are feeding a fussy baby
6. It is suitable for breastfeeding of twins when done simultaneously^4,7

Tips for successful football hold position

• A nursing pillow can add extra comfort
• A chair with low and broad arms can also give more comfort during the process
• The breast can be supported with the other arm^4,7

Side-lying position

Description and technique

This position involves lying on the side just as the name implies. Both baby and mother lie on their sides facing each other, tummy to tummy. One arm is used to support the baby close to the mother.^4,7

Benefits

1. It gives comfort to tired or recovering mothers
2. It ensures restful feeding during nighttime when it may not be convenient to sit up
3. It promotes relaxation and bonding
4. It is suitable for mothers after a Caesarean section when they need to lie flat
5. It is also suitable for mothers who may have a haemorrhoid after delivery and find it difficult to sit
6. It is convenient for mothers who are unwell^4,7

Tips for successful side-lying position

1. The mother's back can be supported with the use of a pillow
2. The baby may be returned to the cradle after breastfeeding^4,7
3. The mother should be mindful enough not to block the baby's nose as cases of infant death have been reported in babies fed in this position⁹

Laid-back or reclined position

Description and technique

This position is also called "Biological nurturing". In this position, the mother lays as far back as possible but completely flat. The baby lies on the mother's body tummy to tummy. The baby latches on following natural instincts. This position is also frequently used in the delivery room immediately after the baby is born to encourage mother-baby bonding.⁴

Benefits

1. It encourages natural instincts and rooting reflex
2. It is supportive for babies with reflux or colic
3. It calms restless and crying babies
4. It enables a deep latch and an optimal milk flow⁴

My tips for successful laid-back position

It is best carried out with the mother's chest bare and the baby having no clothes on.⁴

Choosing the right position

Factors to consider

1. Did the mother have a vaginal delivery or a Caesarean section?
2. Is mother well or unwell?
3. Is mother suffering from haemorrhoids?
4. Did the mother have twins?
5. Are mother's breasts engorged? Are her nipples sore? Is her breast milk rushing?
6. Is the mother breastfeeding for the first time? 
7. Does the baby have difficulties latching on?
8. Is the baby preterm? Small? Or has the baby got any special conditions such as Down's syndrome?

Individualizing positions based on specific needs

Breastfeeding twins: Twins can be fed one after the other. However, they can also be fed simultaneously. The commonly employed methods of breastfeeding twins at the same time are: 

1. The double football hold
   This requires positioning each baby in the football hold manner on either breast. Two pillow supports would be needed on either side. However, both babies may not get sufficient skin contact with their mother.¹⁰

2. The double cradle hold: Similar to the Double Football Hold, each baby is placed in a cradle hold on either side of the mother supported with a double breastfeeding pillow. The first baby will have more body contact with the mother while the other will have more body contact with the first baby. One challenge may be that the feet of the first baby may be getting in the way of the second baby which can be gently adjusted to lie under the opposite breast of the mother.¹⁰
3. Other positions include the Cradle Clutch (Cradle+Clutch Holds) and the Cradle Cross (Cradle+ Crossover hold).¹⁰

Breastfeeding with a disability: This requires a lot of creativity to find the positions that best suit both mother and baby. The mother may also need to use a breast pump to express the breast milk if she is unable to position the baby. Furthermore, the use of breastfeeding pillows can support her arms or her breasts. Finally, human support like a sibling, a spouse or a friend can assist in handing her the baby or holding the baby while she breastfeeds.¹¹

Summary

Several positions exist for breastfeeding babies. Mothers should be aware of these positions, and the advantages of each one and make a choice of whichever one suits them based on the circumstances of the mother and or baby. In whatever situation, breastfeeding is still possible and can be enjoyed.