By Emma Pickett, IBCLC
A dad at my breastfeeding support group this week had a bit of an epiphany. “It’s never felt like this before,” his wife had said. We’d spent just three or four minutes together. I’d mentioned one or two things about the way she was holding her baby. It was enough to make all the difference.
Just like in golf, he noted, with a tiny change to swing and position the game had been transformed.
As a lactation consultant, you study for hours and hours and pages and pages and pages. You know lots of things you may not talk about from month to month. But there are 20 or so things you say nearly every day.
So many mums have their experience transformed by a tweak. They are sore, dreading each feed, wondering how things will ever change and one comment – that may not even be 20 words long – can make all that go away in an instant.
It’s one reason why even a rushed midwife or GP can turn breastfeeding around with the right training, even if they don’t always have the time to devote to a long support session.
Here are a few of my favourite tweak considerations:
- Get a glass of water. Take a drink. Notice how you tip your head back and your chin comes away from your chest? Now try to take a drink with your chin pointing down towards your chest. Not so easy. Try and do that every time you drink, and I think you’ll find you take less, give up sooner that you might otherwise and probably get a bit windy. So, tweak number one is hold your baby in a position where they can lift their chin away from their chest. If you are using a cradle hold or a cross-cradle hold, that means you might need to have them further away from the feeding breast’s armpit and slid more across towards the non-feeding breast. We talk about “nose to nipple” because that’s encouraging the baby to reach towards the nipple with their head tilted back. If you are using a rugby hold, super important the baby isn’t too far forward so they end up curling around the breast with their chin hunched towards their chest.
- Don’t hold the baby’s head too high on the back of their head or push the baby’s head towards the breast. Babies are clever at protecting their breathing (why we don’t need to press our fingers into the breast near baby’s nose). And nature has given them a reflex which means when someone pushes on their head, they’ll be very unhappy about attaching in case they can’t rescue themselves when breathing becomes restricted. They may even push back and shallow the latch and sometimes even refuse to feed entirely. So, support baby’s head by holding around the base of the skull – supporting around their shoulders and chin and ears area – but no higher. Imagine Elvis towards the end of his career in Las Vegas with those diamond encrusted collars. You’re holding your baby’s Elvis collar and no higher. And even then, as gently as possible. Just enough to support baby’s head without being too bossy or firm. You might even be using a position where this isn’t a risk at all – you might be lying down or using a reclined position where your hand is nowhere near baby’s head.
- Beware the cushion myth. I am not kidding when I say that most people I meet using breastfeeding cushions are using them in a way that makes their life harder for themselves. The gap between your lap and the natural fall of your breast is probably very different from your mate’s. It’s going to depend on the length of your torso, the size of your breast, the way your breasts fall, the height of your lap which varies with your chair. It’s also going to depend on the shape of your baby. So how on God’s green Earth did we all get the message that the same size of breastfeeding pillow fits everyone?
Again and again and again, taller mums are slumping forward and hunching over their baby lying on their cushion. “This cushion must be right. I just have to contort myself to get to it!”
And shorter women also think that the cushion is surely the answer, so they put baby on the cushion and umm, there’s no space between their breast and the cushion for baby to fit. They often end up lifting their breast so baby can fit underneath. They might then have to hold their breast throughout the entire feed, compressing ducts and causing hand pain and usually not holding the breast in the same position the whole way through a feed so things wobble around.
Or folks might put the baby on the cushion and baby is a few centimetres too far away from them with sometimes not even the chin and chest making contact with mum at all.
Cushions can be handy to support mum’s arms, but it doesn’t normally work that the baby can’t be held by mum and is entirely on the cushion.
What often works even better is no pillow at all and mum leaning back a bit. Check out: http://www.mothering.com/articles/natural-breastfeeding/
- Baby needs to be clooose. If you can see the buttons down the front of baby’s sleep suit, they are probably too far away. If baby’s arm is trapped between you, they are being pushed too far away. If there’s a big blob of your clothing and a breast pad between you, they are probably too far away. I once supported a mum who found nighttime feeds much more painful. She was sitting in the same chair to feed as she did in the day and was using exactly the same position but at night it was pinchy and uncomfortable. It turns out the difference was that the baby was wearing a sleeping bag at night. Just a few extra millimetres of padding meant that baby’s chest and chin was a little bit further away from mum’s body and the nipple wasn’t going back far enough into baby’s mouth. Baby’s chin needs to be close into the breast. It’s not going to work if the baby’s chin isn’t touching the breast at all. And the chin can’t touch if the chest is too far away.
It’s common for a mum to say, “Wow it doesn’t hurt anymore!” followed by “I haven’t been having them close enough!”