Because Breastfeeding doesn't always "Come Naturally"

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I want to start off this blog by saying I am not a breastfeeding specialist or a lactation consultant (as much as I one day hope to be!) But I am a registered nurse and mother of 3 boys with a wealth of knowledge from years of education and helping new parents learn to breast feed as well as successfully breastfeeding my 3 children for a span of 6-10 months each time.

Every hospital is different in regards to how they talk to their patients before delivery. In the hospital I work at, we do what's called a "pre-registration" at about 36 weeks gestation to get a little bit of a history from patients before they deliver. Essentially we find out about their prenatal history, any medical conditions, how many babies they've had, any complications they've had etc.

One of the questions that we normally ask during that pre-reg is "are you planning on breastfeeding?" If they answer yes, I have always asked if they have done any research on breastfeeding, if they have taken any classes, or if they have breastfed before.

If they have never breastfed before, they usually look at me like I have 2 heads..... Why would I need to take a class on breastfeeding? Isn't it completely natural?? Is it really that hard?

To that I will say, for some people, yes. It really is that hard. For others, you're right. It comes completely naturally. You're not going to know which category you fall into until your baby is here and you actually try. So, just like EVERYTHING else new in life, maybe learning a thing or two about breastfeeding can actually be beneficial. So let's jump into it.

ANATOMY

One of the things that plays a factor in breastfeeding is the size and shape of ones breast and nipple. Everyone's breast is a different shape, and size, and that is totally ok, but understanding what about your breast could help or hinder your journey is important.

Size doesn't have anything to do with the amount of milk you will produce. But it can play a factor in your baby's ability to latch on to your breast. Larger breasts can be more difficult for a baby to latch onto if they do not open their mouth wide enough, or the baby is born smaller in size. Different positions can help with this, as well as understanding how to hold your breast while nursing. I'll get into that in a little bit.

The other thing that plays a factor is nipple shape and size. The three most common nipple shapes (that I have personally seen) are as follows:

1. "Normal" nipple: This would be a standard anatomy nipple. Where the nipple is protruding from the breast. It makes it easier for baby to latch onto, and triggers their suck reflex when they can actually feel the nipple at the roof of their mouth. This would be the easiest nipple shape to nurse with.

2. Flat nipple: The shape is the same as a normal nipple, it just doesn't protrude from the breast as far, even when stimulated. This can make latching for baby more difficult. Some flat nipples will pop out more when stimulated, which will make it easier for baby to latch on.

3. Inverted nipple: This is when your nipple goes inwards instead of outwards. I personally have found this nipple shape the hardest for babies to latch onto, because there simply is no nipple for them to "suck" on.

One thing that can be beneficial for individuals with any shape nipple is something called a nipple shield. Everybody has their own preference to the nipple shield, and even babies too. My opinion? If it helps baby get a deep effective latch, increases your breastfeeding success, and decreases any pain associated with nursing, then I say use it. It's a tool that is available, and it may not be something that you have to use forever. I have seen MANY individuals successfully nurse with the nipple shield and then ween from it and have great success.

With the right positioning, and potential tools, breastfeeding with ANY shape and size of breast or nipple is possible, so don't get discouraged! You may just have to work a little harder to learn and teach baby. That's all.

PROPER LATCH

This right here is going to be a huge part in having a successful breastfeeding journey. At the end of the day, if baby's latch is terrible, and causing cracking and bruising and bleeding, breastfeeding will suck, and you will quit. Because it hurts, and no one wants to do something that hurts for an extended period of time. Plus, cracked and bleeding nipples just increase your risk of infection, and that also is not ok. So let's go over what a good vs bad latch would look like!

GOOD LATCH:

• Deep latch

• Minimal areola showing

• Minimal pain

• Mouth is wide at the breast

• Chin touching and tucked to breast

BAD LATCH:

• Shallow latch

• Can see lots of areola

• Generally quite painful

• Mouth is narrow and lips are pursed

• Chin is out and not touching breast

With a good, deep latch, regardless of your nipple or breast shape, you should have great success in breastfeeding. The biggest thing is making sure that you get baby to that deep latch, and keeping them there.

"Bailey, you're talking about this Good, Deep Latch.... That's great... how the heck do I do that??"

I'm so glad you asked! There's many different ways and positions that you can use to get your baby in that nice, deep, effective, COMFORTABLE latch... so let's get into it.

Latch that Baby!

Until baby get's older and gets stronger with holding their head and neck, you are going to have to assist them into an optimal breastfeeding position. Personally, for all my babies, I "assisted" them into an optimal breastfeeding position until they were around that 3 month mark. After that age, they started to have really good head and neck control and were able to better support their heads independently, and navigate the breast a little better.

I see a lot of new parents holding baby in a "Cradle Hold" breastfeeding position, and I'd say a lot of babies cannot breastfeed right at the start in this position. They need someone guiding their head to and at the breast, supporting it, and also someone supporting the breast that they are trying to nurse on. Cradle Hold, is literally just that; holding baby in cradle position with both of your arms. Once baby is a little older and is more familiar with breastfeeding, or you have baby successfully latched, this is a great position to use and is quite comfortable.

The best 2 positions to use to support babies head would be "Cross Cradle hold" and "Football hold". Both have there pros and cons, but both of these positions demonstrate the ability to support babies head and your breast and assist baby in getting that good deep latch. We'll get into positions in a minute, lets start with the latch:

• Support baby. Babies are small, and have little control over their own muscles, which makes it difficult for them to latch to the breast. So you are going to have to use your arm and hand to support them properly. Baby's body will lay on your arm, and their head will be supported by your hand. This way, you will be able to help baby and guide them towards your breast and assist them in getting that deep latch.

• Support your breast. If one hand is supporting baby, your other hand will support your breast, holding it in a "sandwich hold" and being able to direct your nipple towards the baby's nose and roof of their mouth.

• Encourage open mouth. In order for baby to get a good latch, you need them to open their mouth wide. If a baby is really ready to nurse and has a strong rooting reflex, they may open their mouth as soon as they sense your breast. Others take a little more coaxing. You can rub your nipple on their mouth and cheek. You can hand express a little colostrum and put it on their lips or their tongue.

  Some babies are quite sleepy in the early newborn days, and getting them to wake up may be the trouble to them opening their mouth. So getting them undressed and un-swaddled and skin to skin may be the ticket to having them wake up just enough to open their mouth for you.

• Nipple to nose. Once baby has their mouth open nice and wide, you are going to do 2 things; you are going to guide their head gently towards your breast, and aim your nipple and breast towards the roof of their mouth. Once they have enough of that breast in their mouth, it should trigger their sucking reflex and they will begin to feed!

  Now, this may take a few attempts. Some babies will pop on the breast, take a couple sucks and then pop right off. DON'T GET DISCOURAGED!! They are learning something new, just like you. If they pop off, try again, and keep encouraging them.

Once your baby is latched on well, and having a good nursing session, you are not going to want to disturb that baby until they're done (unless you have been recommended to do so by your provider in regards to health issues regarding baby!) So making sure that you are in a good and comfy position is going to be your first step before even attempting to latch.

In the early stages of learning to breastfeed, your most common nursing positions that are going to be the easiest for you to establish breastfeeding are Cross Cradle Hold, and Football hold, as well as Cradle hold once the nursing has been established. Until you have gotten the hang of breastfeeding, these are the three I would suggest sticking to. All three of these positions involve you getting into a very similar position, the only real differing factor is what position baby is in. So let's get you comfy:

• Prop yourself up with pillows. I don't care how many pillows it takes to get yourself in a good position. Especially if you are in a bed; hospital, home, hotel.... doesn't matter. USE THE PILLOWS. I like to suggest having one on each side of your body, and one or two in front of you, depending on what position you are using. The ones on the side of you will help to keep you propped up and stabilize your abdomen, and the ones if front are going to help you support baby.

  If you have a breastfeeding pillow, feel free to use this, but it's definitely not required to have a successful breastfeeding experience.

• Position baby properly. Regardless of what position baby is in, you want their head/mouth and your breast to mesh so that they have an adequate latch, and you have minimal pain. Wide mouth, chin to breast, nipple to roof of mouth, areola covered. Those are your 4 main points to remember.

Breastfeeding Positions

There are multiple positions that you can use to nurse your baby. Some of them require your baby to be a little bit older, or for you to have a little bit of practice, but every position has a place and time.... so let's get into it! (Pictures included below)

Cradle Hold: So I mentioned this one earlier. It is the go to position for any new mom who has never nursed a baby before and has zero knowledge or experience in nursing a baby. Understandable! Because every single movie or show you watch, this is how they hold their baby, and MAGICALLY that baby just pops right on. This position is great if you have latched baby in cross cradle and feel comfortable holding them. Once you and baby have a little bit more experience in nursing, this is a great position to use. Or, if you're really good at maneuvering your elbow to prop babies head up, that works too!

Cross Cradle Hold: Every single nurse or Lactation consultant that you will meet, will have a preference for the position that they feel is "best" when it comes to learning breastfeeding, or the position that they always go to first. For me.... that's the cross cradle hold. It's the one that I mastered first as a new breastfeeding mom, and I find it's the easiest to learn. You can have support at the front of you and sides and you are using your hands and arms to support that baby into a proper feeding position.

Football Hold: This position is exactly how it sounds. You are holding your baby off to the side like a football in order to nurse them. This position is great for someone who has had a C-section or has a very tender abdomen post birth. It's also great for a woman who has larger breasts or a women that is tandem nursing twins. Similarly to a cross cradle hold where you are supporting baby's head and body with your arm and hand, instead of using the opposite arm from the breast you are feeding on, you will use the same arm, and then maneuver your breast with the other hand. I personally never mastered this feeding position, but many women love it and have found great success.

Those first 3 positions are the most common positions used when first starting to breastfeed. Here are a few more that you can use once breastfeeding has been more established:

Side lying: This position can be a great position when utilized properly. Essentially you will be laying on a flat surface on your side, and baby will be lying on their opposite side beside you facing your breast. Your breast will lay on the surface or you can support it with your hand, and baby will nurse off your breast. Again, this position can be great for someone who has had a c-section, or who has larger breasts.

Please, use caution when using this position, especially in the early postpartum days. Women have fallen asleep in this position, which can be unsafe for baby if they fall under your breast or are on an unsupportive sleep surface.

Laid back: This is exactly how it sounds; you are laying back reclined in a bed or in a chair and nursing baby on your chest. This position can be used to assist with an optimal latch in the early nursing days, or for a woman who has a stronger let down, as gravity will help slow the flow of milk. Baby can be laying more on top of you in this position, or off to the side in one of your arms while still being propped up.

The biggest thing to remember with any of the breastfeeding positions is to make sure that both you and baby are comfortable. If a position hurts, or is too difficult to maintain, then don't use it! That's why there are multiple different positions.

Sometimes, you try everything under the sun.... different positions, nipple shields, hand expression and nothing works to get that baby latched deep enough. Or, you get them latched and even though the latch LOOKS good, it hurts soooo bad and you end up with cracked and bleeding nipples. If that is the case, please talk to your provider or get a referral to a lactation consultant as there may be some other underlying issues that are happening with baby, such as a tongue or lip tie that may be physically preventing them from getting that good deep latch.

The last thing to keep in mind is that EVERY BABY IS DIFFERENT. Every baby will nurse different and for different periods of time. Some babies will nurse on one side for 10 minutes and be content, others will nurse on 20 minutes each side, and still seem hungry after. There are a MILLION different factors that contribute to this; cluster feeding, slower let down, lower milk supply. Keeping track of your babies weight and wet diapers is how you will tell that baby is getting enough milk.

For the first couple of days, until your milk comes in, it may seem like baby isn't getting any milk, or that you "have no milk". The stimulation of the breast through pumping or nursing is actually what triggers your body to make milk. So immediately after birth, do not panic if it seems like "baby isn't getting any milk". They will be getting the drops of colostrum that is FULL of nutrients. It is nutrient dense, and therefore does not need to be high in volume. The hospital will keep track of babies wet and dirty diapers and monitor their weight to make sure that they are getting an adequate amount of food.

At the end of the day, every breastfeeding journey will be different. It is important for you to advocate for yourself, and the way to do that is to have a bit of an understanding of what you need to do before you actually do it.

Like I said, until you actually try nursing your baby, you won’t know what your journey is going to look like. Your breastfeeding journey may last 2 days, 2 months, or 2 years. And I hope that you are able to take something from this blog and use it in your own journey. Until next time….

-B