Breastfeeding provides optimal nutrition and health protection for the first 6 months of life, and breastfeeding with complementary foods for at least 12 months is the ideal feeding pattern for infants. Breastfeeding is also a public health strategy for improving infant and child health survival, improving maternal morbidity, controlling health care costs, and conserving natural resources.
Breastfeeding contributes significantly to the health and well-being of both baby and mother. NOCIRC recommends that babies be breastfed, except in those few rare circumstances when a particular mother may have a medical condition that contraindicates breastfeeding.
During the early weeks optimal positioning is especially important. Babies who feed at the mother's breast soon after birth generally have an easier time adapting to the latching-on process when regular feedings begin. When you and your baby are well positioned, your nipples stay healthy and your baby can feed most efficiently. Concern about sore nipples is a common reason that mothers contact helps eliminates many cases of sore nipples. There are two aspects to proper positioning:
1. The position of the nipple in your baby's mouth.
2. The position of your baby's body in relation to yours.
It is normal to experience slight tenderness when baby latches on in the first three to five days after birth. After that, if proper positioning and latch-on techniques are used, you can expect little or no nipple soreness. Finding the right position, staying relaxed and giving the baby time to understand the process all help to make breastfeeding a healthy, enjoyable time with your child. Experiment with various positions until you feel comfortable.
Ideally, you should offer both breasts at each feeding. But it is even more important to make sure that your baby has enough time to finish at the first breast before switching sides. This is because the fat content of the milk increases the longer the baby nurses.
Place your opposite hand underneath your breast and, using your thumb, gently push up under your areola, and position more of your breast in your baby's mouth, making sure not to get your fingers inside. If your baby's lips are puckered inward, or if you can see their gums, the "latch" may not be complete. You can hold your baby in a number of ways. Your baby shouldn't have to turn his or her head or strain his or her neck to nurse.
Healthy infants should not be placed prone to sleep. In several studies the sudden infant death syndrome (SIDS) has been significantly associated with sleeping in the prone position. The elevated risk of SIDS is increased by each of four factors: the use of natural-fiber mattresses, swaddling, recent illness, and the use of heating in bedrooms. Several reports described that in a significant number of SIDS cases, the heads of the infants, including some infants who slept supine, were covered by loose bedding. Many of these studies found loose bedding to be an epidemiologic risk factor for SIDS.
Bed-sharing allowing a baby to sleep in his or her mother's bed promotes breastfeeding and closeness. Infants should be placed on their backs; not on their stomachs and sides to sleep. Babies should sleep on a firm crib mattress, covered by a sheet, with no soft, cushy bedding such as pillows, comforters or quilts, in a room that isn’t overly hot.
The original 1992 sleeping position recommendation from the American Academy of Pediatrics identified any nonprone position (i.e., side or supine) as being optimum for reducing SIDS risk. Subsequent studies from England and New Zealand have shown that side sleeping has a slightly higher risk than the supine position, although the side-sleeping position still seems to be considerably safer than prone. The higher risk for SIDS among infants placed on their sides may relate to the relative instability of this position. Although infants placed on their sides usually roll to their backs, the risk of rolling to the prone position from the side is significantly greater than rolling to the prone position from the back.
If your baby is feeding properly, you should hear only a low-pitched swallowing noise; not a sucking or smacking noise. If you need to start over, gently insert your finger into the corner of your baby's mouth to break the connection to your body, then reposition your breast and your baby, and try again.
First, make sure your baby's body is not turned awkwardly: Her head, shoulder, and hips should be facing the same direction, toward your breast and abdomen. You should be positioned tummy to tummy and your baby should not need to turn her head or dip or lift her chin to reach your nipple with her mouth. She should be relaxed and not stiff. Head should be in a neutral position, not bent forward or back, and resting comfortably in the crook of your arm.
Cross-cradle position:
Sit up straight in a comfortable chair with armrests. Hold your baby crosswise in the crook of the arm opposite the breast you're feeding from — left arm for right breast, right arm for left. For this position, your baby is supported on a pillow across your lap to help raise him to your nipple level. Pillows should also support both elbows so your arms don't hold the weight of the baby; they will tire before the feeding is finished.
The baby's body should be in a straight line with his head. The other hand (right hand for right breast and left hand for left breast) is used to cup the breast – placing your fingers beneath your breast and your thumb on top of your breast. Your nipple should be placed within the baby's mouth and then the baby pulled against your body. Some mothers find they can tuck the baby's bottom into the crook of their arm. When your baby opens wide, pull him into the breast far enough that the tip of his nose, his cheeks, and his chin are all touching your breast. The 'underarm position’s also known as the 'footy hold'. It’s possible to feed twins together in this position.
Cradle hold position:
The cradle hold is similar to the cross-cradle hold, but you support the baby with the arm on the same side as the nursing breast, rather than the opposite arm. The cradle position is most commonly used after the first few weeks. Your baby's head will be on your forearm and his back will be along your inner arm and palm. The baby’s head should be in the crook of your arm and its chest should be right against your chest so that it can reach your nipples without having to turn its head. When you look down, you should see his side. His mouth should be covering at least a half inch of the dark area around your nipple. Baby “hugs” the breast.
The baby's body should be in a straight line with his head, although his legs may dangle to your stomach or thighs. The other hand (left hand for right breast and right hand for left breast) is used to cup the breast, placing your fingers beneath your breast and your thumb on top of your breast. You’ll want to make sure you have enough support for your arm or it will become tired before the feeding is over.
Position your baby's body so that a straight line is formed from his ear to his shoulder to his hip. Tuck the baby's lower arm around your waist, out of the way.
Clutch or Football Position:
This position is especially popular among mothers who:
* Are recovering from Caesarean births
* Have large breasts
* Are nursing a premature baby or two babies at once
* Need to encourage a baby to take more of the nipple into his or her mouth
In the clutch position you support your baby's head in your hand and his back along your arm beside you. You support your breast with a "C" hold. Place the baby's head in the palm of your hand. Support the base of her head between your thumb and forefinger. If your baby doesn't seem to like this, put a soft blanket between your hand and her head for padding.
The baby's body and feet are tucked underneath the arm on same side the baby is nursing, so that his legs dangle behind you. Pillows can be used to bring the infant to the right level. The baby's body should be in a straight line with his head.
The other hand (left hand for right breast and right hand for left breast) is used to cup the breast - placing your fingers beneath your breast and your thumb on top of your breast. This keeps him from being able to push against your chair. Pillows again help bring the baby to the correct height. The baby’s body should be lying on your arm and the face should be towards your breast. The other arm should be used to support your breast. In this position you get a good view of baby latching onto the breast, while your hand at the nape of his neck gives you control of his head.
Side-lying Position:
A lying position may help your baby latch on to your breast correctly in the early days of breast-feeding. It's also a good choice when you're tired. If you're recuperating from a Caesarean birth, reclining may be your only option for the first few days. The baby can be cradled in your arm with his back along your forearm. Having his hips flexed and his ear, shoulder and hip in one line helps your baby get milk more easily. Place your baby on her side facing you, and nestled in your arm. Slide baby up or down along the mattress to get her mouth lined up with your nipple. Put a pillow or rolled up baby blanket behind the baby's back. Lay the baby next to you on the bed so that his mouth is opposite your nipple. When he opens his mouth wide, he is ready to latch on.
The side-lying hold can be extremely comfortable, especially when pillows are used to relieve stress on the back. It takes a little practice to get the baby to latch on properly. At night, breastfeed either lying down on side or back is comfortable. Pillows can be placed under the arm or head and between the knees to find the perfect position. You should ensure that the baby can breathe properly. It’s also easy to feed the baby from both breasts, which is essential for avoiding plugged milk duct.
A study of 40 mothers breastfeeding in different positions found that babies' natural reflexes kicked in more easily when the mothers were lying down. A majority of women in the study initially reported problems with breastfeeding but mothers who breastfed lying down seemed to have more success. All the women in the study continued to breastfeed. When mothers were lying flat or semi-reclined, babies could find the breast easier and in many cases attach themselves and feed whilst asleep.
Reversed Cradle Hold Position:
A reverse of the cradle hold, this across-the-body position allows better visibility of baby's mouth during latch-on and better control of baby's head. It's a good alternative to the clutch hold if your baby needs extra support during latch-on, but you like the maternal feelings that come from having baby across your body. Use this position in the following situations:
* Babies who have difficulty latching on.
* Babies who come off the nipple frequently during breastfeeding.
* Babies who are small or premature.
If parents or caregivers cannot find the cause of the inconsolable crying of an infant, they might react sharply and shake the baby, causing brain damage and, as a result, the infant stops crying, explained study leader Concepcion Ruiz Rodriguez of the University of Granada. Being born in a Baby-Friendly hospital gives babies the best possible chance of breastfeeding to 6 months. This is particularly true for low-income populations and for families from backgrounds that traditionally have low breastfeeding rates; another study suggested.
Family physicians have assumed many administrative roles in hospitals, managed care plans, insurance companies, and large physician organizations. In these roles, family physicians are in a position to promote breastfeeding and ensure appropriate reimbursement for lactation services provided by physicians or lactation consultants.
"Most women experience difficulties when they leave the hospital. These challenges often lead to premature weaning," told a Pediatrician, Center for Child Health Research explained. Women need access to lactation consultants and others who can support their efforts to fully breastfeed their babies. Supporting women early on, she added, means healthier babies and children in the long run.
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