A common reason is that a mother is not holding her baby in the best position to achieve good attachment. For example if a baby is held too high or too much to the side he cannot aim his mouth in the best direction. This is more common with first-time mothers or mothers who have previously bottlefed. However every baby is different and even experienced mothers may need a little help with a new baby. Here are the key points of good positioning:
Sit or lie wherever you feel most comfortable.
1. Your baby's head and body should be in a straight line. Whether you hold her sideways, upright or under your arm, her body should 'face' yours. A baby cannot suckle or swallow easily if her head is twisted to one side or her arm is in front of her. Try drinking with your head twisted round sideways and you will realize it is not easy.
2. Her face should face your breast, with her nose level with your nipple. This enables her to take in more of the underneath of the areola than the top part. The touch of the nipple on her lips will stimulate her to open her mouth wide (Figures 4a, 4b and 4c).
3. Hold your baby close to your body so that she can take in a good mouthful of breast. Bring your baby to your breast, not your breast to the baby. Do not lean forward as this may give you backache.
4. If the baby is newborn, support her whole body, and not just her head and shoulders. This helps her stay close but still be able to move her head and neck freely.
5. If you feel your breast needs support, cup it from below with your spare hand. Avoid holding your fingers like scissors8 as this can pull the breast out of your baby's mouth and spoil the good attachment. This common practice comes from a mistaken idea that a baby cannot breathe easily at the breast. Actually nature has designed a baby's nostrils to be at the sides of her nose so that she can breathe while she breastfeeds. A baby can look squashed at the breast and that is fine. As long as she can extend her head freely she will adjust herself to breathe comfortably.
8 Also called 'the cigarette hold'.
If you are exclusively breastfeeding, your baby is healthy and growing and your breasts are comfortable, then you are doing it right, whatever the position.