Changing your position can reduce breastfeeding pain

Why is positioning important for reducing breastfeeding pain?

Nose to nipple, nose to nipple, nose to nipple… you’ve probably heard that mantra. I wouldn’t START there though. If anything, lining a baby’s nose up to your nipple is the last step in a series of steps.  If you START with nose to nipple, then you could actually end up with quite an uncomfortable latch.  Get the positioning right (for both you and baby) and often breastfeeding pain disappears, AND baby transfers more milk at the breast.

1. Get yourself comfortable first

We often get so focused on getting our babies to latch on that we end up, hunched, over our babies, scared to move a muscle.  We’ve got them latched on and we know that if we move, they’ll just come off the breast.  

So… before you even bring your baby to the breast, get yourself comfortable first.  You can adapt a true “laid back” position, like this one below.  Lie back on the sofa, or your bed and make sure that your back, neck and shoulders are completely supported with cushions and pillows.  Once you adopt this position, you can just lie baby on top of you, and your baby’s reflexes will take over.  Your baby has a set of inbuilt reflexes which work to help your baby find and latch on to the breast.  You can use your arms to cradle and support your baby, and often nature just takes care of the rest.

Cartoon of a woman breastfeeding her baby in a laid back breastfeeding position

The laidback position, above, works really well for some parents and babies.  However, if that doesn’t work for you (for example, if you have larger, downward pointing breasts) you can adapt a similar position and still use those reflexes to your advantage while actively helping your baby latch on a little bit better.

So, get yourself comfortable.  Lie back a bit, maybe just not as reclined as the picture above.  Make sure you have plenty of pillows and cushions to support your back and arms.  If you’re sitting on the bed, slip a cushion behind your knees.  If you’re sitting on a sofa, lean back and put a small footstool under your feet.  Dr Pamela Douglas calls this a “deckchair position”.  

Cartoon of a blonde woman breastfeeding a mixed race baby

2. Bring baby in close

Bring baby in close to your body, with their tummy, torso and legs completely against your body.  Imagine wrapping baby around your body.  Sometimes babies’ arms get trapped across their chest between both of you, and this prevents their mouth from getting close to the breast. If you position your baby’s arms with one on either side of the breast, it will help your baby stay close to you and reduce the pull on the breast.

The illustration below shows what positioning might look like, if you were looking down at your baby as you latch them on.

Cartoon showing a baby in a good position to latch onto the breast

3. Give baby some support

Don’t automatically reach for a breastfeeding pillow to give your baby support.  Sometimes pillows work great, but more often they don’t actually line the baby up with where your breast lies naturally, so you end up lifting your breast to the baby.  Instead, use your arms to support your baby, and if you need to, tuck cushions under your arms to support you!  You can use your arms to bring your baby to the exact right level, and once baby is latched on, slide those cushions in.  

In a more reclined position, you’ll find that your baby ends up lying on top of you, so your body supports the weight of your baby and your arms take less of the weight.  In a reclined position, gravity helps to keep your baby close too.

Always keep your hands well away from your baby’s head.  If necessary, you can provide some support across your baby’s shoulders.  Babies will often push back against a hand on their head.  (Imagine how you’d feel if someone pushed your head down to your plate of food, so you only had a centimetre of space to work out how to eat it!)

4. Anchor the chin

When your baby is close to you in this position, you can help anchor your baby’s chin on the breast, BELOW your nipple (see the illustration above to see where the chin is, in relation to the nipple).  If your baby can get their chin on the breast, it helps them to work out where they are.  Often, you’ll see little heads bobbing around and moving from side to side.  That’s a baby that can’t work out where the nipple is.  Chin on the breast and one arm on either side of the breast, body in close, and your baby will feel stable and be able to orientate themself to the breast.  Less bobbing around, less time trying to latch your baby on.  

5. Nose to nipple

And yes, finally!  Nose to nipple.  But actually, with good positioning, and anchoring your baby’s chin on your breast well below the nipple, usually what happens is that the nose automatically lines up with your nipple.  When your baby feels your nipple on his/her top lip, it triggers a reflex and baby will tip their head back, open his/her mouth wide and latch on.

If your baby doesn’t open wide to latch on and the initially the latch looks/feels a bit shallow, don’t panic! Use the next steps to make the latch deeper without re-latching your baby. 

6. A comfortable latch

Once your baby is latched on, you shouldn’t be able to see their mouth because the chin will be deeply buried in the chest, but the nose will be free.  By keeping your baby’s body in close to yours, there will be less pull on the nipple and less breastfeeding pain.  Even if your baby didn’t latch on with a wide mouth, often it’s possible to fine tune positioning, just by making little positional changes.  Try moving your arms ever so slightly, up, down, move baby towards the other breast slightly, press across your baby’s shoulders slightly, tuck their bum in a little bit more… Try one little shift at a time, and see if it helps.  Usually these tiny little position changes result in a comfortable latch.

Still need some help?

If you are still struggling to get your baby to latch on, or it’s painful in spite of good positioning, a feeding assessment may help pinpoint what’s going on. You can contact a breastfeeding counsellor, or a lactation consultant for some skilled breastfeeding support.

If you are in N Ireland, you can make an appointment to see me in person:   Breastfeeding support : Rebecca Scott-Pillai, IBCLC (rebeccascottpillai.co.uk)

Published by Rebecca Scott-Pillai

Rebecca Scott-Pillai is a paediatric sleep consultant and lactaction consultant (IBCLC) based in Lisburn, Northern Ireland. She lives there with her two kids, two cats and dog! With over 20 years experience working with families, Rebecca uses her knowledge and experience to provide collaborative flexible plans for gentle, responsive families.