Breastfeeding Positioning and Attachment

Breastfeeding is a learnt art. If you experience nipple soreness beyond a slight tenderness when your baby latches on you may need to make some adjustments so you can be comfortable and enjoy breastfeeding your baby.

Changing the way your baby is attached to the breast can help sore or cracked nipples and allow healing to begin. Breastfeeding should not hurt, although some mothers describe the initial sucks in the early days as tender, as the baby stretches the breast tissue. If pain persists throughout the feed it indicates some adjustments need to be made.

You and your baby need to be comfortable so he can attach himself to your breast well. He needs to open his mouth wide and take a big mouthful of breast.

Uncomfortable positioning and attachment is the most frequent cause of sore nipples. Often, any perceived problems with breastfeeding such as not enough milk, sore nipples, low weight gain, and baby suckling too long are an indication that the baby's attachment needs some adjustment. A good attachment is comfortable, with the baby's lips curled out. The tip of the baby's nose and chin may maintain contact with the breast throughout the feed.

Some nursing mothers find these tips useful:

• Calm your baby if he is crying; it is difficult to feed and cry at the same time. By calming your baby, his tongue will be in the right position to feed, ie over the lower gum line.


• Support your baby on his side on your lap, coming to the breast slightly from below, chin and lower lip first. To feed on the left breast, for example, with your baby facing you, support his back with your right forearm, your right hand on his shoulder blades, your fingers and thumb either side of the back of his neck. He should not have to turn his head to reach your breast.


• Allow your breast to rest naturally, ie not held up to your baby. If you wish to support your breast, do so with fingers underneath and thumb on top, keeping your fingers well back from the brown part.


• The baby's chin is held to the breast about 3cm from the nipple (nose to nipple).


• When you bring your baby onto the breast, he will tilt his head back a bit, open his mouth wide with his tongue down and take a big mouthful of breast tissue along the tongue.


• After the initial rapid sucks, your baby will settle into slow, rhythmical sucking and swallowing. When he is sucking strongly, the mother will often bring her arm around the baby so the baby's head is along this arm, and then the other arm can relax.


• Your baby should come off the breast when he has had enough.

Some mothers prefer the rugby or clutch position, with their baby's feet out behind them, or the cradle hold (across the lap), or lying down. In each position it is important to enable your baby to take a large mouthful of breast so that your nipple is protected at the back of the mouth. If it hurts after a few sucks, put your little finger in your baby's mouth and break the suction, then try again. If the pain persists beyond the first few 'stretching' sucks after a day or two whilst healing is happening, help from a breastfeeding specialist is advisable, as there can be other causes.

Many people who are breastfeeding fine still worry if there baby is getting enough milk. Several wet and dirty nappies each day, a steady increase in baby's weight and baby only asking for a feed every 3 hours or so (some more often, some slightly less often) are all good indicators of a well-fed baby. The length of time between feeds varies, but if baby is happy it is a good guide.

Subsequent articles will review common breastfeeding problems and how to recognise and resolve them, and where you can turn for practical help; Dads roll in breastfeeding (yes, you do have a part to play!), breastfeeding while out and about, and expressing and storing milk.