When feeding your baby in a sitting position, seat yourself comfortably. Try to make sure that there is no tension around your shoulders; sometimes a pillow placed behind helps you to relax. Some mothers find also that by lying the baby on a pillow placed across the lap also helps to minimise back strain. It also helps if you can use some sort of firm footrest.
Hold your baby either in the crook of your arm or with your hand supporting baby behind the shoulders with the head resting on the edge of your open palm. Roll your baby towards you so that the chest is facing yours. Support your breast with one hand and touch your baby's upper lip with your nipple. Because all newborn babies have a strong "rooting reflex", your little one should open its mouth wide, at which time you should bring your baby quickly to the breast, making sure that the chin is up against the bottom of the breast.
It is important for the baby to get a good mouthful of breast tissue (ie areola and nipple) when suckling. Your baby's lips should be flanged out, and, if your baby is attached well, your nipple should lie at the junction of the soft and hard palate. As the milk is suckled by means of soft, pulsatile tongue movements, it should not hurt and your baby will have deep jaw movements. It helps to look for an imaginary straight line coming from the crown of your baby's head towards the centre of your breast. If there is any tension around the nipple because of poor positioning it will hurt. Often just by reattaching after encouraging a wide gape, or moving your baby's body slightly, will fix the problem.
If you need to break the suction, depress the breast gently away from the corner of your baby's mouth. Never pull the nipple out abruptly as this could hurt the nipple. In most cases your baby will leave the breast automatically when he/she has had enough milk. Immediately after withdrawal, the nipple should look flat and evenly compressed. If the nipple has a wedged shape, it usually means that your baby has taken in too much nipple tissue either at the top or bottom of the nipple, and you should adjust your attachment technique accordingly.
Cracked or bleeding nipples may occur as a result of poor attachment. Occasionally a nipple shield may be used as an interim measure. However, these should be used with caution and under supervision as they can cause a reduction in milk supply and baby's progress needs to be monitored. Seeking help for positioning and attachment is essential.
All pages in this section come from the Appendix of my book The Homoeopathic Physician's Guide to Lactation. Permission is given for this information to be downloaded to assist mothers who are having problems with breastfeeding just so long as acknowledgement of authorship is maintained.