Getting It Right from the Start
Proper positioning and latching are the foundation of comfortable, successful breastfeeding. When done correctly, breastfeeding shouldn’t hurt, and your baby will effectively remove milk from your breast. This guide will help you master these essential skills.
Why Position and Latch Matter
Good Position and Latch:
- Prevents nipple pain and damage
- Allows baby to remove milk effectively
- Stimulates adequate milk production
- Prevents breast problems (engorgement, blocked ducts, mastitis)
- Ensures baby gets enough milk
- Makes breastfeeding enjoyable rather than dreaded
Poor Position and Latch:
- Causes nipple pain, cracking, and bleeding
- Results in ineffective milk transfer
- Can lead to low milk supply
- Causes baby to be frustrated and fussy
- May lead to early breastfeeding cessation
General Positioning Principles
Before learning specific holds, understand these universal principles:
Your Positioning:
- Get comfortable first: Use pillows to support your back and arms—you’ll be nursing many times per day
- Bring baby to breast: Never lean forward or hunch over to bring breast to baby
- Stay relaxed: Tension in your shoulders and neck will cause discomfort
- Support your breast if needed: Use C-hold (thumb on top, fingers below, several inches back from nipple) or U-hold
Baby’s Positioning:
- Tummy to tummy: Baby’s entire body faces you, not twisted at the waist
- Ear, shoulder, hip alignment: Baby’s head, shoulders, and hips form a straight line
- Head slightly extended: Nose tilted slightly up (not chin tucked to chest)
- Body close to you: No gap between baby’s body and yours
- Nose level with nipple: Before latching, baby’s nose (not mouth) should be at nipple level
- Adequate support: Support baby’s entire body, not just the head
The Five Major Breastfeeding Positions
1. Cradle Hold
The most common position once you and baby have mastered latching.
How to Do It:
- Sit comfortably with back support
- Hold baby across your lap, tummy to tummy
- Baby’s head rests in the crook of your elbow on the same side as the breast you’re using
- Your forearm supports baby’s back
- Your hand supports baby’s bottom or thigh
- Baby’s head and body form a straight line facing you
- Bring baby to breast when mouth opens wide
Good For:
- Once breastfeeding is established
- Older babies with good head control
- Feeding in public or on the go
Not Ideal For:
- First days when learning (cross-cradle gives more control)
- Very small or premature babies
2. Cross-Cradle Hold
Excellent for newborns and learning to latch.
How to Do It:
- Similar to cradle hold, but using opposite arm
- If nursing from right breast, use your left arm to support baby
- Your hand supports baby’s neck and base of head (between baby’s shoulder blades, not back of head)
- Your fingers are behind baby’s ears, thumb on one side, fingers on other
- Your right hand supports your right breast
- More control over baby’s head position
- Once latched, you can switch to cradle hold if more comfortable
Good For:
- Newborns learning to latch
- Small or premature babies
- Babies who have trouble latching
- Mothers who want more control of positioning
Tips:
- Don’t push on back of baby’s head—this causes baby to arch away
- Support at neck and upper back instead
3. Football/Rugby/Clutch Hold
Baby is tucked under your arm like a football.
How to Do It:
- Sit with pillow at your side
- Position baby along your side, body extending behind you
- Baby’s feet point toward your back
- Baby faces your breast
- Support baby’s head with your hand at the base of the skull
- Baby’s nose is level with your nipple
- Bring baby to breast when mouth opens wide
Good For:
- After cesarean section (keeps baby off incision)
- Mothers with large breasts
- Feeding twins simultaneously (one on each side)
- Babies who have trouble latching
- Flat or inverted nipples (gives better view and control)
- Small or premature babies
Not Ideal For:
- Feeding away from home (requires more space and pillow support)
4. Side-Lying Position
Both you and baby lie on your sides facing each other.
How to Do It:
- Lie on your side with pillow under your head
- Place pillow behind your back for support
- Pillow between your knees for comfort (optional)
- Baby lies on their side facing you
- Baby’s mouth is level with your nipple
- Your lower arm can extend above baby’s head or support your own head
- Use your upper arm to support baby’s back or support your breast
- May need rolled towel behind baby to keep them positioned
Good For:
- Nighttime nursing (you can rest while feeding)
- After cesarean section
- Mothers who find sitting uncomfortable
- Allowing baby to comfort nurse while you rest
- Reflux babies (ensure you burp before lying baby flat)
Safety Note: Don’t fall asleep with baby in your bed unless you’ve followed safe co-sleeping guidelines. Many mothers feed in side-lying position then move baby to bassinet.
5. Laid-Back/Biological Nurturing Position
You recline comfortably, baby lies on top of you.
How to Do It:
- Recline at about 45-degree angle (not flat, not sitting upright)
- Use pillows to support yourself comfortably
- Place baby tummy-down on your chest/abdomen
- Baby can be completely on top of you or slightly to the side
- Baby’s cheek is near your breast
- Gravity helps keep baby in place
- Baby uses natural feeding reflexes to find breast and latch
- You can guide with your hands, but baby does much of the work
Good For:
- Very early days (first hours and days)
- Babies with strong reflexes who push away when positioned in other holds
- Mothers with very full breasts or fast letdown
- Making breastfeeding feel more intuitive and relaxed
- Babies who struggle to latch in other positions
Benefits:
- Uses baby’s natural feeding instincts
- Very relaxed for mother
- Good skin-to-skin contact
- Baby has more control
Achieving the Perfect Latch
The latch is more important than the position. A baby in a perfect position with a shallow latch will cause pain and won’t get enough milk.
Steps to Latch:
- Position baby at breast with nose level to nipple (not mouth to nipple)
- Tickle baby’s lips with nipple to stimulate rooting reflex and encourage mouth opening
- Wait for WIDE open mouth (like a yawn, not just partially open)—this is KEY
- Move quickly when mouth is widest—bring baby onto breast in one swift motion
- Baby’s chin touches breast first, then lower lip, then upper lip
- Baby takes large mouthful of breast tissue, not just the nipple
Common Latch Mistake: Many mothers aim the nipple toward the center of baby’s mouth. Instead, aim the nipple toward the roof of baby’s mouth (nose side). This helps baby take more breast tissue into their mouth.
Recognizing a Good Latch
What You See:
- Baby’s lips are flanged outward (rolled out like fish lips)
- More areola visible above baby’s top lip than below bottom lip
- Baby’s chin is pressed into breast
- Baby’s nose is clear or just touching breast
- Cheeks stay rounded (not sucked in or dimpled)
What You Feel:
- Perhaps brief discomfort for first 30 seconds as baby establishes suction
- Then comfortable pulling/tugging sensation
- NO ongoing pain—pain means latch needs correction
What You Hear:
- Initially rapid, light sucking to stimulate letdown
- Then slower, rhythmic suck-swallow pattern
- Quiet swallowing sounds (like small gulps)
- NO clicking sounds (indicates poor suction)
What Baby Does:
- Sucks with rhythmic jaw movement
- Pauses to swallow
- Relaxed hands (not fisted)
- Body relaxed
Fixing a Poor Latch
If nursing hurts beyond initial 30 seconds, the latch is incorrect. Break the suction and try again.
To Break Suction Safely:
- Insert your clean pinky finger into corner of baby’s mouth
- Slide finger between baby’s gums to break seal
- Remove baby from breast
- NEVER pull baby off breast without breaking suction—this damages nipples
Common Latch Problems and Solutions:
Baby Takes Only Nipple (Shallow Latch):
- Wait for wider mouth opening
- Aim nipple toward roof of mouth
- Ensure baby’s chin touches breast first
- May need to use different position with more control (cross-cradle, football hold)
Baby’s Lips Are Tucked In:
- After latching, gently pull baby’s lower lip out
- Ensure mouth opened wide before latching
Tongue-Tie: If baby can’t latch despite correct positioning, has clicking sounds, or causes persistent nipple pain, check for tongue-tie (tight frenulum). Your pediatrician or lactation consultant can assess. A simple procedure can correct this if needed.
Flat or Inverted Nipples:
- Breast shells worn between feeds can help draw out nipples
- Pump briefly before feeding to make nipple more prominent
- Try football hold or cross-cradle for better view and control
- Manual nipple stimulation before latching
- Most babies can successfully nurse even with flat nipples once they learn
Tips for Success
Practice Skin-to-Skin: Holding baby skin-to-skin frequently (not just during feeding) helps baby become familiar with your breast and triggers feeding reflexes.
Stay Patient: Learning to latch can take days or even a couple weeks. Don’t give up during the learning phase.
Try Different Positions: If one position isn’t working, try another. Some babies latch well in football hold but struggle in cradle hold, or vice versa.
Feed at Early Hunger Cues: Trying to latch a screaming, frantic baby is much harder. Watch for early hunger cues:
- Rooting (turning head, opening mouth)
- Bringing hands to mouth
- Smacking lips
- Stirring from sleep
Get Professional Help Early: If you’re struggling for more than a day or two, contact a lactation consultant. Problems are much easier to fix early than after days of incorrect latching.
Watch Videos: Seeing breastfeeding in action helps tremendously. Look for videos from reputable sources showing various positions and latch techniques.
When to Seek Help
Get professional lactation support if:
- Breastfeeding is painful beyond the first 30 seconds of latch
- Your nipples are cracked, bleeding, or damaged
- Baby seems frustrated or cries at the breast
- Baby can’t latch or falls asleep immediately upon latching
- Baby makes clicking sounds while nursing
- Baby isn’t gaining weight appropriately
- You’re dreading feedings due to pain
Most positioning and latching issues can be resolved with proper support. Don’t suffer in silence—help is available!