Something as natural as breastfeeding should just happen naturally … shouldn't it? For humankind to have survived over the centuries, babies have needed to be able to attach to their mothers' breasts and must have done so. Yet in our society today, attachment problems seem to be very common.
Could it be that we have lost the advantages of the extended family or village groups where young girls would have observed and assisted mothers, aunts, or sisters who were breastfeeding. They also would have had the assistance from them when they in turn had their own babies. Many new mothers today may have never handled young babies let alone seen one being breastfed. The art of attaching a baby to the breast is therefore a skill to be learned.
In a relaxed birthing atmosphere, the newborn baby will seek out the mother's breast and attach and suckle with little intervention necessary. However, few mothers have this opportunity as birthing may be fraught with many interventions and procedures. In some cases it may be a number of hours before the mother gets to hold and feed her baby. Drugs used during labour and surgical procedures may result in the mother, baby or both being sleepy, tense or in pain when it comes to feed time. Incorrect advice and assistance during initial attempts at attachment may further confuse both mother and baby.
The results of sub-optimal attachment can be far-reaching. The first symptom noticed may be sore, grazed or cracked nipples. Other consequences could be insufficient drainage of the breast resulting in reduction of milk supply in that breast. The baby who is not milking the breast efficiently may then fail to thrive and be weak, therefore continuing to fail to attach well. Conversely, the well-attached baby causes no pain to the nipple, milks the breast well ensuring a good supply and grows accordingly.
Steps to attaching your baby:
- Sit or lie comfortably with your back and feet supported.
- Have your clothing open as much as possible for the first feeds; it may also help to remove your bra or even your upper clothing.
- Unwrap your baby and hold him close, with his head and shoulders supported along your forearm. He will be on your forearm with his head supported at the back of his neck.
- Turn him onto his side with his chest towards you, head tilted slightly back, at the same level as your breast and his nose and mouth level with your nipple. If you are sitting, tuck his feet around your side and his lower arm around your waist.
- Gently brush your baby's mouth with the underside of your nipple. This will encourage your baby to open his mouth wide. You may find holding your breast similar to a sandwich allows him to take more of your areola in, and makes it easier for him to attach.
- When your baby opens his mouth wide and his tongue comes forward over his lower gums bring him quickly to the breast with your nipple pointing to the roof of his mouth. His first point of contact will be his lower jaw or chin well down on your areola.
- As his mouth closes over the breast he should take in a large portion of the areola.
- If you are engorged, expressing around the areola can soften it, allowing him to attach more easily.
To check that baby is attached properly, look for these signs:
- Chin is touching the breast and nose is clear.
- Lips are flanged out, not sucked in.
- Tongue is forward over the lower gum (may be difficult to see at first).
- Your baby has much of the areola in his mouth, more so on the 'chin side'. There is no serious pain in the nipple (new mums may feel a tingling sensation as the nipple adjusts to being drawn out).
- You may notice your baby's whole jaw moving as he sucks and even his ears wiggling. He should not be sucking in air or slipping off the breast.
If the attachment does not appear to be successful or feeding is painful, take your baby off the breast by inserting a clean little finger in the corner of his mouth to break the suction, then reattach. Sometimes some small adjustment of the baby's position can help, such as ensuring his lower arm is around your waist or his body is in a straight line. Chest to chest and chin to breast is a quick way of describing good positioning.