Breastfeeding positions: everything you need to know

May 14, 2024 Manuel Fernández

The mother's posture and the way your baby latches on to the breast have been the subject of all kinds of recommendations, some of them contradictory. Although it is well known that what really matters is the relationship between your baby's mouth, your nipple and your areola. Identifying the positions that can help your baby latch on properly will help you establish your breastfeeding. That is why the midwife team at Happymami has put together this post based on the latest AEPED recommendations on breastfeeding positions, everything you need to know.

How should you position yourself to breastfeed?

Why is a good position important for breastfeeding?

As for the correct position versus an incorrect one, scientific evidence shows that when a baby does not feed in the correct position, they cannot remove the hindmilk, and what is known as “poor positioning syndrome” occurs. The mum experiences nipple pain and cracked nipples, because the baby applies constant pressure to a small area, and engorgement, inflammation or even mastitis can also occur, since the breast is not emptied.

You may also notice strong and repeated let-down reflexes, because oxytocin secretion increases to release the milk your baby cannot actively take. Your baby has long feeds (>30 minutes) and does not come off the breast spontaneously, as they cannot get the hindmilk. They ask for the breast very often (they rarely “last” >2 hours) and seem nervous, restless and tearful, and may even “fight the breast”, because they are hungry and frustrated at not getting the milk they expect.

They also often bring up or vomit milk, because they take in a large amount of low-fat milk. In general, weight gain is poor, because their calorie intake is insufficient. That is why it is important to stress a correct position and latch for breastfeeding.

General points about positions for breastfeeding your baby

Whatever position you choose to breastfeed your baby in, there are some basic tips you should bear in mind that will make it easier for your baby to latch on. And, as a result, will help you establish your breastfeeding, with effective emptying of the breast.

As a mum, you should feel comfortable in the position. Pillows or cushions can help you with this.
Your baby's body should be in close contact with yours. When you are lying back, your baby's weight will rest on your body. This makes it easier to keep that close contact, which helps get your baby's reflexes going.
Your baby's head should be in front of the breast, well aligned with the body. (Their neck should not be flexed, nor their head turned.) It is better to move the baby than to move the mother's breast.
Your baby's chin should rest on the breast, with the nipple above the upper lip, level with the nose. That way, when your baby triggers the rooting reflex and latches on to your breast, their neck will be slightly hyperextended, which makes it easier to coordinate sucking, swallowing and breathing.
Remember that it is better to encourage a spontaneous latch with a correct breastfeeding position. When your baby's mouth is wide open, bring them to the breast and let your baby be the one to latch on. If your baby cannot manage it, a guided latch can help

Positions for breastfeeding

BIOLOGICAL NURTURING POSITION (CRIANZA BIOLÓGICA®*)

Position yourself semi-reclined (between 15° and 65°) and comfortable.
Your baby lies on top of you with their face between your breasts.
Let your baby move towards your breast and latch on spontaneously.
This position is especially useful when there are difficulties with latching, as it helps the newborn to use their instinctive reflexes. You will see your baby bobbing their head and moving around looking for their mother's breast.
This position is also useful when there is perineal pain.
It was registered by Suzanne Colson.

Sitting CRADLE position

It is one of the most widely used positions.
Sit up straight with your back supported, and bring your baby to the breast (rather than leaning towards the baby). Pillows or a footrest can be used for extra comfort and to raise the baby to the level of your breast.
As a mum, support your baby's neck and head with the same arm and hand as the breast you are offering.
So that the neck is not flexed, in most cases you need to put the head on your forearm rather than on your elbow, and your hand on their back rather than on their bottom.

Breastfeeding lying down or LYING ON YOUR SIDE

Lie on your side so that your breast rests on the mattress.
Place your baby lying on the bed in front of you.
You can put a pillow under your head, behind your back or between your legs.
Your baby lying on their side, looking at you, with their head resting on the mattress (not on the mother's arm).
Move your baby (not the breast) until your nipple is level with their nose.
This position is especially useful for helping the mother rest when there is perineal pain (instrumental birth, haemorrhoids...).

RUGBY hold for breastfeeding

Support your baby's body and head with the forearm and hand on the same side as the breast you are going to offer. This leaves one hand free to guide the latch if you need to.
Your baby's body tucks under your arm, and your baby's feet point towards your back.
It can help to have a pillow or cushion to rest your forearm and your baby's body on.
This position is especially useful for:
- Caesarean sections, to protect the surgical wound.
- Mothers with very large breasts or with morbid obesity.
- When the outer quadrant of the breast needs to be drained.
- When other positions need to be tried to improve the baby's latch.
- Breastfeeding twins at the same time.
  - With twins, the mum can breastfeed one at a time, or both at the same time, in the cradle position, in the rugby position or a combination of both.

DANCER** position

This position was registered by Sarah Couter Danner and Ed Cerutti.
Place your baby sitting astride your thigh, with their head in front of the breast.
With one hand, hold your baby by the back, and with the other, bring your baby's chin to your breast.
Place your hand like a tray under the breast and use your index finger and thumb in a U shape to support the chin.
This position is especially useful for:
- Palate problems
- Hypotonia (Down syndrome...)
- Retrognathia
- Gastro-oesophageal reflux.

As well as the classic positions described in the PSBC guide, some authors refer to the “spontaneous latch” position. When the baby's mouth is wide open, bring them to the breast and let them latch on themselves. If the baby cannot manage it, a guided latch can be useful.

Breastfeeding positions and tips: is one position better than another for breastfeeding?

At present there are no studies comparing the different positions, but the clinical practice guidelines and the group of breastfeeding experts suggest that:

the cross-cradle and rugby holds are useful at first, until both learn to latch on, and also when there is nipple pain or cracked nipples;
the cradle position is usual after the first few weeks;
the lying-down position is useful for night feeds.

The evidence shows that although there is a variety of positions for breastfeeding your baby, what matters is to check that the baby's body and the mother's are close together and that the baby's head and neck are aligned. You can choose one position or another depending on the mother's preference, although the evidence suggests that the spontaneous latch position of the baby on to the breast can be useful for preventing and treating breastfeeding-related problems such as a poor latch and pain.

Conclusion: breastfeeding positions, everything you need to know

Remember that at Happymami we have a team of midwives who are experts in breastfeeding who would be delighted to advise you and help you establish your breastfeeding and find the best breastfeeding positions.

What is more, if you do need to use a bottle to feed your baby, it is important to have an option that supports and protects your decision to breastfeed. That is why Happymami stands out as the only bottle in the world designed by mothers, for mothers, with the specific aim of preserving and promoting breastfeeding.

When it comes to breastfeeding, positions can make all the difference to the comfort of both mother and baby. As we have seen, there are various breastfeeding positions that can be adapted to the individual needs of each mother-baby pair. The “cradle” position is one of the most common, with the baby placed on the mother's lap, their head resting on her forearm, forming a kind of cradle. Another option is the “rugby ball” position, where the baby is placed at the mother's side, their body under the mother's arm, imitating a rugby ball. There is also the “lying on your side” position, which can be especially useful during sleep times. Exploring different positions can help you find the one that is most comfortable and effective for both of you, encouraging a pleasant and successful breastfeeding experience.

By avoiding nipple confusion in your baby, this bottle helps to keep the harmony between natural breastfeeding and bottle feeding, which makes the transition from breast to bottle easier and minimises the possible obstacles in the breastfeeding process. With Happymami, you can rest assured that you are making informed decisions carefully designed for your baby's wellbeing and health, without compromising your wish to breastfeed.

So, once the moment to breastfeed arrives, knowing the best breastfeeding positions can make a big difference to the breastfeeding experience. Choosing the right breastfeeding positions helps to ensure that both mother and baby are comfortable, which makes feeding effective and pain-free. By avoiding nipple confusion in your baby, this bottle helps to keep the harmony between natural breastfeeding and bottle feeding, making the transition from breast to bottle easier and minimising the possible obstacles in the breastfeeding process.