It is essential for the mother to choose a comfortable position to change, from time to time, to allow the child to put pressure in different areas of the nipple and areola, and to avoid any irritation to the nipple with the risk of annoying breast engorgement. This will allow the mother to relax, and the baby to stay at the breast for a long time without any effort.
In the sitting position, the child should be supported by the shoulders, and held in your arms. The baby’s body should be straight, but turned on its side with the belly facing the mother’s breast.
In this position, the child’s head will rest on your forearm slightly, tilted a bit to the back, and the baby’s mouth will be in front of the nipple (Fig. 6a).
In the first few days after birth, it is particularly important that the mother’s back is straight at a right angle with respect to her hips. This will avoid muscle contractures in the spine. While staying comfortably seated, a pillow can be used as support. On the other hand, to relax the abdominal muscles, it may be useful to support the legs on a stool. In this position, it is recommended to always bring the child up to the nipple, avoiding bending over to give him the breast, thus risking experiencing back and nipple pain.
By resting the baby’s mouth against the nipple, delicately and insistently, the child will start spontaneously sucking, draining the milk from the breast.
In this position, the child’s head will rest on your forearm slightly tilted a bit to the back, and the baby’s mouth will be in front of the nipple (Fig. 6a).
In the stretched on the side position, the child stays right in front of the mother, stomach to stomach; a particularly useful position after a cesarean section or in case of pain in a sitting position (Fig. 6b).
In the position called “football“, the child is lying on a pillow, with the belly facing upwards and back on top of the mother’s the arm as she holds the infants head with her hand (Fig. 6c).
For this position, which is useful in children that have difficulty latching and allows to better monitor their sucking, is also indicated after cesarean delivery because it avoids direct pressure on the wound; it is also a useful position for feeding twins, and in case of very large breasts because it appears to facilitate emptying of the deepest milk ducts.
In many cases, it can be useful to support breasts with hand at C (thumb above the areola and the other fingers underneath and further to the back) and to stimulate the opening of the mouth by touching it with the nipple (Fig. 7a – 7b).
The breast should be placed so that the child takes not just the nipple in the mouth, but also a good part of the areola, more at the bottom than at the top. Particularly at the beginning of breastfeeding, when feedings are frequent and improper latching can damage the nipple, it is best to have relaxed shoulders and a supported back. The whole body of the newborn is close to the mother, chest to chest, and is ideally placed from ear to hip along a straight line.
When the baby latches on well, the baby’s chin touches the breast, the mouth is open wide and the lower lip is everted, namely, folded outward and NOT inward as if sucking from a straw.
Once the emission reflex is started, the baby sucks deeply for a long time using the lower jaw (note the movement of the muscles near the ear), cheeks do not hollow in and no pops can be heard.
Once the feeding is started, the baby becomes calm and relaxed, while the mother does not feel any nipple pain.