Laid Back Breastfeeding

By Martha Peelor, RN, IBCLC

How We’ve “Always Done It”

Over the last 40 years, first as an LLL leader (1971) and then as an IBCLC (1985), I have been able to observe, assist and encourage countless mothers and babies as they begin the dance of breastfeeding. I taught prenatal breastfeeding classes and I have been able to see new mothers with their babies in their homes, at meetings, in the hospital and now, in the pediatrician’s office for their first one or two visits.

In all of these settings, both before and after the baby was born, I have found that most mothers, fathers and other family members have a mental picture of the new breastfeeding couple. Usually, mom is in a rocking chair, in a beautiful new nursing gown. She is holding the baby in the cradle hold, leaning over the baby and gazing adoringly into the baby’s eyes. There is usually no sign of pillows supporting the baby or the mom’s arms.

What we don’t see in this picture is the pain in mom’s eyes and face as she sits on her sore perineum or holds the baby tight against her cesarean incision; the tension in her body as she struggles to hold the baby’s weight; the ache in her back, neck and shoulders from leaning over the baby; and, the pressure she is exerting on the baby’s back or head to keep the baby from rolling too far into or away from the breast.

While the football and side-lying positions change the above dynamics, many new moms find these positions problematic as well. These are the ones I knew, however, and these were the positions I taught new mothers.

A New Idea

A few years ago, at an International Lactation Consultant Association conference, I had the opportunity to hear Suzanne Colson, PhD, MSc, BA, RGN, RM and Honorary Senior Midwifery Lecturer at Canterbury Christ Church University, speak about Biological Nurturing. Her research, video and discussion of the value of “laid back breastfeeding” totally amazed me. If you are not familiar with her work, please do yourself the favor of going to her website checking it out.

I returned from that conference as a fervent convert to the concepts involved in Biological Nurturing. These include the release of neonatal reflexes which help baby to latch and the importance of gravity with the baby in a full frontal position in optimizing the baby’s ability to find the breast and nipple and achieve a deep, asymmetric latch. There is a lot more to Biological Nurturing than these two concepts but they were the main ones I brought home.

In my office/lactation room at work, there is a small, cushioned recliner for the new mom to use while we do a consult. Mom and I talk about the positions she has been taught and I ask her if she would like to learn a new one that will be very comfortable for both her and baby. Most moms were glad to do that but not all were thrilled about the idea of nursing in that position. (Remember the mental picture above?) However, when I tell them that their babies might do an amazing thing (self latch) it makes them more willing to try. The moms who have latch problems or sore nipples or problems keeping the baby awake are very happy to try this “radical” way of breastfeeding.

So mom takes her shirt off and we fix the recliner so that she is lying at about a 45 degree angle. Then we put the undressed baby face down between the breasts and watch what happens.

Most of you have probably watched one of the “self-attachment” videos showing the newly-born baby crawl up the mom’s belly to her breast and start nursing. During a consult there is a lot to do and a limited time so mom helps the baby to the breast and puts her by the nipple. The baby then bobs around, lifts his head, does some pushing with her feet and legs and brings his head around in alignment with the nipple. There is usually a quick, deep latch, face down and then the baby turns her head to the side as he starts to feed. A pillow is put under the mom’s arm on the side where she is stabilizing the baby.

The look on the mom’s face is priceless. Two wonderful things have happened. The first is that she is not sitting on her perineum; she is sitting on her sacrum. So that pain is gone. Her body is relaxed and completely supported. There is no tension in her neck, shoulders or back. Since the baby can feed this way in a vertical, horizontal or oblique lie, mom does not need to have the baby’s weight on an incision. Unless she is supporting a very large or pendulous breast, her opposite hand is free.

The second wonderful thing is that the baby, who may have been really struggling with latch, generally gets on with very little trouble. This is wonderful for both mom and baby. Most babies nursing this way have very effective feedings; they are less likely to fall asleep because of poor milk flow. Moms often say that this was the best feeding the baby had ever had!

This laid-back position has worked really well for the moms who have tried it. Many mom has loved nursing this way and if the babies could talk, I know they would agree. This position can be used even if the baby is using a nipple shield to latch.

Check here for a GREAT resource about laid-back nursing from Nancy Mohrbacher.

Martha Peelor, an International Board Certified Lactation Consultant, was a long-time member of our staff.