The cross-over hold. Take time to position yourself comfortably. If you are nursing in a hospital bed, sit up as straight as possible with a pillow behind you. As soon as you are able, sit in a chair with arms (most couches are too deep). Place one or two pillows on your lap so that the baby is lying on his side at the level of your breast. Instead of holding his head in the bend of your elbow as in the cradle hold, hold him with the opposite arm, so that your hand rests between the shoulder blades and supports the back of his neck and head. Place your thumb behind and below one ear and your other fingers behind and just below the other. Position the baby's face directly in front of your breast, instead of pushing your breast sideways toward the baby.
If you're starting on the left breast, hold it with your left hand so that your thumb is positioned about 11/2 inches from the nipple, at the spot where the baby's nose will touch the breast, or at about two o'clock if you imagine a clock face printed on the breast. Your index finger should be at the same distance from the nipple, at the spot where the baby's chin will touch the breast, or at about eight o'clock . Compress the breast at the margin of the areola with your thumb and index finger, so that your hand forms almost a U-shape. Compressed this way, your breast should closely match the shape of your baby's mouth, so that he can take in more of the breast.
With the baby and breast in position, you are ready to proceed. Your goal is first to stimulate the baby to "root," and then to bring him onto the breast. Touch the baby's lips to your nipple until he opens wide. When he opens his mouth really wide-0and not before--quickly bring him onto the breast. Do not lean toward the baby; bring his shoulders and head to you. When you pull the baby in, keep the areola compressed until he begins sucking. The two mistakes mothers tend to make is letting go of the breast before the baby is well latched on and not pulling the baby on far enough. You may need to repeat these steps several times before the baby latches on correctly. Once the baby is actively nursing, you'll probably need to support the breast for him, by gently pressing your fingers against the underside. If your breasts are small, though, you may be able to let go of your breast or even switch arms and continue nursing using the cradle hold. Football hold. The football hold is a great position when-
• You have had a cesarean birth and want to avoid placing the baby against your abdomen.
• You need more visibility in getting the baby to latch on.
• Your breasts are large.
• You are nursing a small baby, especially if he is premature.
• You are nursing twins.
Sit in a comfortable armchair with a pillow at your side to help support your arm and lift the baby. Support the baby in a semisitting position facing you, with her bottom at the back of the chair. Your arm closest to your baby should support her back, with your hand holding her neck and head. Place your thumb behind and below one ear and your other fingers behind the other. The top of the baby's head should be as high as the top of your breast.
Support your breast with your free hand so that your thumb is about 1 1/2 inches from the nipple at twelve o'clock and your index finger is the same distance from the nipple at six o'clock . Compress the areola with your thumb and index finger, so that your hand forms a C-shape. This will more closely match your breast to the shape of your baby's mouth, so she can take in more of the breast. As with the cross-over hold, stimulate the baby to open her mouth wide, and bring her onto the breast.
Side-lying position. The side-lying position is an especially good choice for nursing when:-
• You must be flat after a cesarean birth.
• You are uncomfortable sitting up.
• You need help from someone else to get the baby latched on.
• The baby is sleepy and reluctant to begin nursing or stay awake very long.
• You are nursing during the night.
• You and your baby lie on your sides, tummy to tummy, as with the cuddle hold. Place your fingers beneath the breast and lift upward, then pull the baby in close after he roots with a wide open mouth.
Ending the feeding. Waiting until your baby lets go of the nipple is the ideal way to end a feeding. If the baby does not come off the breast by himself after 20 to 25 minutes on a side, and you want to switch breasts or rest awhile, you can take him off by first breaking the suction. Even if he is not actively sucking, his hold on the nipple is tremendously strong. To release the suction, pull down on his chin or insert your finger into the corner of his mouth, pushing your finger between his gums until you hear or feel the release. You can also try placing your finger on the corner of the baby's mouth and pulling the skin gently towards his ear.After taking the baby off the breast, leave your bra flaps down so that the air can dry your nipples. Air drying helps to maintain healthy nipples.
