Position

• Ensure mom is comfortable and well supported with pillows for her arms and baby as needed.
• Baby in skin-to-skin position.
• While sitting in a chair or on the couch, mother may want a stool to lift her knees to hip height. This puts her hips into a pelvic tilt and helps to prevent back strain.
• Baby’s ear, shoulder and hip should be aligned in all feeding positions.

Laid Back (biological nurturing) Breastfeeding

Semi-reclined position that allows a newborn to have more control of his head and utilizes his stepping reflex. The mother may need several pillows behind her for support. Baby is positioned entirely on mother, allowing him to self-latch.

Cradle Hold

Baby on side, facing tummy-to-tummy with mom. Head rests on mom's forearm or in bend of elbow, nose aligns with nipple, chin touching breast. Baby’s lower arm is tucked under her breast. The mother uses her free hand to support breast if needed.

Cross-Cradle Hold

Same position as cradle hold except supporting arm and hand are reversed. The different hand angle of the supporting arm offers more head support for a newborn. The mother’s hand should be placed at base of infant's skull and not across the back of the head.

Football (Clutch) Hold

Place pillow behind the mother’s s back to provide space between the baby’s feet and bed. Place another set of pillows along mother’s side to keep baby level with breast (depending on the length of mom’s torso, more than one pillow may have to be used). Tuck baby under the mother’s arm with tummy pressed against the side of her body, slightly rotated. Infant’s hip is flexed, with feet tucked up, not pressing against a chair or bed. 

Side-Lying Hold

Place pillows behind the mother’s back, under head and between knees. The mother should lie on her side facing the baby in a tummy to tummy position. Support the infant’s back with the mother's hand, a small pillow or a rolled-up blanket. Align the baby nose to nipple.&

Clinical Guidelines

• Brodribb, W. (2018). ABM Clinical Protocol #9: Use of Galactogogues in Initiating or Augmenting Maternal Milk Production, Second Revision 2018. Breastfeeding Medicine, 13(5), 307–314. 
• Kellams, A., Harrel, C., Omage, S., Gregory, C., & Rosen-Carole, C. (2017). ABM Clinical Protocol #3: Supplementary Feedings in the Healthy Term Breastfed Neonate, Revised 2017. Breastfeeding Medicine, 12, 188–198. 

Reference

1. Campbell, S. H., Lauwers, J., Mannel, R., & Spencer, B. (2019). Core curriculum for interdisciplinary lactation care. Jones & Bartlett Learning. 
2. Lawrence, R. A., & Lawrence, R. M. (2016). Breastfeeding: A guide for the medical profession (8th ed.). Elsevier. 
3. Section on Breastfeeding (2012). Breastfeeding and the use of human milk. Pediatrics, 129(3), e827–e841. 
4. Walker, M. (2017). Breastfeeding management for the clinician: Using the evidence. Jones & Bartlett Learning.