Breastfeeding Positioning and Latching at SickKids

Early cues: Stirring, mouth movements, and head turning.
Mid cues: Stretching, increased physical movement, and hand to mouth.
Late cue: Crying, agitated baby. Calm the baby before attempting to latch.

Observing Feeding Cues

Comfort and Support: Find a comfortable position for you and your baby.
Common Positions:
- Cross Cradle:
  - Most common for support.
  - Parent supports baby with opposite arm, back supported with forearm.
  - Baby's head tilted slightly back, supported by parent's hand.
  - Skin-to-skin contact, baby aligned ear, shoulder, hip.
- Football Hold:
  - Useful post-cesarean.
  - Baby can lie on back or side, tucked close to parent.
  - Baby's neck and shoulders supported, nipple opposite nose.
- Cradle Hold:
  - For babies latching well.
  - Transition from cross cradle after latch.

Proper Latching:
- Position baby’s nose to nipple, chin to breast first.
- Wait for wide-open mouth (like yawning) before bringing baby to breast.
- Avoid stretching breast into baby's mouth.
Signs of a Good Latch:
- Wide-open mouth with angle >130°.
- Baby’s nose not touching breast, chin first.
- Asymmetrical latch, more areola visible above top lip.
- Lips flanged out.
Avoiding Pain:
- Ensure nipple reaches soft palate.
- Avoid compressing nipple against hard palate.
- Break latch gently with a finger if necessary.

Pumping Coordination:
- Pump immediately after feeding.
- Exceptions for partial pumping before feeding if large milk supply.
Ensuring Effective Feeding:
- Switch breasts when swallows decrease.
- Protect milk supply with consistent pumping.

Remember, the right position is what feels comfortable for you and your baby, and promotes a good latch and effective feeding.