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What is baby-led attachment and how can it help you get started with breastfeeding? This video has expert tips and shows a mum using baby-led attachment.

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Back to my Breastfeeding Information Homepage

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Adjustments to make breastfeeding more comfortable

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Adjustments to make breastfeeding more comfortable

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Straightforward and practical tweaks you can try

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A dad at my breastfeeding support group this week had a bit of an epiphany. 'It's never felt like this before,' his wife had said. We'd spent just 3 or 4 minutes together. I'd mentioned one or two things about the way she was holding her baby. It was enough to make all the difference.

Just like in golf, he noted, with a tiny change to swing and position the game had been transformed.

As a lactation consultant, you study for hours and hours and pages and pages and pages. You know lots of things you may not talk about from month to month. But there are twenty or so things you say nearly every day.

So many mums have their experience transformed by a tweak. They are sore, dreading each feed, wondering how things will ever change and one comment - that may not even be 20 words long - can make all that go away in an instant.

It's one reason why even a rushed midwife or GP can turn breastfeeding around with the right training, even if they don't always have the time to devote to a long support session.

Here are a few of my favourite tweak considerations:
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1. Get a glass of water. Take a drink. Notice how you tip your head back and your chin comes away from your chest? Now try to take a drink with your chin pointing down towards your chest. Not so easy. Try and do that every time you drink, and I think you'll find you take less, give up sooner that you might otherwise and probably get a bit windy. So, tweak number one is hold your baby in a position where they can lift their chin away from their chest. If you are using a cradle hold or a cross-cradle hold, that means you might need to have them further away from the feeding breast's armpit and slid more across towards the non-feeding breast. We talk about 'nose to nipple' because that's encouraging the baby to reach towards the nipple with their head tilted back. If you are using a rugby hold, super important the baby isn't too far forward so they end up curling around the breast with their chin hunched towards their chest.

2. Don't hold the baby's head too high on the back of their head or push the baby's head towards the breast. Babies are clever at protecting their breathing (why we don't need to press our fingers into the breast near baby's nose). And nature has given them a reflex which means when someone pushes on their head, they'll be very unhappy about attaching in case they can't rescue themselves when breathing becomes restricted. They may even push back and shallow the latch and sometimes even refuse to feed entirely. So, support baby's head by holding around the base of the skull - supporting around their shoulders and chin and ears area - but no higher. Imagine Elvis towards the end of his career in Las Vegas with those diamond encrusted collars. You're holding your baby's Elvis collar and no higher. And even then, as gently as possible. Just enough to support baby's head without being too bossy or firm. You might even be using a position where this isn't a risk at all - you might be lying down or using a reclined position where your hand is nowhere near baby's head.

3. Beware the cushion myth. I am not kidding when I say that most people I meet using breastfeeding cushions are using them in a way that makes their life harder for themselves. The gap between your lap and the natural fall of your breast is probably very different from your mate's. It's going to depend on the length of your torso, the size of your breast, the way your breasts fall, the height of your lap which varies with your chair. It's also going to depend on the shape of your baby. So how on God's green Earth did we all get the message that the same size of breastfeeding pillow fits everyone?

Again and again and again, taller mums are slumping forward and hunching over their baby lying on their cushion. 'This cushion must be right. I just have to contort myself to get to it!'

And shorter women also think that the cushion is surely the answer, so they put baby on the cushion and umm, there's no space between their breast and the cushion for baby to fit. They often end up lifting their breast so baby can fit underneath. They might then have to hold their breast throughout the entire feed, compressing ducts and causing hand pain and usually not holding the breast in the same position the whole way through a feed so things wobble around.

Or folks might put the baby on the cushion and baby is a few centimetres too far away from them with sometimes not even the chin and chest making contact with mum at all.

Cushions can be handy to support mum's arms, but it doesn't normally work that the baby can't be held by mum and is entirely on the cushion.

What often works even better is no pillow at all and mum leaning back a bit. Check out: http://www.mothering.com/articles/natural-breastfeeding/

4. Baby needs to be clooose. If you can see the buttons down the front of baby's sleep suit, they are probably too far away. If baby's arm is trapped between you, they are being pushed too far away. If there's a big blob of your clothing and a breast pad between you, they are probably too far away. I once supported a mum who found night time feeds much more painful. She was sitting in the same chair to feed as she did in the day and was using exactly the same position but at night it was pinchy and uncomfortable. It turns out the difference was that the baby was wearing a sleeping bag at night. Just a few extra millimetres of padding meant that baby's chest and chin was a little bit further away from mum's body and the nipple wasn't going back far enough into baby's mouth. Baby's chin needs to be close into the breast. It's not going to work if the baby's chin isn't touching the breast at all. And the chin can't touch if the chest is too far away.

It's common for a mum to say, "Wow it doesn't hurt anymore!" followed by "I haven't been having them close enough!"

5. Mums are fiddling around and 'checking the latch'. It's completely understandable that when someone tells you the baby's mouth should be a certain way and the bottom lip should be flanged out like a fish lip, you think you are supposed to check! But the minute you push your baby's cheek out of the way and have a bit of a rummage, you've made some adjustments. Better to go with a look at the baby as they approach the breast and the mouthful you saw them take and how it feels. And how the nipple looks when it comes out of baby's mouth (might be elongated but shouldn't be squashed and flattened at the end.) If the baby is close enough, you usually can't see the lips at all. The rounded part of baby's cheek is in contact with the breast and the lips are hidden.

6. And while we are talking about lips, the top lip doesn't need to flange out and do the fish lip thing. It can rest in a neutral position. An excessively flanged top lip can even be the sign of a shallow latch. I've met several mums who have been told that the top lip should stick out and even flip it out themselves to make that happen. Curled in isn't ideal but it doesn't need to flip out.

7. Babies are sinking. Mums might start with baby on a squishy pillow and as the feed goes on, gravity does evil things and the baby starts to sink. The movement might be imperceptible but it's enough to pull the baby away from the breast. That pregnancy pillow filled with beans that the manufacturers claimed was super for breastfeeding? Meh. If it's bean-filled, it's likely to sink. That favourite feather filled bed pillow? Going to sink. Holding all the weight of your baby on your arms and hands and sitting bolt upright? You are going to sink. You are not designed to hold the weight of your baby in that position for minutes and minutes throughout the day. It's a big clue if you finish a feed rubbing your wrist and thinking, 'phew, glad that's over!' Gravity is your enemy. You need to find a position which you can sustain. That might be the right cushion for you (or more than one) or again, it might be about leaning back. Babies also latch better when they are anchored. If they feel themselves slipping, they may even clamp down and things can get even more sore.

8. What's the bottom cheek doing? Not many of us have nipples that come out from our body at precise right angles. So why do so many of us feed a baby as if that's true? The baby is precisely 'tummy to mummy' and lying on a breastfeeding cushion as if our nipples are pointing directly in front of us. In fact, most women have nipples that point slightly down (or off to one side and down). But we put baby into the 'right angle' position anyway. What ends up happening is that the top cheek (which mum can see in a cross-cradle or cradle position) is nice and close to the breast and rounded. However the bottom cheek can be centimetres away from mum's body with an unhelpful gap for air to get in and a shallowed latch. Get someone to check that the bottom cheek is touching the breast too. Look at your natural body shape. Your baby may need to look up towards your shoulder rather than at the back of the chair. You may be able to see both of their eyes.

9. Ear/ Shoulder/ hip in alignment. Get that glass of water again. Twist your neck and try to take a drink. It's rrrreally hard. And if what you were drinking was gradually getting thicker and fattier, again, you're likely to be taking in air and giving up sooner than you might. Baby can't lie on their back and twist their neck towards you to come to the breast. We want the ear and shoulder and hip to all be pointing in the same direction. Even a baby with a twisted torso and the twist is around the hips can run into problems.

10. Look at your body. Look, that mum over there in Costa seems to be able to drink her coffee (yes, you can drink coffee) and is just supporting her baby on one arm! How the heck! Can I do that? You know how hairdressers' clients turn up to their appointments with a celebrity photo and say, 'make me look like that!' That sometimes happens in breastfeeding too. 'Can I hold my baby like that mum I saw?'

Sometimes the answer is yes and sometimes it's no. Your humerus is the bone that goes between your shoulder and your elbow. Sometimes your humerus bone and the height of your breast isn't ideal for particular positions. Long humerus and high firm breast? You may not be able to do the cradle hold. I mean seriously - you may NEVER be able to do the cradle hold. The baby will be too low. Short humerus and long low breast? You may not be able to do the position that that woman in Costa can do and drink coffee. You might always need a hand to support the breast if you want to do the cradle hold.

It's not all about the pictures in that breastfeeding book or what your mates are able to do. It's about the shape of your body and the shape of your baby. Do you need to factor in wheelchair arms? Do you need to think about how your breast texture changes in the day? It's all very individual. Trying to make it work like everyone else does it can be unhelpful - which is why getting face-to-face help tailored to you can be so useful.

11. Give the baby more space for their tongue on the breast. You may have heard people talk about baby getting more of a mouthful of breast below the nipple than above. Or seeing some areola above the top lip and less (or none) below the bottom. If the baby has more space for their tongue on the breast, they have a chance of scooping more breast into their mouth and the latch being deeper. When the nipple is going in, picture it pointing towards the roof of baby's mouth rather than pointing down the back of their throat. Even just a little bit of re-angling can make things easier.

12. Don't make your baby eat cotton. Breastfeeding clothes also assume we're all the same. If you find them a faff - as you pull open a teeny slit to find your nipple hidden in there somewhere - I'm pretty sure your baby does too. If they ping back so the baby's nose and cheek comes back into contact with fabric again, maybe rethink. I've even seen babies with fabric in their mouths with a look of resignation that says, "This is the best I'm going to get". Cheap vest tops you can pull out of the way are very sensible. You can layer more than one so different bits are covered. And a bulldog clip is useful for securing fabric (not your chin holding your clothing and preventing it from flopping down onto baby's face).

As I say, some of that really isn't complicated. It's what we talk through on the breastfeeding helplines and what we point out every day in breastfeeding support groups. While at the same time NOT saying that it's 'normal' to be pain at 10 days or your nipples just need to get used to things. If you feel breastfeeding is just all too hard, remember you could be seconds away from fixing things.

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'Breastfeeding is just like golf! A tiny adjustment makes all the difference'

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A dad at my breastfeeding support group this week had a bit of an epiphany. 'It's never felt like this before,' his wife had said. We'd spent just 3 or 4 minutes together. I'd mentioned one or two things about the way she was holding her baby.

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Some helpful webpages and videos of attachment.

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Video transcript

Narrator: Getting a good attachment is an important step towards getting breastfeeding working for you and your baby. Becoming skilled at it can take time. Having you and your baby calm and relaxed is the first key step towards getting a good attachment to the breast. One thing that can help is to recognise the things your baby does to tell you he's ready for a feed, like turning his head from side to side with his mouth open.

To start the feed, hold your baby in close, along your forearm so that her chest is touching yours. Remember to bring your baby to your breast and not your breast to your baby.

Narrator: Bring your baby's nose directly opposite your nipple. As your baby tips her head back, her top lip brushes over your nipple. This encourages her to open her mouth wide. When her mouth is wide open, hug your baby to your breast and she can take your breast into her mouth with her chin leading. When your baby attaches well, she will have a large mouthful of breast in her mouth and your nipple will be positioned far back in her mouth, towards her soft palate. Breastfeeding will more likely feel comfortable and she can get the milk she needs.

So here is how it will look to you. Bring your baby's nose directly opposite your nipple. Allow your baby's head to tip back. As it does, her top lip will brush over your nipple. This encourages her to open her mouth wide. Sometimes it can take a few goes to get the timing right. So you can encourage her to open her mouth wide again by brushing your nipple over her top lip.

When her mouth is open wide, quickly hug her onto your breast directing your nipple towards the roof of her mouth. This helps achieve a deep attachment where your nipple is deep inside your baby's mouth towards her soft palate.

When your baby is attached well to your breast, her chin will be touching your breast and her nose is clear or only just touching your breast. Her lips are flanged out, not sucked in. There will be more of your areola showing above your baby's top lip, as compared to her lower lip.

You also know you have good attachment if there is no pain, although it is common for some mums in the early weeks to feel some nipple pain that ceases after the initial attachment.

At the start of the breastfeed, your baby sucks will be fast and shallow as she gets the milk flowing, by triggering the reflex that allows the milk to flow. After this, she will do groups of deeper, slower, suck and swallows.

Swallowing can be identified by a soft tick sound and also by a pause in her chin when it drops down to its lowest position when she has a mouthful of milk. The longer the pause in her chin, the bigger the mouthful. Rest periods between sucking are a normal part of breastfeeding too. As the breastfeed continues, the groups of sucks and swallows gradually become shorter and the rest periods longer.

Most of the time a baby will come off on her own accord when she is finished with that breast.

If you feel nipple pain beyond the initial attachment, you can try attaching your baby again. To break the attachment, avoid pulling your baby away from your breast. This could cause more pain and damage your nipple. Instead, break the attachment by inserting a clean finger into the corner of your baby's mouth between her gums. Gently but firmly press down on her lower gums and remove her from the breast.

Every mother and baby have slightly different ways of attaching to the breast. Doing what works best for you and your baby is important. So long as breastfeeding is comfortable and your baby is getting enough milk, exactly how you position and attach your baby doesn't matter. You can find out more about whether your baby is getting enough milk in our common questions video.

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Breastfeeding: getting a good attachment

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Good attachment is key to successful breastfeeding, but how do you make it happen? This video shows you how to do mother-led attachment to the breast.

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A nice clip showing laid back breastfeeding in action.

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Another example of biological nurturing.

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Natural Breastfeeding - Love to Love Breastfeeding

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is crucial to effective and pain-free breastfeeding.

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Watch safe YouTube videos without comments, related videos, or any other distractions. It’s great for teachers, parents, and organizations alike - or really, anybody.

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It can be a shock when your baby is born early. Small Wonders have videos about all aspects of caring for a prem baby, including feeding

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This information is available in verified by experts in our Editorial Board including representatives from Royal College of Midwives, Royal College of Paediatrics and Child Health and Royal College of Psychiatrists as well as other key health organisations in the UK. To download Baby Buddy, visit the relevant app store of your choice:

Introduction

The first video from the Small Wonders DVD explains the different levels of care your baby might need, and who might give it. We meet some of the families and hospital staff, and guide you as to how to use this DVD to get support, wherever you are on your journey.

In the second video from the Small Wonders DVD, we meet three families, two who had time to prepare for life in a neonatal unit and one who had very little warning. We see three births, one of which is the birth of triplets, and we follow the babies being prepared for transfer to the neonatal unit.

First hours

The third video from the Small Wonders DVD provides a look into the first hours and days in the neonatal unit and shows you how you, as a parent, can play a very important role in your baby's care.

Expressing breast milk

The fourth video from the Small Wonders DVD shows how mothers can express breast milk for their baby within a few hours of giving birth (if at all possible mothers should express milk within the first 6 hours after giving birth). Starting to express breast milk early and expressing milk often will help your body produce plenty of milk for the weeks and months to come.

Holding your baby

The fifth video from the Small Wonders DVD shows how skin-to-skin contact (also known as 'kangaroo care') can help both you and your baby. You will see families move from being nervous to being able to hold their babies with confidence.

Your time in hospital

The sixth video from the Small Wonders DVD follows families as they begin to feel more confident in caring for their babies on the neonatal unit. You will also see how some of our families cope with their baby's condition getting worse.

Feeding independently

The seventh video from the Small Wonders DVD follows four families as they learn to help their babies feed independently of tubes. Although some babies may go home being fed by tube, most will be feeding independently before they are discharged from hospital, whether they are breastfeeding or formula-feeding.

Preparing for home

The eighth video from the Small Wonders DVD covers what to expect when your baby is ready to leave hospital. We follow five families as they prepare to go home.

First months at home

The ninth video from the Small Wonders DVD follows nine families enjoying the early weeks and months at home with their pre-term baby. They all have different experiences and challenges.

Twins and triplets

The tenth video from the Small Wonders DVD follows four families who had twins or triplets and discovers some some of the joys and challenges that come with having more than one baby.

Bereavement

This video from the Small Wonders DVD is only for families who have to deal with bereavement. We have included it because parents asked us to. Only watch this video if you feel it will be helpful to you and please be aware that everyone's experience of bereavement is different and may not reflect your own. This film follows the journeys of families who lost babies during filming and chose to carry on sharing their experiences to help others.

The twelfth and final video from the Small Wonders DVD shows the families whose journeys we have been following in films 1 to 10 looking back on their experiences and sharing their thoughts and feelings.

Latest

The Impact Lead will focus on developing Best Beginnings' frameworks for monitoring and evaluating our national and international work ensuring that learning continues to be captured in ways that can be shared and used for effective advocacy and influencing. The successful candidate will also play a pivotal role influencing policy and its implementation within the maternity, early years, digital health and public health context.

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The Small Wonders videos have been designed to help you on your journey with your sick or premature baby.

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A useful technique for getting a deeper latch. sometimes helpful with a baby with compromised tongue function

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*More information on this topic can be found in my NEW BOOK on breastfeeding and tongue ties, "All Tied Up! How To Keep On Boobin' Through A Tongue Tie". Available here.
Most babies will latch on the best when they are supported to self-attach on their own, with the mother in the "laid-back" breastfeeding position, or self-attachment in the "koala" hold. Here is a video to show what this process looks like. It's an amazing thing to see (and experience yourself!)...

But what about the babies who cannot latch on well by themselves? What about the babies with tongue ties or other physical issues going on that inhibit their ability to keep enough of the areola in their mouth while breastfeeding? This is where the "flipple" technique can really help. In the following video I discuss how this little breastfeeding trick can work even better if the mother does this while her baby is in the "koala" position which looks like this:

Step 1. Try to get your knees lower than your hips as this can make it easier for some mothers.

Step 2. Put your baby's mouth right at your nipple.

Step 3. Use the "flipple" technique to get as much of your breast tissue into your baby's mouth as possible. Point your nipple very high towards their nose, try to get as much of the bottom part of your areola into your baby's mouth and use your finger to flip their top lip up after they have latched on.

*You may need to use this "flipple" technique before AND after you get a laser or scissor tongue/lip tie revision done. Some mothers find that they need to use this for quite some time as their baby get's the hang of using their new tongue!

Step 4: Watch this video to see it in action!

And here is another video demonstrating the flipple in an upright position but baby is supported from behind by both a pillow and their mother's arm...

Have you used the flipple and/or the koala hold? Share your experiences below! If you need some help getting your baby to latch on or have questions about tongue ties please CLICK HERE.

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How to get a better latch! The exaggerated latch or "flipple" breastfeeding technique... - The Milk Meg

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And here is another video demonstrating the flipple in an upright position but baby is supported from behind by both a pillow and their mother's arm... Have you used the flipple and/or the koala hold? Share your experiences below! If you need some help getting your baby to latch on or have questions [...]