Over the last 40 years, first as an LLL leader (1971) and then as an IBCLC (1985), I have been privileged to observe, assist and encourage countless mothers and babies as they begin the dance of breastfeeding. I taught pre-natal 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.

Two years ago, at the ILCA 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 very familiar with her work, please do yourself, and the moms and babies you work with, the favor of going to her website, www.biologicalnurturing.com and checking it out.

I returned from that conference as a fervent convert to  the concepts involved in BN. 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 BN than these two concepts but they were the main ones I brought home.

In my little office/lactation room at work, there is a small, cushioned recliner for the new mom to use while we do a consult.  I gradually started to suggest to moms that they use the recliner to lie back and get their (usually swollen) feet up.  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, over the last six months or so, I have started really encouraging moms to try it. Most of the moms who have latch problems or sore nipples or problems keeping the baby awake were willing 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 30-45 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 obliquelie, 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!

The laid-back position (someone needs to find a name for it) has worked really well for the moms I’ve seen in the past six months.  Since most have learned or tried the football or cradle hold, this is the one I usually show them.  Every mom has loved nursing this way and if the babies could talk, I know they would agree.

When you are working with a mom and baby who are struggling, this position can be one more tool in your arsenal.  I primarily see moms and babies in the first week post-partum so I haven’t used this position with older babies.  However, on the Biological Nursing website, there is a wealth of information and pictures which involve new babies and older babies as well.  There is a new DVD and a new book by Suzanne Colson which we will purchase for the WPLCA library.

One unexpected outcome of having moms try this position during a consult is that the area furniture stores should be experiencing a run on recliners!  Mom looks at dad and says,”We need one of these at home”.  And dad usually agrees!  I love watching babies nurse this way and I hope that you will feel encouraged to go the website and start trying this position with the mothers you see as well.