哺乳中最容易忽视的要点（下）：含乳姿势

Positioning and Latching

Breastfeeding is like dancing. If you are going to learn to dance you need to know where to put your body and then how to move your feet. It may feel awkward at first. It might come easily or it may be difficult. But with practice nursing your baby can become second nature. The first thing to think about when breastfeeding or chestfeeding is how you are going to position your body and your baby’s body. Once you are in a good position, it will be easier for your baby to latch.

Good positioning and latching is important for building and maintaining your milk supply. When your baby latches deeply onto your breast, your baby is able to remove milk effectively. When your breasts are well-drained, your body gets the message to make more milk. If you are concerned about how much milk you are making, improving positioning and latching is an important first step.

Checklist for a good, deep latch and effective suck

●Baby’s chin is pressed deeply into the breast.

●Baby’s mouth is wide open with both lips uncurled.

●Baby’s head is tipped back slightly with the nose not touching, or lightly touching the breast. The nose should not be poking into the breast.

●No nipple pain.

●Good suction; baby doesn’t fall off easily.

●Steady sucking with audible swallows.

For information on your baby’s very first feeding immediately after birth, please see The First Hours After Birth（https://www.lllc.ca/first-hours-after-birth-nine-instinctive-stages）and Establishing Your Milk Supply（https://www.lllc.ca/sites/default/files/Establishing%20Your%20Milk%20Supply-1.pdf）.

Getting a good latch

A comfortable, secure position allows your baby to use her instincts to latch deeply onto the breast. With a good latch your baby takes in a large mouthful of breast tissue. This gently stretches your nipple to the back of her mouth. When this happens, your baby is able to effectively remove the milk. A deep latch ensures that your baby gets plenty of milk and your body gets the message to keep making more. It also prevents pain and damage to your nipples.

Chin planted on the breast.

If your baby’s chin is not touching your breast, your baby will often turn his head searching for your breast. When your baby’s chin touches the breast, he smells your nipple. This triggers him to open his mouth wide, reaching up for a big mouthful of breast.

●It’s helpful if your baby plants his chin well away from the base of the nipple.

●If you are holding your breast, your fingers need to be far enough away from your areola (dark area around the nipple). Then they will not be in your baby’s way.

●The farther away your baby’s lower jaw is from the base of your nipple, the more breast tissue your baby will be able to take into his mouth. This helps to get a deeper latch.

Head tipped back and nose tipping away.

●Position your baby so that her head can tip back as she approaches your breast.

●Support your baby’s head with your thumb and fingers at her neck and your palm at the upper back. If you touch the top of her head, she will likely pull away.

●Allow your baby’s chin to touch your breast with your nipple near her nose.

●With her head tipped back and her chin planted on your breast, your baby is able to open her mouth wide.

●With a wide open mouth she can reach up and over your nipple, taking in a large amount of your breast tissue. (Think about how you take a big bite of a burger. You start by placing the bottom of the burger on your lower jaw. Then you reach up and place your upper jaw up and over the top of the burger. This is the same motion your baby uses to get a big mouthful of breast.)

●Gently press between your baby’s shoulder blades as she reaches up to latch. It is important that you not shove your baby onto your breast. Allow her to lead the way.

Once your baby is latched, her nose may touch the breast but it shouldn’t be poking into it. You shouldn’t feel like you have to hold your breast back so your baby can breathe. Chin in, nose tipping away, head back is the same position you take when you drink something. (Try it now, pretend to take a drink of water. See how your chin goes forward and your head tips back?)

Both cheeks touching the breast. 

If once latched, one cheek is not touching the breast, consider adjusting your baby so that both cheeks are touching your breast. This will help to make sure your nipple is straight and deep into your baby’s mouth.

Adjust your baby as needed.Babies often creep upwards or forwards while feeding.

●If your baby’s chin is tucked into his chest, he will not be able to hold onto the breast with his mouth. He will also find it hard to swallow. (Try it now. Tuck your chin into your chest and swallow. It is very difficult.)

●You may need to occasionally adjust your baby during feedings by sliding him downwards or backwards towards his feet.

●You may also need to pull your baby in gently from behind the shoulder blades. This will push your baby’s chin forwards, deeper into your breast. And it will tip your baby’s head back. In this position your baby can drink comfortably, just like you do.

The Nipple Tilt Technique

To get an even deeper latch, you can try using the nipple tilt technique. This is also known as the “flipple” technique.

●Hold your breast with your thumb on top and your fingers on the bottom. Place your thumb well back from the base of the nipple. This is in line with where your baby’s upper lip will be once she has latched. Make sure your fingers are far away from where your baby’s chin will be.

●Press in with your thumb. This will tilt your nipple away from your baby.

●Bring your baby to your breast so that her chin is touching.

●When your baby reaches up for a big mouthful of breast, release your nipple at the last moment by removing your thumb. This allows your nipple to fall deeply into your baby’s mouth.

●Avoid pushing your nipple into your baby’s mouth.

Drinking vs. Sucking

There is a difference between “drinking” and “sucking”. Babies can suck for comfort or to drink. You’ll see chin movement for both. It’s important to know when your baby is drinking your milk.

Swallowing is the main sign that your baby is getting milk. When there is a mouthful of milk, your baby’s chin will drop with a “pause” in order to swallow. You may hear a “kah” sound as the baby breathes out after a swallow. When your baby is drinking, she has a steady suck, swallow breathe pattern. Your baby will take short breaks between letdowns of milk. When another letdown of milk occurs, your baby will begin drinking again.

If swallowing or sucking slows down, you can gently squeeze or compress your breast with your whole hand for several seconds. This will increase milk flow and encourage your baby to keep drinking.

What if it hurts?

A deep latch prevents the nipple from being pinched by the tongue and the hard palate of your baby’s mouth. A shallow latch often results in sore nipples. If your baby is not latched correctly, the end of your nipple may be creased, flattened or pinched. It may look like a new tube of lipstick, when it comes out of your baby’s mouth. The end of the nipple may be blanched (white).

If you feel that your baby is not latched well, it is important to deal with it right away, even if other people tell you that the latch looks fine.Pain is your body’s way of letting you know that something is wrong and needs to be changed. A painful latch is usually a shallow one. With a shallow latch your baby is not able to remove milk easily. It is not helpful to suffer through a painful latch. A good, deep latch will be comfortable for you. And your baby will get lots of milk. 

●If it feels painful, you can unlatch your baby by slipping a finger in the corner of her mouth to break the suction. Then you can try latching again.

●Often the latch can be adjusted while your baby is still attached. This will prevent your baby from getting frustrated by being taken on and off the breast. And if your nipples are already damaged, this prevents you from continually experiencing the pain of the first few seconds of latching. If you are hearing a “clicking” or smacking sound, or see dimples in your baby’s cheeks, try improving the latch by bringing your baby’s chin deeply onto your breast. Or you could gently pull down on the baby’s chin to uncurl the lower lip.

For more information see The Sounds of Breastfeeding(https://www.lllc.ca/skin-skin-care).

In a small percentage of babies, the tongue is restricted because of a tight frenulum, or tongue tie. Because of this the baby may not be able to pull the nipple deeply into the mouth. If the latch is still painful even after trying to improve it, you are encouraged to seek the help of an International Board Certified Lactation Consultant (IBCLC). Then, if necessary, you may want to consult with a healthcare professional who specializes in diagnosing and treating tongue ties.

Videos You May Find Helpful

For the laid-back position:

https://www.biologicalnurturing.com/sample-of-biological-nurturing/

For latching and good feeding at breast: https://ibconline.ca/breastfeeding-videos-english/