The Baby Knows How—To Breastfeed, That Is

By Kittie Frantz
Issue 138, September-October 2006

First I was a mother of 19 years, nursing my first baby without any help. As was the practice in the early 1960s, the nurses just handed my baby to me in the hospital and she nursed herself. Then, for 20 years, I was a La Leche League leader. We just said to mothers, over the phone, "Keep nursing, the rhythm will come." Then, 15 years into being an LLL leader, when I went back to work as a nurse practitioner, I saw women nursing in greater numbers. In those days, we were told that all nursing babies made your nipples sore, but I noticed a pattern: Women who had sore nipples held their babies differently from women who didn't. When I applied what I'd learned to the mothers experiencing soreness, they got relief.

In 1980, I decided to present this simple concept at a breastfeeding conference in Israel. I illustrated my talk with a series of pictures, taken by a photographer friend, of a well nursing infant as she went to the breast and attached. The presentation of this simple concept went well, and I was asked to publish it.¹ I hired an artist to make drawings based on the photos, as the publication would accept only drawings. These drawings became very popular; for teaching purposes, I made them available as slides, postercards, tear-offs, etc. They were used for years by those who teach new mothers how to breastfeed. In the 1990s, new, more complicated concepts in attachment became popular, and everyone was concerned about doing "the latch" correctly. At about that time, medical journals began revealing more about how an infant uses the tongue in suckling, and where the infant's optimal placement is on the breast. What seemed best was an asymmetrical latch, the baby's mouth covering the lower part of the areola more than the upper. Wondering if my drawings were outdated, I looked at them again and saw that the baby we'd photographed had done it perfectly. That baby wasn't outdated at all.

Holding the Baby
Babies prefer to be somewhat upright, lying in the mother's arms at about a 45 degree angle, not laid flat on a pillow or lap. When babies are laid flat, the milk can escape from the stomach, come back up the throat, and disrupt swallowing. Babies also prefer to face the mother. When baby is laid on her back, she must turn her head to the breast, which also disrupts how she swallows. When baby is facing you, you should be able to see her eyes—all babies love that—for perfect placement.

Holding the Breast
However you hold your breast, keep your fingers off the areola—that is where the baby's mouth will fit. And watch those fingers under the breast: using all four fingers under the breast and your thumb on the top will best support a heavy breast. This helps a newborn's tongue get the nipple deeper into his mouth, and more quickly, as he learns how to suckle in those first days.

Getting the Mouth to Open
A baby will open her mouth automatically, as a reflex action, when her chin and/or lower lip touches the breast. (The third baby in Dr. Lennart Righard's video Delivery Self Attachment shows this beautifully.²) Touch the baby's lower lip and chin with your nipple. She will open her mouth wide and tilt back her head ever so slightly. Babies do this best when only the lower lip is touched; they don't open as wide when the upper lip is touched. Try this with your finger before you start to breastfeed and see for yourself which lip the baby responds to more.

When she opens wide, move the baby straight in toward you with the arm holding her, and she will attach to your lower areola. If you use an opposite-hand or cross-cradle hold, just move her shoulder toward you and her head will follow, in perfect position. She has tilted her head back slightly to attach to the lower areola. How clever!