Baby-led attachment

Nature designed a perfect system: keep the baby within reach of the breast day and night. Create subtle feeding cues easily noted by their mother long before the desperate crying which will alert predators. Allow the mother to quickly move the baby to the breast from their position on her chest. When baby falls asleep at the breast, continue to keep them close. In the learning days, lean in to staying close. Contact naps lead naturally into baby-led attachment. Nappy changing can nearly always wait until a break between breasts or even longer. Aim to move baby from chest to breast with minimal delay in the early days.

Babies have wonderful reflexes in place to help them breastfeed. One is referred to as the "rooting reflex".

When we think of the natural carrying position of young primates on their mother's chest, gripping on to her body hair with hands and feet as she moves about, being able to find the breast by facial touch makes sense. A baby swiping their face backwards and forwards across the chest area would be able to zero in on the nipple area which would feel different to the surrounding skin.

The "rooting reflex" works best when are no false signals from other touch. A hand supporting the head, clothing tickling the face or fingers brushing a cheek will all trigger the baby to focus in that direction. Confusing for baby and frustrating for mum. Waving the nipple around like a moving target will also confuse them.

To support your baby in naturally seeking the nipple, focus on supporting their body close to yours without holding the head. Make sure bra straps, clothing etc is clear of the breast (strip down when you are at home) and remove all blankets, wraps and mittens. Babies hands help guide them. Allow your baby to brush their face against you. Keep your breast in a natural resting position and don't "chase" the mouth with it.

The touch of breast tissue on their face will trigger them to open their mouth wide and start bobbing in the nipple area, seeking just the right spot. This takes practice and they may go on poorly. You can detach them gently and they will try again.

Supporting babies by holding their heads doesn't help them. They might push back, twist in reaction to your touch or present to the breast in a poor position, with their chin tucked down. .

Sometimes it's the little things which make the biggest difference. And babies arms and breastfeeding are a great example of this. In the fuss and bother of getting baby to the breast, it's easy to think it can't really matter that much if an arm is in the way. But it means your baby can't be as close as they need to be and that can make the Latch just that bit more shallow.

Imagine how difficult it is getting close to the dinner table in those final weeks of pregnancy. Your body shape means you need to lean your head in closer to bring your food to your mouth. It changes your posture and uses muscles in a different way, which can be fatiguing.

It's the same for your new baby at the breast. If they need to stretch a bit more to reach the breast, they need to hold that position or the nipple will slip out of their mouth. They "keep coming off" can be they are struggling to hold the breast in place.

If we bring their body as close as possible, then the breast is right in front of them. They can relax and focus on removing milk without having to stretch to reach.

Attachment is important. But don't overlook the other half of the equation: positioning. Getting the position right enables good attachment. Poor positioning hinders it.

It makes so much sense that a relaxed, comfortable position will allow your baby to comfortably take a mouthful of breast tissue and keep it in their mouth without losing their latch. It's comfortable for babies and their mothers.

When positioned this way they are embracing their mother with their belly against hers, hips in close and their head free to move as they bring their mouth into just the right spot. There is no need to support the head as gentle support across their shoulders and hips keeps their head in the right place.

When it comes to positioning your baby, it’s easy to feel overwhelmed. Here is what you need to keep in mind:

"Chest to chest and chin to breast"

This is all about presenting your baby in the best orientation to seek the breast and attach well.

Decades ago, when breastfeeding rates were at a historical low, bottle feeding techniques got mixed up with breastfeeding advice. We held our babies on their backs, swaddled tightly to keep their hands out of the way and brushed their cheek so they would turn their head towards the breast. This position meant babies had to grasp the nipple with their head twisted towards their shoulder - obviously not a comfortable position for anyone! Babies would grab the nipple and hold on for dear life, because it would spring out of their mouth the moment they paused.

A calm, relaxed baby will seek and attach to the breast much more easily than one who has become distressed by waiting. Sometimes they will be so overwhelmed by the whole thing, they fall asleep when they do finally take some milk. It can be tempting or even advised to remove them from the breast and stimulate them to wake again. Changing nappies, cool face washers and other techniques are often suggested. However, if you accept the cat nap at the breast allows your baby to reset and wait for hunger to trigger natural waking, it is likely that 15-20 minutes later they begin to stir and seek the breast. With the nipple directly in front of them they are likely to find it quickly and attach well and feed for longer. Following your baby when you are uncertain in fine.

Babies arms! Why are they always in the way when you are trying to breastfeed?

It turns out, Babies practice sucking in the womb and will suck on whatever gets close to their mouth ... basically, their hands! Although a newborn doesn't have much intentional control of arm and hand movements, they do seem to have some reflexive drive to bring their hands to their mouths at feeding time.

It's tempting to take an idea from the past and tightly wrap your baby in a blanket to restrict arm movements. Unfortunately, this not only confuses them but prevents them assuming the natural position to come to the breast.

Instead, focus on supporting your baby close to you, with their chest against your body and their arms embracing you, like a hug. Keeping the lower hand below the breast means it won't get in the way of attachment. Be patient as your baby mouths their upper hand as part of seeking the breast: a hungry baby will quickly work out they are sucking the wrong thing and begin rooting around seeking the breast instead. This interest in their hands and arm waving decreases gradually over the early weeks as they mature and learn through practice.

Avoid having an arm caught between your bodies as it prevents baby getting in close.

Your patience will be tested at times! Minimise the time between early feeding cues and attachment by keeping your baby within arms reach so you can respond as soon as they begin to stir. Delay changing nappies until they have taken the edge of their hunger with the first breast and will be calmer during the interruption!

Each time your baby attaches well and effectively removes milk from the breast they learn and improve their technique. Your breasts get positive feedback to continue producing milk and replenish your supply. It takes time to learn new skills and babies learn quickly. By following their lead, taking a more passive role in the attachment relationship and letting them practice frequently, breastfeeding becomes something which happens rather than something you do.