Positioning and attachment | breastfedbabies
The way your baby is positioned and attached to your breast can make the difference between a happy, comfortable and successful feed and one which is painful for you and frustrating for your baby. It can be helpful to have a few reminders to help you develop the skill of helping your baby attach well and recognising when your baby is getting milk.
Helping baby feed – positioning
Remembering CHIN can be helpful (Close, Head free, In line, Nose to nipple):*
- Bring your baby in close to your body so that he doesn’t have to stretch to reach your breast.
- Support his neck, shoulders and back (see photo 1). Make sure his head is free to be able to tilt back.
- Check his head and body are in a straight line facing the same way as he will be uncomfortable if he is twisted when feeding.
- Move your baby so that he starts the feed with his nose pointing to your nipple (see photo 2).
- Starting ‘nose to nipple’ like this allows him to reach up and get a mouthful of breast from underneath your nipple (see photo 3).
*CHIN acronym developed by Lynette Harland, University of Teeside.
Pillows or cushions are sometimes useful in the early days. However, nursing pillows can make breastfeeding more difficult as the baby may be too high and you end up fitting the baby around the pillow which leads to poor positioning.
Further information on getting positioning and attachment right can also be found in Off to a Good Start.
If you need practical help with positioning and attachment, ask your midwife or health visitor to carry out a feeding assessment with you. You can also visit your local breastfeeding support group – see our section on support groups for details.
If you wish to speak to a breastfeeding counsellor there are a number of voluntary groups you can contact. See breastfeeding support section.
Attachment – how your baby breastfeeds
When your baby is interested in feeding and you hold him close and offer your breast, he will usually open his mouth wide and start looking for your nipple. If your baby’s mouth is not wide open, encourage him to open his mouth wide by gently rubbing your nipple against his upper lip and moving away until he opens wide. When your baby’s mouth is wide open, bring him to your breast in a swift movement allowing his bottom lip or chin to make contact with the breast first.
Once baby has started feeding you can check for signs that he is well attached.
Signs that your baby is well attached
- The baby’s chin is close to the breast and should touch the breast.
- The baby’s mouth is wide open.
- You may not be able to see the areola (darker area) around your nipple, but if you can, there is more showing above the baby’s top lip.
- You may be able to see that the baby’s lower lip is curled back, however it isn’t always possible to see this if the baby is well positioned and is close to the breast.
- The baby’s cheeks are round and full, not sucked in or dimpled.
- No smacking or slurping sounds will be heard.
- At first the baby’s sucks may be fast and then they become slower and longer.
- It should feel like a strong drawing sensation. This may be a bit uncomfortable for the first few sucks, but after that it should be pain free.
Finally, if your baby has been well positioned and attached for breastfeeding, he will finish the feed by coming off the breast and will appear sleepy and satisfied.
Signs that your baby is not well attached
- Feeding is painful.
- There is no change in the rhythm of the baby’s sucking – it stays as short flutter sucks.
- His cheeks are drawn in and dimpled.
- The baby is restless and keeps coming off the breast.
It is important that you are able to recognise when feeding is going well and when you might need some further help. Off to a Good Start contains a checklist which you may find useful.
There are several different positions which you might want to use for breastfeeding. You may want to feed sitting up with your baby across you or lying down or perhaps holding your baby underarm. Whatever position you choose, it should be comfortable so that you are able to stay in the position without it being a strain.
Pillows or cushions are sometimes useful in the early days. However sometimes nursing pillows can make breastfeeding more difficult as the baby may be too high and you end up fitting the baby around the pillow which leads to poor positioning.
If you need practical help with positioning and attachment, ask your midwife or health visitor to watch you feeding. You can also visit your local breastfeeding support group – see our section on support groups for details.
If you wish to speak to a breastfeeding counsellor there are a number of voluntary groups you can contact:
National Breastfeeding Helpline 0300 100 0212 (9.30am-9.30pm)
La Leche League 0845 120 2918 (24 hours)
Breastfeeding Network 0300 100 0210
National Childbirth Trust 0300 330 0771 (8.00am-12.00 midnight)