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Nipple Sandwich with a twist
by (Kathy Kuhn, IBCLC)

One thing you can try is to compress your breast firmly in the direction of her lips as you latch so you are making the breast smaller for her to get more of her mouth around it and so you are making the nipple and surrounding areola more firm so she notices it in her mouth. When a baby is latched well they generally have what we call an asymmetrical latch. Meaning the baby isn't perfectly centered on the nipple. Imagine your baby has lipstick on, if the baby is latched well the lipstick will leave an imprint that is somewhat oval and has the nipple a bit off center closer to the top lip imprint. The baby should take in more breast tissue with the lower lip than the upper lip. Let me try to describe it:

1) When you hold your baby to approach the breast support the baby's head with your thumb and index finger behind the baby's ears, supporting the lower head and upper back with the palm of your hand. The rest of your arm supports the baby's back and your elbow cuddles the baby's tush closely to your body. You should feel that you have very good control of the baby's body this way.


2) Line the baby up nose to nipple, either in the football hold, which means you are putting the baby under your arm on the side you will nurse from or in the cross cradle hold which means you are placing the baby across your chest and nursing from the breast opposite the arm you are holding the baby in. In the cross cradle hold also be sure to place the baby's tummy toward your tummy so she doesn't have to turn her head to reach the breast.

3) Support your breast with the free hand with thumb on one side and four fingers on the other side. Make sure your fingers are not covering or on the areola at all. If you are using the football hold, compress the breast horizontally (in the direction of the baby's lips) with your thumb and index finger pressing firmly at about 12 o'clock and 6 o'clock.


5) If you are using the cradle hold compress vertically with thumb and index finger at about 3 o'clock and 9 o'clock. (think of squishing a big thick sandwich on a roll to fit in the baby's mouth, you squish it in the direction of the lips).




6) Stroke the baby's lips with your nipple, one time, nose to chin, then pull the baby a bit away from your nipple to see if the baby is opening wide like a yawn. You may need to stroke numerous times, so the process is like this, stroke, pull away, look, stroke again, pull away, look, and keep repeating until the baby opens wide like a yawn. Do the stroking, pulling away or pausing, and looking slowly, if you repeat the process too quickly you aren't giving the baby time to respond. It should take to about a count of 2-4 for the stroking part and the same for the pausing and looking part.


7) When the baby opens like a big yawn it usually occurs on the down stroke or just after. You can then quickly lay your breast onto the baby's lower lip with the breast (usually closer to the chest wall than the edge of the areola) lining up with lip and then bring the rest of the baby's head/lip around the top of the breast to latch.


8) Maintain the compression (this is really important for a baby who has used bottles) on the breast firmly until the baby begins to suck well through one burst of sustained rhythmic suck and then you can slowly release the compression and just support the breast with your hand slightly back from it's original position. Holding the breast in this way usually helps the baby feel the breast in the mouth and encourages the baby to suckle.

Copyright 2000 - 2003  Jim Yount

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Disclaimer:  The pages contained herein are meant purely for informational purposes and every effort is made to provide accurate and up-to-date information. This information, however, is not meant to take the place of your doctor, nor should the information contained on this web site be considered specific medical advice with respect to any specific person and/or any specific condition. The author, therefore respectfully but specifically disclaims any liability, loss or risk - personal or otherwise - that is, or may be, incurred as a consequence, directly or indirectly, from use or application of any of the information provided on this web site.