Positioning: It’s All About the (Baby’s) Chin.


Babies and breasts come in different shapes and sizes. This may be a very obvious statement but it bears consideration when we bring babies and breasts together. Suzanne Colson, Nancy Mohrbacher, and Christina Smillie teach us to lie back to achieve good positioning. This often works very well but not for everyone. If a parent lies back and the nipple points downward, the baby cannot get in a position where the chin contacts the breast under the nipple.

In the past, breastfeeding helpers taught the tickle (the lips with the nipple) wait for a wide open mouth, and RAM (rapid arm movement) method. Some providers suggest aiming the nipple toward the palate or brushing the upper lip with the breast and waiting for a wide open mouth. But what comes next? Often the baby’s head is pushed onto the breast and the baby can’t breathe and becomes frustrated. Or the baby is brought to the breast but closes their mouth on the way causing a shallow latch. Why is it so hard?

Again, breasts and babies come in different shapes. Some babies have very receding chins. Some breasts are very round and some are flatter or softer or smaller or larger or…

The best positioning for a particular parent and baby is to be sure that the baby’s chin contacts the breast before latching. Chin contact below the nipple allows a baby to achieve a deeper latch. There are many techniques that can help achieve this positioning (try Googling “laid-back breastfeeding” or “flipple” or “deep latch technique”) but the technique needs to match the shape of the baby and the breast so they come together in harmony.

I absolutely love the following photo for showing how to position your baby.

http://www.cwgenna.com/quickhelp.html (click on “Latching Your Baby 101”)

Whatever your shape or your baby’s shape, if you can achieve chin contact before latching, you may have a more comfortable latch. If not, you might just need more help from an International Board Certified Lactation Consultant.

Choosing a Breastfeeding Helper


Parents who are struggling with breastfeeding need high-quality, timely support in order to ensure they meet their breastfeeding goals. Because optimal breastfeeding is critical for the health of Baby and Parent, it is important that they receive the best help available.

There are many knowledgeable volunteer breastfeeding supporters that can help parents to breastfeed. Often this peer-to-peer help is all that is needed to resolve a breastfeeding difficulty. For more complicated problems such as low milk-supply, painful breastfeeding, babies who have difficulty latching, and slow weight-gain, it is important to get timely professional help in order to get back on track quickly.

I frequently see parents who have tried many other professional breastfeeding helpers and did not receive the help they needed. Time, energy, and resources may have been wasted. Delays in following the best interventions often result in parents not meeting their breastfeeding goals and babies missing out on optimal breastfeeding. High quality professional breastfeeding support may seem expensive but it saves time, effort, and financial resources in the the long run. Additionally, lactation help from an IBCLC is usually reimbursable by insurance.

Parents are often confused about the many different kinds of professional breastfeeding support providers available in the community. It is critical that parents have access to information regarding these differences so that they can make informed decisions about whom to hire for help. The following links explain the different types of breastfeeding supporters and the training required for each. Be aware that the term “Lactation Consultant” can be used by anyone, no matter what training or experience they have with breastfeeding.



The following article explains why I chose to become an International Board Certified Lactation Consultant.



This site  is dedicated to helping parents find answers to their breastfeeding concerns and to provide a platform for posts regarding current breastfeeding topics. It has recently been optimized to be smartphone friendly. Breastfeeding information is easily accessible by clicking on the Menu link or Search box located at the top of the site.

None of the information on this site is intended to replace medical advice. Please consult your health care provider for medical advice. If you are not able to solve your breastfeeding difficulties, please contact a Board Certified Lactation Consultant (IBCLC) or breastfeeding peer helper for more assistance.

Find a Lactation Consultant

Find a La Leche League Leader

Other Breastfeeding Support

The contents of this site are the property of Laura Spitzfaden. Please do not reproduce anything without permission. You are welcome to link to my site if you wish to share any of the material you find here.

Contact me: laura@feedthebabyllc.com

Milk Expression

If you are expressing milk after you have established a full milk supply, a personal pump such as a Hygeia Enjoi, an Ameda Purely Yours or a Medela Pump in Style will likely be adequate for your needs.  If you are establishing a milk supply for a baby who is not directly breastfeeding, a multi-user pump will likely be necessary.  This type of pump is also referred to as a, “hospital grade pump.”

Be sure that you check and change membranes and tubing as needed and have properly fitting flanges.  Your nipples should fit well into the flanges with just a little space between your nipple and the flange.  Your nipples should not rub in the flanges.  Your nipples should also not bobble about in the flange.   This would indicate that the flanges are too large.  You may want to experiment with flange sizes to find which remove the most milk.  Some moms have better success with alternative type flanges such as Pump in Pals.

Before begining to pump try these techniques

-Massage your breasts in concentric circles as when doing a breast self exam.

-Draw the backs of your fingers or a comb across your breasts from the chest wall to the nipple all around your breast.

-Lean forward and shake your breasts.

Use reverse pressure softening (developed by K. Jean Cotterman RNC-E, IBCLC) until you see drops of milk, then apply the pump.

Use hands-on double pumping. Whenever milk flow slows, take the pump off and repeat everthing including the reverse pressure softening and re-apply the pump. Try to do this cycle three times.

Hands on pumping:


Reverse pressure softening (developed by K. Jean Cotterman RNC-E, IBCLC):


If you only have single pumping capacity, just switch back and forth a few times using all the techniques in this article.  If you do not have a pump, use these techniques and then hand express.

http://www.bfmedneo.com/BreastMassageVideo.aspx (from Breastfeeding Medicine of Northeast Ohio)


http://ammehjelpen.no/handmelking?id=907  (video created by the Norwegian mother to mother breastfeeding support organization, Ammehjelpen–scroll down for English video)

Maintaining a Robust Milk Supply When Parent and Baby Must Be Separated


I was inspired to write this post due to some recent helping situations.  I decided to compile all this information in one place.  I may add to it later.

In order to have an excellent milk supply, it is important to remove milk from the breasts at least 8-10 times a day. (http://feedthebabyllc.com/care-plan-for-milk-supply/)  When parent and baby are together, it is beneficial to keep baby skin-to-skin and allow free access to the breast.  A baby is better at maintaining a milk supply than a pump and the extra nursing stimulates breasts to make more milk.

When a breastfeeding parent is separated from baby, it is important to express milk as frequently as possible, at least every 3 hours from the beginning of one expression to the beginning of the next.  A double electric pump with properly fitting flanges works the best.  Be sure to check the membranes frequently and change them at least every 3 months.  A pump that is older than 1 year may not be as efficient.  See (http://newborns.stanford.edu/Breastfeeding/MaxProduction.html) for learning a technique that increases the amount of milk that can be expressed by 48%!

Continue reading

Why I Became an International Board Certified Lactation Consultant


In Honor of IBCLC day, March 6th 2013, I decided to explore the reasons why I chose to become an IBCLC, though there are easier and less costly pathways to providing professional breastfeeding support.

I had already been an active La Leche League volunteer leader for nearly 12 years when I decided that I wanted to extend my services to include professional breastfeeding support.  I knew that I had acquired a lot of the experience and knowledge needed through my volunteer work.  I had dedicated thousands of hours to learning about and supporting breastfeeding.  I had helped several hundred parents overcome breastfeeding difficulties and realize their breastfeeding goals.  I did not believe, however, that this was adequate training to provide professional breastfeeding services. Continue reading