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What works best to bring baby on to a generous breast?

Dr Pamela Douglas1st of Sep 202324th of Dec 2024

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The gestalt method of fit and hold is only one part of the Neuroprotective Developmental Care (NDC) or Possums breastfeeding programs (under development as Breastfeeding stripped bare), but an important place to start. This version of the gestalt method of fit and hold for breastfeeding women has been available since 2016. I'm hoping that Breastfeeding stripped bare, the comprehensive NDC approach to breastfeeding and lactation, will be publicly available by the end of 2024. Key elements of the NDC breastfeeding work are also found in The discontented little baby book, and in my research publications, starting here.

Some ideas for bringing baby on if you have a more generous breast

Do you have a wonderfully generous breast? Do you have a generous breast with downward looking nipples?

  • If there is not good exposure of your breast's landing pad, you might experiment with a face-washer or soft cloth tightly rolled up and tucked up high under your breast. You can find out how to do this here.

  • You might also find that you need to lift the breast with your hand to help the baby get on. If so, try not to move your breast far from where our breast naturally wants to fall, and use the baby's face to support the breast once you bring the baby on, so that there is no drag of the tissue out of his or her mouth. Change back to having your forearm under the baby's head for micromovements in the classic gestalt position just as soon as possible.

  • Some women use their upper arm to hold the breast forward, or wear a bra with a supportive side strap, so that their generous breast doesn't fall too far off to the side.

  • Being very reclined, perhaps even more than 45 degrees if you can do it, helps open up your lap and breasts so that the baby comes up under your breasts.

  • You may not be able to see much, but that's normal - your baby has the inbuilt reflexes to get on, if you keep experimenting and applying the gestalt method.

You can find more about breastfeeding when you have a generous breast here.

Selected references

Douglas PS, Keogh R. Gestalt breastfeeding: helping mothers and infants optimise positional stability and intra-oral breast tissue volume for effective, pain-free milk transfer. Journal of Human Lactation. 2017;33(3):509–518.

Douglas PS, Geddes DB. Practice-based interpretation of ultrasound studies leads the way to less pharmaceutical and surgical intervention for breastfeeding babies and more effective clinical support. Midwifery. 2018;58:145–155.

Douglas PS, Perrella SL, Geddes DT. A brief gestalt intervention changes ultrasound measures of tongue movement during breastfeeding: case series. BMC Pregnancy and Childbirth. 2022;22(1):94. DOI: 10.1186/s12884-12021-04363-12887.

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