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  • step #1. how babies suck in breastfeeding

Watch three babies drinking beautifully from their mother's breast

Dr Pamela Douglas1st of Sep 202325th 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.

The demonstration videos below show us what we are aiming for in order to achieve very good milk transfer. You will notice that

  • The lower half of the baby's face from the nose down is deeply buried in the mother's breast

  • The little nostrils are peeking up just above the breast tissue

  • It is not possible to see the lips

  • The head is tilted back

  • The jaw drops down beautifully

  • The soft 'k' sound of swallows as the jaw relaxes upwards.

Baby 1

This baby is less than a week old but is drinking happily. You will see that although she has delicate breasts, this mother is producing lots of milk. She has been feeding her baby frequently, to cue, since his birth. This tiny one manages high volumes of milk during the letdown very well, because of his excellent positional stability. When babies pull off the breast, it is not typically because they can't manage the letdown, but because they aren't stable enough.

Baby 2

It's worthwhile looking at a number of videos of a baby transferring milk efficiently. Not all of a breastfeed goes like this, and some babies take time to get started with the feed. They usually need pauses at the breast to catch their breath, and we don't need to hurry them. Some feeds there is lots of milk transfer, in other feeds very little. Some feeds are longer, others much shorter. What matters is that you offer the breast frequently and flexibly (perhaps 12 times each breast in a 24-hour period, without looking at the clock!).

Baby 3

In this video, the newborn is drinking well. If there had been any problems at all, he could have been snuggled back a few millimetres in the direction of his feet, so that his upper lip was even more buried in and less visible, with less gap between the breast and his nose. Then his jaw would have dropped even deeper with the chin buried into the breast, and even more breast tissue would have been drawn up into his mouth. Notice the ratio of sucks to swallows is unpredictable and irregular, which is normal. Never worry about counting sucks and swallows!

It's one thing to show you these videos of babies transferring milk efficiently. Please keep going through the articles in this collection to explore how can you and your unique baby can fit together so that your baby ends up drinking beautifully like this, transferring milk well and protecting your nipple from damage!

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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Next up in step #2. preparing your body & mind for relaxed and comfortable breastfeeding

Finding the best position for a relaxed and comfortable breastfeed

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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.

We need to prepare for breastfeeding by placing your own body in a relaxed and comfortable position, which can be sustained without causing muscle tension or pain.

The semi-reclined or deck-chair position is by far the

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    How babies breastfeed: the biomechanics of infant suck (short animation)
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