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.

Let your shoulders relax down, opening them back against the couch. It helps to breathe in deeply, and purposely relax your muscles with the exhale, before and during breastfeeding, particularly if you are experiencing pain, but still want to bring your baby on to the breast.

You might notice that you bring your shoulder forward or up in a nurturing gesture when bringing the baby to the breast on that same side. When there is nipple pain, women often accidently tense and lift their shoulder high. But this may

• Create breast tissue drag in the baby's mouth

• Worsen nipple pain due to the breast tissue drag

• Make it difficult for the baby to have a symmetrical face-breast bury

• Result in musculoskeletal pain, if this is happening as a pattern over time.

Recommended resources

Slow deep breathing really does help

What to do when you have musculoskeletal pain, and how to prevent it

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.