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.

What is meant by the landing pad?

Can I suggest you take a look at the size of your baby's gorgeous little face? This helps you get a feel for the kind of 'landing pad' your baby needs on the breast.

Depending on your baby's age and size, you will see that baby needs a landing pad of perhaps 5 cm radius or more around the nipple (>10 cm diameter) if the lower half of that little face is to properly bury into your breast.

Contact between the bare skin of the breast and the lower half of baby's face switches on the baby's suckling reflexes. We don't want your upper arm or clothing to press against your baby's upper face either because that will interfere with a symmetrical face-breast bury. It's important to have the landing pad as clear and as exposed as possible.

The best way to do this in the early days, while you're laying down new neurological pathways, is to take off your upper garments and bra if you possibly can.

In the video above, you'll see that the baby has difficulty getting oriented at the breast due to the lack of an adequate landing pad. Notice how the woman's arm and bra compromise the amount of exposed breast available, so that they have difficulty switching on the baby's breastfeeding reflexes.

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.