Aligning baby's spine during breastfeeding

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.

For stable breastfeeding, the baby's spine needs to be aligned through the midline from top to bottom. If his little spine or neck is rotated, it becomes difficult to drink comfortably for long, and the baby will pull off. It is much the same as us trying to drink from a glass of water turning our head to one side - it's difficult to sustain!

Often, as you experiment with micromovements, using your forearm as a lever, it's most comfortable to have your wrist neutral (not bent) on your forearm as you support baby's head. That is, your hand sits out, relaxed and perhaps looking weirdly redundant, not bent in to rest against your baby!

But this protects your wrist from strain and injury (which is quite common actually after having a baby), and gives you best use of your forearm for micromovements.

While you're starting out, that same arm will need firm pillow support under your elbow.

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.