If you’ve learned about breastfeeding in the Westernized world in the last 25 years you’ve likely heard about good positioning. For "good positioning" the baby should be tummy to tummy with mom, should not turn his head to swallow, should open his mouth wide to nurse, his lips should flange and he should take the nipple deep in his mouth. This is the mantra of "good positioning." However, many times a mother and I discover that to solve her nursing problems we need to break the rules of "good positioning."

One mother, Shannon, who ‘s baby was sleepy with a "lazy suck" and spent hours on the breast with little weight gain wrote, "Beverly, it's amazing! I wanted to try the nursing hold [position] you described, just to see.... well it's amazing! She was able to take long drawing sucks rather than gulp, gulp, gulp like she has been. She also kept sucking that way past the let down for a bit! She even sucked well on the other side when I switched breasts doing it this new way... it's so amazing!"

So what had I told her? Let the baby choose to turn her head to the side with her tummy out, let her turn away and pull off the breast whenever she wants to, allow her to take the nipple in only as deep as she wants and see if she will start sucking stronger. In her case it made a difference. At times we get so locked in to "effective nursing position" that we don’t get the baby’s subtle message that he is finding it challenging. What we have come to call "good positioning" I think of as "maximum flow positioning". Some babies do welcome the fast flow throughout the feeding that these behaviors afford, however other s don’t. It is helpful to watch babies cues and be open to his shifts in position, even if the position is unorthodox.

Another mother, Demetra, wrote to me after we spent some time working through her nursing problems and sore nipples "…I have learned from you to have a more open attitude about what may work and I am willing to troubleshoot until we find a more comfortable position. You have given me a greater appreciation of Lola’s communication skills."

The principals of "good positioning" are useful in resolving some breastfeeding difficulties, they are tried and true methods. However, getting locked into form and not being mindful of how the baby likes the changes can also cause problems. So say after me… Sometimes it is OK to break the rules!

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