Positioning for breastfeeding.

Difficulties in breastfeeding frequently arise from the failure of mothers and caregivers alike to understand what is happening as babies breastfeed, and what that means about positioning the baby for breastfeeding. This paper summarizes and criticizes some concepts of how babies breastfeed that have been inadequately researched or influenced by literature about how babies bottle feed. Recent ultrasound studies confirm overlooked earlier work and offer the basis for a rational understanding of how to facilitate adequate contact between the baby's mouth and the mother's breast and how to recognize poor positioning. The importance of breast shape, tension, and protractility are discussed, and the role of engorgement in nipple trauma explained; the differences between breastfeeding and feeding from so-called orthodontic teats are outlined. Understanding these matters is important to preventing breast and nipple problems and premature weaning.