Possums Breastfeeding - How To
Here you will find a written guide to using the Possums approach, which is also called Gestalt Breastfeeding - reflecting there are greater benefits beyond the feed alone to be gained. Becoming familiar with the steps will support you to handle your baby with confidence from the very start to achieve what we refer to as "good fit and hold".
Further down this page you will also find a pictorial visual guide.
At Newborn Home Care we join a team of health practitioners across many parts of the world who have embraced Gestalt breastfeeding principles. Its practice has transformed the lactation and breastfeeding support we offer in ways that only serve to inspire us more.
The two things we hear women say over and over is - "this is so comfortable" and "this makes so much sense". The third is - "how can I thank you enough?" It is incredibly humbling to have at our disposal such useful evidence-based tools with which to empower breastfeeding women.
We invite other health care professionals to explore the value of the Possums principles. You can find a wealth of resources and how to become an NDC practitioner at ndcinstitute.com.au and at possumsndc.com.
Gestalt breastfeeding acknowledges the powerful role played by the mother in lying back and holding her baby to her chest to begin a feed. A baby is not 'put to the breast', but rather explores the breast, nuzzling in above the nipple to turn on his innate oral seeking feeding reflexes. This will help him place his mouth over the nipple and draw it and incrementally more and more breast tissue up to fill his mouth as he sucks and creates a vacuum. Using a footstool or resting back in bed is helpful while you aim for a 'deck chair' reclining position.
When your baby is cue-ing for a feed, hold him close on your chest and tell him his feed is coming. It is important that he is in a calm state to begin his breast seeking behaviour, so that his feeding reflexes remain organised. Being skin-to-skin with him for breastfeeding in the early days is biologically beneficial to establishing your milk supply and the full expression of his reflexes.
Begin by clearing a good 10 cm area where there is no bra or clothing encroaching on your breast that will interfere with him flexing and exploring his instincts. We call this area the 'landing pad'. This is where his hands and entire face, not just the chin, will bury and nuzzle into the breast and feel your skin. This is often after he has shown some quite spectacular head-bobbing and upper body throws that are awe inspiring to witness.
Then, try this as a guide.
• Ease your baby's lower arm around your breast so it doesn't lie between you preventing the close fit you need. Once he has his mouth over the nipple, immediately tuck bub in closely to you, wrapping him securely onto your ribcage and up under your other breast by placing what we call your "paddle arm" along the length of his back. Your hand will come to rest somewhere between his shoulder blades. He needs to be turned right on his side, so check to see that there is no twist in his body. We call this a 'rib cage wrap'.
• A deep chin and face bury will enable him to draw the nipple and more and more breast tissue up into his mouth through to where the hard palate meets the soft palate (beyond where it would otherwise hurt). He will naturally achieve this by the vacuum he creates with his sucking and jaw action.
• Look down and check that his chin and both cheeks are equally and symmetrically buried into the breast. You should not be able to see his lips or chin - and be reassured that he only needs a slight gap between his nose and breast to breathe. He will pull off if there's not. If more of a gap is needed, just wrap him slightly further around your other breast with a firm paddle hand between his shoulders - and his head will 'sniff' back.
• Lastly, check that his head is coming onto the breast in the same neutral line with where the breast and nipple want to naturally fall - not higher, or lower, to the left or the right of it. Also look to see if there is any dragging of the areola and breast tissue in any up, down or sideways direction. If there is, you will likely feel discomfort from the opposing forces between the twisted tissue and the up and down action of his jaw. We call this 'breast tissue drag'.
Make any positional changes with slight micromovements until your breastfeeding is completely comfortable. This is best achieved by having your baby's head on your mid forearm, instead of tightly into the crook of your elbow, so that it can act like a lever. Along with your paddle hand, it is now easy to adjust his position with small micro-movements, while you tune into the difference each move makes to your comfort with feeding.
There are three pillars to identifying that your baby is feeding with positional stability.
1. How does it feel? (Are the stretching forces created by your baby's sucking painless?)
2. Baby's behaviour (Is he settled and sucking contentedly?)
3. Is his head in alignment with where the breast and nipple naturally fall? (Check front, side and back views)