Expert Q&A

	By Melissa Clark Vickers International Board Certified Lactation Consultant Moms & Babies Huntingdon, Tenn.

I am 31 weeks pregnant with my first child and am hoping to begin a successful long breastfeeding relationship with this child when it is born in June. I have large breasts that have sagged due to being overweight and my nipples are now downturned on the underside of my breast. (I can't see them when I look down). Will this affect successful positioning/attaching?

There is so much variation from mom to mom on size of breast and how the nipple looks, what direction it is aimed, etc. The important thing as far as breastfeeding goes is to find a position that works for you and your baby. The principles are the same regardless:

1. Think of the breast as a dinner plate. Baby needs to have the "plate" centered in front of him with one arm on either side of the plate. He shouldn't have to turn his head side to side or front to back to get to the nipple.

2. Use pillows to get yourself comfortable and to support your baby when you nurse him so you both have plenty of support.

Moms like yourself with large breasts sometimes benefit from extra support. One easy and effective means of supporting the breast in this case is to take a long stretchy scarf that you can tie around your neck and under one breast to lift and support it. This acts like a third hand, and can be easily switched from one breast to the other without untying or taking it off.

It may help to make a "nipple sandwich": Support your breast from underneath with your fingers on the bottom and your thumb on the top of the breast, a little bit behind the areola (the dark area). Compress, or slightly flatten the breast so that it fits into your baby's mouth – much like when we eat a hamburger.

If there are La Leche League meetings in your area, try attending some meetings before your baby is born. You can learn some ways to position your baby ahead of time.

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