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Expert Q&A

	By Ann Calandro BSN, RNC, IBCLC Lactation Consultant

I had rather large breasts to start with before I became pregnant. My breasts are so large now, I am worried I will smother my baby if I try to breastfeed. Also, will my breasts return to their former size?

Each mother learns to hold her baby in the most efficient and comfortable way that works for her and for her baby. Since breasts come in all sizes, sometimes it takes a little practice to find the best way to nurse. Many women with large breasts like to use the under-the-arm ("football" in the US) hold. Baby's body is on a pillow alongside Mom, with his feet pointing towards her back. In this hold, Mom is able to see exactly what she is doing as she latches the baby onto the breast, and is able to keep the baby's nostrils unobstructed. Babies enjoy breathing(!), so if the eating position impedes this, the baby will choose to breathe rather than to eat. You will find the best way to accommodate the baby's need to breathe AND eat.

In whatever position you choose, be sure to leave space for the baby to move his head back if needed. Babies will not feed well if the back of their heads are held in close to the breast. For that reason, moms often support the baby by the shoulders and neck, putting the thumb on one ear and the index finger on the baby's other ear, and the palm of the hand down on the neck and shoulders. In this position, baby can pivot his head back to breathe if the breast does cover the nose. It is important however, to get the baby's nose up to the breast for a deeper latch-on. As long as you can see a little space for his nostrils, the baby can breathe.

If you need to lift the breast slightly up or to slightly press the breast down to clear the airway, that is fine. Just be careful if you are pushing down on the breast not to also pull the breast away from the baby's mouth. This pulls the nipple away from the back of the roof of his mouth. Then baby can't nurse as well, and it won't be comfortable for you.

Get some assistance if you need help learning in the early days. If your hospital has an International Board Certified Lactation Consultant (IBCLC), request a visit at a time your baby is ready to eat.

All of this sounds complicated, but it isn't. Once your baby is here and you begin nursing, it will all fall in place and will make sense. It's well worth it! I work with many women with very large breasts who are very successful with nursing. As one mom said to me once, "Now I know why I have carried these things around with me all these years!"

Pregnancy changes the breasts in order to prepare for breastfeeding. Most times mothers will return to their former size, although some find after pregnancy is over they will be smaller and some find they are a bit larger. This is true whether mom chooses breastfeeding or not.

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