C-Hold The purpose of the C-Hold is to ensure that the breast is held in a proper position to ensure optimal breastfeeding for the baby and comfort for the Mom. It is important in this position to be prepared so that as soon as the baby opens their mouth to begin feeding Mom is ready. The C-Hold is done by using the fingers and thumbs to make a C shape, and then placing the C around the areola with the thumb at the 12 o’clock position and the fingers at the 6 o’clock position. It is important that Mom is very careful about where the fingers are placed. They should be about 1 ½ inches away from the nipple to ensure that the baby is able to get the entire nipple in the mouth. Not grasping enough of the nipple is considered a shallow grasp and this can cause nipple pain.
U-Hold The U-hold position follows the same principles of the C-Hold, but the positioning of the thumb and fingers are at different points. In this hold, Mom should make a C-shape with the fingers, but place the thumb at 3 o’clock, and the fingers at 9 o’clock. Again, it is important to make sure that the fingers are not blocking the areola so that the baby can get a full latch and nipple pain is reduced. This position may be more comfortable because Mom’s arm is against her body instead of sticking out as is the case in the C-Hold.
Scissor Hold This hold consists of using two fingers from the side as if cutting the nipple with the fingers. This position is challenging for some women because it may be difficult to ensure that the fingers are not on the areola. It is also important to not press to hard in this position so that milk flow is not obstructed.
Rooting and Attachment After the position and the hold have been established, the baby is ready to begin nursing. The next step is to ensure that attachment occurs correctly. The nipple should not be centered in the mouth. Instead, the nipple should be towards the roof of the mouth so that when the baby closes their lower jaw the nipple is compressed against the roof of the mouth to excrete milk. It is important to understand that the jaw is a hinge joint, and the top of the mouth is not able to move in order to create proper attachment. It may help to align the nose of the infant to the nipple, and tilt the head backwards to that the nose is slightly facing up. This will help with attachment.
After attachment is accomplished, the rooting reflex will occur. Take the nipple and stroke the lower lip. This will stimulate the baby to begin to suck and move the muscles of the mouth. The initial response may not be latching, but Mom should continue to stroke the baby’s lower lip so that once the baby is ready, latching can occur. The stroking of the lip initiates the rooting reflex. It is also important to ensure that the baby is awake enough to feed. If the baby is not alert, latching might not occur properly.
Davidson, M London., Ladewig, P. (2008), Old's Maternal - Newborn Nursing & Women's Health Across the Lifespan. Upper Saddle River, New Jersey: Pearson