Keep baby as dialled down as possible when bringing baby to the breast

The gestalt method of fit and hold is only one part of the Neuroprotective Developmental Care (NDC) or Possums breastfeeding programs (under development as Breastfeeding stripped bare), but an important place to start. This version of the gestalt method of fit and hold for breastfeeding women has been available since 2016. I'm hoping that Breastfeeding stripped bare, the comprehensive NDC approach to breastfeeding and lactation, will be publicly available by the end of 2024. Key elements of the NDC breastfeeding work are also found in The discontented little baby book, and in my research publications, starting here.

Your baby has hardwired neurological reflexes that help him or her get started with healthy breastfeeding. Your job is to switch these on, and then set up an environment in which you and the baby can lay down neurological pathways for enjoyable, effective breastfeeding through practice and experimentation.

A dialled up sympathetic nervous system - especially if it's very dialled up! - makes it difficult for the baby's breastfeeding reflexes to switch on, or for the baby to learn new things.

One of the best ways of getting around this is to offer the baby the breast when he or she is still quite content, rather than waiting for him or her to dial up with hunger. You can't go wrong offering the breast whenever you think it might work. It's important never to pressure the baby, though, just to offer and notice what happens.

Selected references

Douglas PS, Keogh R. Gestalt breastfeeding: helping mothers and infants optimise positional stability and intra-oral breast tissue volume for effective, pain-free milk transfer. Journal of Human Lactation. 2017;33(3):509–518.

Douglas PS, Geddes DB. Practice-based interpretation of ultrasound studies leads the way to less pharmaceutical and surgical intervention for breastfeeding babies and more effective clinical support. Midwifery. 2018;58:145–155.

Douglas PS, Perrella SL, Geddes DT. A brief gestalt intervention changes ultrasound measures of tongue movement during breastfeeding: case series. BMC Pregnancy and Childbirth. 2022;22(1):94. DOI: 10.1186/s12884-12021-04363-12887.