What is meant by the landing pad in breastfeeding?
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.
What is meant by the landing pad?
We suggest you also take a look at the size of your baby's gorgeous little face. This helps us get a feel for the kind of 'landing pad' the baby needs on the breast.
Depending on your baby's age and size, you will see that the baby needs a landing pad of perhaps 5 cm radius or more around the nipple (>10 cm diameter) if that little face is to properly bury into your breast.
Contact between the bare skin of the breast and the lower half of the baby's face switches on the baby's suckling reflexes. We don't want your upper arm or clothing to press against the baby's upper face either which interferes with the symmetrical bury of the lower face. It's important to have the landing pad as clear and as exposed as possible.
The best way to do this in the early days, while you're laying down new neurological pathways, is to take off your garment and bras.
How clothing and bras can get in the way
Our bras or clothing, or the baby's bib, can get in the way of the baby's breastfeeding reflexes without us realising it. Bras can push the nipple towards the midline - we need to remember that baby's legs will spread further off to the opposite side than you would expect when the nipple is pushed more towards the mid-line.
Bras can also create a ledge under the breast which compromises the landing pad for the chin and lower face. You might accidentally have your upper arm positioned too close to the nipple, which also interferes with the baby's landing pad and might trigger baby to pull off. In this case, you'll need to open up some distance between your upper arm and the nipple.
In the video below, you'll see that the baby has difficulty getting oriented at the breast due to the lack of an adequate landing pad. Notice how the woman's arm and bra compromise the amount of exposed breast available, so that they have difficulty switching on the baby's breastfeeding reflexes.
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.