Cradle hold

What is the cradle hold?

In the cradle hold, the mother is seated and the baby’s head is on the forearm with the mouth directly in front of a nipple. The mother is tummy-to-tummy with the baby and the baby’s arms encircle the breast she is using for feeding. If the baby’s body is twisted or the mouth is not aligned with the nipple, that can cause latching problems or nipple pain. The cradle hold is well suited to mothers with breasts of average or shorter length, babies who choke frequently, and older babies. It is less effective for mothers with large breasts, painful nipples, or a larger or tender abdomen, and it is not well suited to weak babies. It cannot be combined with the sandwich technique.

A) Describing the cradle hold

This mother is using the cradle hold to breastfeed. The baby is tummy-to-tummy with the mother, his head, shoulders, and hips are in a straight line, and his arms circle the breast.

In the cradle hold, the mother is seated and the baby is positioned so that the head and body lies on the forearm and the mouth is square in front of the nipple. The baby’s body is horizontal, with the baby’s tummy and mother’s tummy in close contact (tummy-to-tummy).

Many mothers find that using a breastfeeding pillow makes the cradle hold more comfortable for themselves and the baby. This is especially important if the breasts are small.

The cradle hold is the most commonly-used hold as babies grow. It can accommodate a larger baby’s size and distractibility. It cannot easily be combined with the breast sandwich technique.

B) Using the cradle hold

This baby is breastfeeding in the cradle hold. He has a normal gap between his ear and shoulder.

This is one way to position and latch a younger baby who needs a little help using the cradle hold at the right breast:

  1. Sit in a comfortable position with good back support and your feet flat on the floor.
  2. Consider placing a breastfeeding pillow on your lap.
  3. Roll the baby onto the left side and position the baby’s tummy against your own.
  4. Place your right forearm under the baby so that the baby’s mouth is at the same height as the right nipple.
  5. Using your left hand, move the baby along the right forearm so that the baby’s mouth is directly in front of the nipple.
  6. Use the fingers of your left hand to gently shake the breast so that your nipple taps the baby’s top lip.
  7. Once the baby’s mouth opens, pull the baby towards the nipple with the right arm to latch.

In the first month of life, a baby may need a little more help to latch. This can be accomplished by latching the baby using the cross-cradle hold and once the baby is settled and feeding well, changing to the cradle hold. 

As babies grow and become stronger, they can latch themselves once placed in the cradle hold. This allows you to skip steps 6 and 7.  

C) Common problems when using the cradle hold

A baby poorly positioned in the cradle hold: The baby's head is too far toward the mother's elbow, the ear is touching the shoulder, and the tummy and hips are not touching the mother's tummy. This baby needs to be lifted and brought closer to the mother's midline, and the hips and tummy need to be closer to the mother's tummy. The mother’s right hand should not be between the baby and the breast.

There are several common problems with the cradle hold.

1) The baby’s mouth is not positioned in front of the nipple

The baby’s mouth can be above or below the nipple or the baby can be too close to the bend of the mother’s elbow (crook).

The baby will then need to use more suction to stay latched. This can cause nipple pain and even damage. If the baby is too weak to create this stronger suction, the baby may have latching problems or may quickly tire while breastfeeding.

The baby will also pull the nipple toward the mouth resulting in stretching of the nipple sides and pain.

a) The baby’s mouth is positioned below the mother’s nipple

This causes the mother to lean forward, resulting in neck and back pain. If the mother does not lean forward, the baby will pull downward on the nipple, resulting in pain at the top of the nipple.

This is more common with a shorter breast and in mothers who do not support the baby with a breastfeeding pillow.

To avoid this, raise the baby so the mouth is aligned with the nipple and consider using a breastfeeding pillow.

b) The baby’s mouth is positioned above the nipple

This causes the baby to pull the nipple upward, resulting in pain at the bottom of the nipple.

Mothers with longer breasts experience this more often, since longer breasts may extend below the baby’s mouth.

Avoid this by lowering the baby so that the mouth is aligned with the nipple. This can be done by placing both arms under the baby and spreading them slightly instead of using just one forearm. Alternatively, you may rest the baby on a pillow instead of the forearm.

c) The baby’s head is positioned in the crook of the mother’s arm:

In this position, the baby’s body is placed too close to the elbow of the supporting arm and the head is in the crook of the supporting arm. This is a common issue when using the cradle hold.

By way of illustration, when breastfeeding on the right breast, the baby’s:

  • Body is placed too close to the elbow of the right arm.
  • Head is in the crook of the right arm.
  • Mouth is in front of the right (outer) side of the breast instead of the nipple.

The baby has to bend the head onto the shoulder or chest to reach the nipple. The baby will not be comfortable and will tend to pull on the nipple.

Properly positioned, the baby’s head should be placed on the forearm and not in the crook.

Resolve this by bringing the baby’s body a little closer to the center of your body. This means placing the baby on your forearm with the mouth right in front of the nipple and having your baby tummy-to-tummy with you.

In the above example, the baby would be pulled slightly towards the left side of the mother’s body.

2) The baby’s body is twisted.

This occurs when:

  • The baby’s hips are allowed to roll away from the mother’s body, causing the baby to pull away from the nipple.
  • The baby is lying on the back and the head is turned towards the nipple.

Both positions can cause nipple pain and damage and make it harder for the baby to latch and breastfeed effectively.

If you are breastfeeding on the right breast, resolve this by using the left arm to bring the baby tummy-to-tummy with you. You can rest your left hand behind the baby’s back and your left forearm behind the baby’s hips to keep the baby in place.

3) The baby’s lower arm is in front of the breast instead of circling it.

If breastfeeding from the right breast, the baby's left arm may be in front of the baby's chest instead of circling the breast. When the baby is properly held, the baby’s arms should encircle the breast.

Having the arm in front causes the baby to be on the back instead of tummy-to-tummy. In addition, older babies will use the lower arm to quickly push away from the mother while still latched and cause nipple pain (nip-lash).  

Resolve this by moving the baby’s lower arm under the breast so the arms encircle the breast.

D) Situations in which the cradle hold is effective

The cradle hold is well suited to the mothers with:

  • Breasts of an average or shorter length.
  • Other children, as it frees one hand which can be used to care for them.

The cradle hold is well suited to babies:

  • Who choke frequently while breastfeeding, because the hold allows the baby to release the breast as needed and catch a breath while waiting for the let-down to pass and easily re-latch.
  • Who are older, because the hold allows:
    • The baby to look and move around.
    • The baby to release the breast when distracted and easily re-latch.

E) Situations in which the cradle hold is less effective

It is awkward to use the breast sandwich technique with the cradle hold.

The cradle hold is less suited to mothers with:

  • Longer or larger breasts, because the baby may be positioned too high to reach the nipple.
  • A larger tummy, because it may push the baby away from the breast, making good positioning difficult.
  • A tender tummy, because the pressure from the baby and the forearm may be uncomfortable.
  • Painful or damaged nipples, because there is little or no control of the baby’s head and it is awkward to use the breast sandwich technique to protect the nipple.
  • Twins and wish to breastfeed both at the same time.

The cradle hold is less suited to babies with latching and breastfeeding problems because they often need more support and it is awkward to use the breast sandwich technique. This can affect premature, sleepy newborn, or sick babies.