Side-lying hold

What is the side-lying hold?

With the side-lying hold, the mother lies on her side on a firm surface while breastfeeding and the baby lies beside her tummy-to-tummy. The mother needs to make sure the baby’s mouth is aligned with her nipple and that the baby is not rolling away from her. This hold does not provide as much control over the baby as some others. It works well for mothers with small or average breast sizes and for older babies but not so well for mothers with large breasts or tender tummies or painful nipples. It is not very helpful for babies who are weak as it cannot be combined with the sandwich technique.

A) Describing the side-lying hold

The side-lying hold.

In the side-lying hold, the mother and baby lie beside each other on a firm surface with the baby’s tummy and mother’s tummy in close contact (tummy-to-tummy). The baby is positioned so that the mouth is square in front of the nipple and the body is in a straight line.

The side-lying hold allows the mother to lie down while breastfeeding. It does not provide as much control over the baby as some other holds and cannot easily be combined with the breast sandwich technique. Ensure you follow the safe-sleeping guidelines if there is a chance you will fall asleep while breastfeeding.

B) Using the side-lying hold

To adopt the side-lying hold at the right breast:

  1. Lie on your right side on a bed with a pillow in the usual position under your head.
  2. Roll the baby onto its left side and place the baby’s tummy against yours.
  3. Position the baby’s mouth in front of your nipple, which will usually be about three centimetres (a little more than an inch) above the surface of the bed, by leaning forward or back.
  4. If helpful, use a pillow behind your back to keep your body in this position.
  5. The baby’s head stays on the mattress. It does not rest on your upper arm as this will raise the baby’s mouth above your nipple and may bend the baby’s neck too much.
  6. Support the baby’s neck by placing:
    1. Your left index (pointer) finger pad behind the baby’s left ear.
    2. Your left thumb pad behind the right ear.
    3. The palm and the rest of your fingers should curl behind the baby’s neck and shoulders.
  7. Gently move the breast with your right hand so that the nipple touches the middle of the baby’s top lip. This can be a little awkward and alternatives are to:
    1. Move your right shoulder up and down which will move the breast and nipple.
    2. Rock slightly forward and back to move your breast and nipple.
  8. Once the baby’s mouth opens, latch the baby using your left hand by pulling the baby into the breast.

C) Common problems with the side-lying hold

There are several common problems with the side-lying hold: 

1) The baby’s mouth is not aligned with the nipple

This can cause nipple pain and damage and ineffective feeding.

Resolve this by adjusting the position of the baby by moving the baby towards your head or feet or adjusting your position by leaning further back or forwards.

2) The baby’s hips roll away from you

Resolve this by turning the baby on its side so that its tummy is against yours and keep the baby in this position by placing your hand behind the baby's back.

3) The baby has the lower arm in front of its chest

This may cause the baby to roll away from you and pull on the nipple.

Resolve this by adjusting the baby’s arm to circle under the breast.

D) Situations in which the side-lying hold is effective

The side-lying hold is well suited to:

  • Mothers with small and medium sized breasts.
  • Mothers who are tired and wish to lie down while breastfeeding.
  • Older babies who can latch themselves.

E) Situations in which the side-lying hold is less effective

The side-lying hold is less suited to mothers who:

  • Have tender tummies, since the baby must be positioned against the mother’s tummy or may kick it.
  • Have painful or damaged nipples, since:
    • Mothers have little control of the baby’s head.
    • It can be hard to ensure good positioning at the breast.
    • This hold cannot be combined with the breast sandwich technique.
  • Have large breasts as the baby can be difficult to position at the breast and there is an increased risk of suffocation of the baby if the mother falls asleep.
  • Want to use the sandwich technique.
  • Have twins and wish to breastfeed both at the same time.

Babies who are premature, sleepy newborn, or sick may not receive enough support in this hold to breastfeed well. The side-lying hold can also make it harder for the mother to watch the baby’s face. This is especially concerning for such vulnerable babies.