There are several common problems with the under-arm hold:
1) The hand under the baby is not supported
If you have the whole weight of the baby’s head and body on your supporting hand and arm, you can become tired. This can result in the baby’s head falling below the nipple and the baby pulling down on the nipple causing pain and even damage.
Resolve this by using a breastfeeding or regular pillow to provide extra support under the hand that is holding the baby’s neck. If the pillow is too low, it can be raised using a folded blanket or towel put under the baby or the pillow.
Placing a rolled towel under the wrist can reduce arm and hand strain. To save time and effort, you can keep the towel rolled by securing it with elastic bands or string.
2) The baby’s mouth is too far in front of the nipple
If the baby’s body is too far in front of you, the baby will have to bend its neck to reach the nipple and latch. This can make it more difficult for the baby to swallow and increase the chance of choking. If the baby’s chin is touching its chest, that may be a sign that this is happening. The head should be in the sniffing position.
Resolve this by moving the baby slightly farther behind you. If there isn’t space in your chair to move the baby back, move your trunk forward instead by placing a pillow behind your back but not behind the baby’s legs. You may also bend the baby’s legs at the hips so the feet are up and closer to your shoulder.
This is often a problem with mothers who are breastfeeding in bed and using the under-arm hold right after giving birth.
3) The baby’s body is too high for the nipple
If the baby’s mouth is above the nipple, the pillow may be too thick or the armrest too high.
Resolve this by adjusting the pillow or using a thinner pillow. Alternatively, you can place the baby under the breast in a horizontal under-arm hold and let the breast rest on the baby’s chest and abdomen.
4) One of the baby’s arms is in front of the baby’s chest instead of encircling the breast
This causes the baby to be further away from the breast and nipple. It is also less comfortable for the baby than having the arms encircle the breast.
Resolve this by moving the baby’s arm to the correct position.
5) The baby is too long
As babies grow, they may be too long to tuck in beside the mother. One option is to have the baby’s body rest on a couch (sofa) or bed surface beside the mother (the run-off under-arm hold).