How do you know if your breastfed baby has fit and hold problems?
Unstable fit and hold is a very common problem for breastfeeding mother baby pairs. Unworkable fit and hold causes nipple and breast tissue drag and positional instability for both the baby and yourself.
Your baby may have fit and hold problems if he or she consistently shows one or more of the following behaviours with at the breast:
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Difficulty getting on the breast
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Fussing and fretting at the breast
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Back-arching during feeds
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Pulling off a lot
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Feeding for a time then 'refusing the breast' despite appearing to be hungry.
Unfortunately, poor fit and hold may also cause one or more of the following:
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Marathon breastfeeding
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Excessively frequent breastfeeding
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Cry-fuss problems
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Inadequate baby weight gain.
In our health systems today, fit and hold problems are still very commonly missed. You might have been told that your baby's fit and hold is fine, but you and the baby still have problems from the lists above - in which case, the fit and hold most likely requires some more work, afterall. Often, babies with fit and hold problems are being diagnosed with a range of suck and neuromotor abnormalities, when actually it's a contextual problem: the way baby sucks is affected by the mechanics of fit and hold.
Other babies may have normal weight gain but still show one or more of the signs of poor fit and hold, and benefit from the gestalt method.
If you have concerns about your baby's weight gain or your breastmilk supply, it is important to seek the help of your GP or a health professional. You can also look for a local NDC Accredited Practitioner here.
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.