PROBLEMS OFTEN CAUSED BY THE CROSS CRADLE HOLD, FOOTBALL HOLD, LOG HOLD AND LAID BACK NURSING POSITIONS

HSH = Hand supporting the head or neck holds.

HSH holds include the Cross Cradle, Football, and Log Hold positions.

1. The way baby's head and body are held while breastfeeding can either cause problems or help baby nurse effectively.

To understand why some breastfeeding positions cause many problems including nipple soreness, wrist pain, low milk supply, insufficient weight gain, and premature weaning and some do not, please note the difference in how baby's head and body are supported in each position. 

It makes all the difference!

With the 'Breastfeeding Positions That Help', the Cradle Hold, Lap Nursing Hold, and Lying Down Positions, baby is an active partner in the latch on process, helping to determine when he is ready to latch. 

In the Cradle Hold Position, mother's arm comfortably supports his head at nipple level. As mom leans back after latching, baby's body is comfortably supported as it wraps around mom's stomach.

In the Lap Nursing Hold, mother's lap supports baby's body and head, and mother's breast is large enough that her nipple reaches down to baby's mouth. He does not need to be lifted to the breast.

In the Lying Down Position, the bed supports baby's body and head. 

Mother lies down next to baby and places her breast so that baby can 

latch on. The bed supports all of mom, including her breasts.

In these positions the baby can move his mouth to the nipple. He can make any adjustments necessary to latch. Baby is an active partner in the latch on process.

Mom is comfortable, baby's head is comfortably supported, and he is an active partner in latching on in the Cradle Hold, Lap Nursing Hold and

Lying Down Positions.

This differs from the 'Breastfeeding Positions that Hinder', the HSH positions, the Cross Cradle Hold, Football Hold, and Log Hold Positions. 

In the HSH positions, the baby's head is lifted and controlled by the mother's hand. In lactation literature the HSH positions are described as being 'better for head control' than the Cradle Hold position. 

When a mother first learns to nurse, the idea of being able to totally control the baby's head sounds enticing.

But newborns are born with reflexes including the rooting reflex and the

(TLR) Tonic Labyrinthine Reflex. These reflexes help the baby to find the nipple and to latch on.

The TLR reflex is thought to help a baby during labor to extend his head towards the birth canal.

These reflexes help baby to become an active partner in finding his way to the breast by turning to the nipple that touches his mouth.

The TLR is present for a few months after birth and can be seen when you hold the back of baby's head. He will push his head back towards the hand.

When baby is held in the Cross Cradle Hold, he receives double stimuli from the nipple on his mouth and the hand on the back of his head, which confuses the latch on process.

 It often causes him to repeatedly pull on and off or to turn his head from side to side or to bob on and off the breast.

Often, lactation personnel will push the baby's head onto the breast or will hold it there, further aggravating the situation.

While they are trying to help the baby to latch, they are actually triggering the Tonic Labyrinthine Reflex.

One mom shared that her baby daughter just got wild when the nurse held her baby's head to her breast.

In the HSH positions the mother is holding baby's head or neck, so baby does not have the ability to help move his mouth to the breast. 

Mother has 'total control'. This restricts baby from being an active partner in the latch on process because mother is lifting and holding the baby's head. 

This prevents baby from making those last minor adjustments that he needs to make for effective and comfortable latching.

The mother is the one who tries to determine when to latch the baby, when is his mouth going to be open wide enough and for long enough to get all of the nipple and some of the areola (darker skin around the nipple), often with poor results. Often baby will close his mouth on just the nipple. This hurts.

So, while some say that the HSH positions are better for head control,

we have seen that the baby latches on better when he is allowed

to be an active partner in the Cradle Hold Position

(or Lap Nursing Hold or Lying Down Position). 

In addition, the mother is more comfortable holding baby in the Cradle Hold because baby's head is on her elbow area, in the crook of her arm, which is stronger than holding his head with her hand. She can hold him more comfortably and for longer periods of time, for as long as he needs to nurse. 

In the HSH positions, mothers often complain of sore hands, wrists, arms, and backs because they are supporting baby on their weaker wrist and forearm. 

These holds also lead to pillow dependence. 

Holding baby in an HSH position grows increasingly more difficult as baby grows and gains weight. Many mothers complain of carpal tunnel like symptoms in their wrists, achy arms, shoulder, back, and neck pain.

Straining the hand / wrist muscles in the HSH positions is not relaxing.

And note that in the Log Hold Position, one of mother's hands is holding baby's head and the other hand pulls baby's back into her stomach. 

There is no hand available to support the breast, if needed.

Caution: In the Cross Cradle Hold, Football Hold and Log Hold Positions, mother's hand has 'total control' of baby's head, and when baby will latch.

 This restricts baby from being an active partner in the latch on process.

This often contributes to latch on difficulties and nipple soreness.

2. THE HSH (Hand Supporting the Head / Neck) POSITIONS;

THE CROSS CRADLE HOLD, FOOTBALL HOLD, AND LOG HOLD POSITIONS, TRIGGER THE TONIC LABYRINTHINE REFLEX (TLR).

Latching Problems 

VERY IMPORTANT: AVOID TOUCHING THE BACK OF BABY'S HEAD AND NECK WITH YOUR FINGERS AND HAND WHEN LATCHING AND BREASTFEEDING.

Try not to touch, hold, or push the baby's head with a hand or fingers during latching or nursing (and don't let anyone else touch baby's head) as this may trigger the Tonic Labyrinthine Reflex  (TLR) and cause him to come off the breast, causing latching problems.

This primary reflex, the TLR, is a movement pattern which emerges during fetal life and is critical for the survival of the newborn as it helps the infant with rooting and sucking.

It is active during the birthing process where the baby retracts or pushes back his head, flexes and folds his arms and extends or straightens his legs. 

This reflex can be seen in a newborn by simply pushing on the back of baby's head. A newborn baby will turn towards whatever touches his face or head.

Sometimes the fatigue from birth or the medication mom had during labor will dull this response, but it will be apparent after the medication is out of baby's system and baby has had some rest.

When a baby is put into the Cross Cradle Hold position, one can see the Tonic Labyrinthine Reflex in action. Baby will push his head back towards the hand holding his head and will often arch back from the breast. He looks like he does not want to nurse, but really, he is reacting to the hand holding his head.

The Cradle Hold position does not create these problems. Keeping hands off the baby's head while supporting baby's head on top of the elbow area in the Cradle Hold position avoids these issues.

In the Cross Cradle Hold, Football Hold or Log Hold position, baby gets conflicting stimuli.

Latch on is strongly affected by the mixed signals the baby gets while nursing in an HSH position.

Mothers share that their babies won't open their mouth wide enough when the hand on the back of his head is telling him to turn towards the hand, away from the nipple.

Mothers share that their babies often are getting too shallow a latch. 

3. HSH positions often interfere with the way babies learn to breastfeed.

Lifting the baby's head to the breast in the Cross Cradle Hold for each latch

actually interferes with the way babies learn to nurse. 

With the Cross Cradle Hold and other HSH positions, the mother's hand has total control of baby's head, so baby is not able to make any adjustments. 

Baby is inhibited from being an active partner in latching.

Baby does not learn, and practice with each nursing session, correct latching because he can't move his head as it is being held by mother's hand.

In the Cradle Hold position, baby will naturally root for the breast when his head is placed in front of the breast, with his head supported on top of mother's elbow area, but not held. His head can make any latching adjustments needed.

It is rare for a baby to not latch well when the mother uses the

Cradle Hold position correctly and has not used the Cross Cradle Hold. 

4. Mothers are being told that if they are in pain while using the 

Cross Cradle Hold, that their latch must be wrong.

They are being told that any pain they are having is 'an artifact of

incorrect latch on', not a function of the hold itself.

The mothers who come to us using the Cross Cradle Hold are latched on 'properly'. Baby has all the nipple and some of the areola in his mouth.

Yet mom is still in a lot of pain.  

Babies learn how to latch properly when held in the Cradle Hold position, usually within 3 or 4 nursing sessions. 

Babies learn to open their mouths for long enough and wide enough in the Cradle Hold position, using the Bulls Eye Technique to line up baby's mouth in front of the nipple and keeping baby tummy to tummy with mom.

5. Mothers report these issues from the Cross Cradle Hold, Football Hold and Log Hold positions:

-It looks like baby doesn't want to nurse, pulling on and off or turning his head from side to side, or bobbing on and off the breast 

-Baby won't keep his mouth open for long enough when latching

-Poor suck; baby will latch but won't suck for any length of time

-Mothers are told their babies ‘Have a latching problem'

-Mothers are told their babies have an 'oral aversion' to breastfeeding

This is not a case of an 'oral aversion to breastfeeding'. 

It is the instinctual response of the baby to the double stimuli they are receiving in the HSH position, to root to the nipple and to the hand on the back of their heads. 

It may look like baby does not want to nurse, but it is really the 

Tonic Labyrinthine Reflex happening.

Baby is reacting to whatever is touching his face and head.

Mother's nipple is touching his lips, and her hand is holding his head.

He tries to latch on to the nipple then gets distracted by the hand on his head and roots to the hand.

The hand on the back of the head distracts the baby from latching onto the nipple.

6. The HSH positions, the Cross Cradle Hold, Football Hold and Log Hold are being linked to low weight gain for babies. 

What used to be a rare occurrence, insufficient milk supply with a resulting inadequate weight gain, has become a common occurrence since lactation literature was changed to promote the Cross Cradle Hold and other HSH positions.

We are extremely concerned about the number of babies that are not gaining weight properly while breastfeeding in an HSH position.

Many parents are reporting concerns over their baby's inadequate weight gain, with many babies losing a pound or more of their birth weight.

Mothers call us saying their doctor is concerned about their baby's weight. 

They are using the Cross Cradle Hold or other HSH position.

They are pumping and using bottles or a Supplementary Nursing System (SNS) because of latch on problems. 

They struggle with a low milk supply.

Baby is not gaining weight properly. 

Doctor says he has an insufficient weight gain.

Baby is not learning how to nurse effectively in the HSH positions, which often results in not being able to bring in a full milk supply.

It is difficult to nurse when you experience nipple, wrist, arm, shoulder, neck, and back pain every time the baby needs to nurse.

Yes, pillows can be used for support, but the HSH positions are dependent on pillow usage. Pillows do not solve all the issues that happen with the HSH positions.

And the Cradle Hold position is a superior hold in all respects. Why is it being discouraged?

For information on establishing a full milk supply see How to Build an Effective Milk Supply.

7. Some ask: Why not use the Cross Cradle Hold position and just keep mother's hand below baby's ears, on his neck?

Keeping mother's fingers and hand below baby's ears will decrease the pulling on and off problem, but the other issues remain.

Supporting a baby on the wrist and forearm in an HSH position is more difficult than on the elbow area in the Cradle Hold position. 

Mothers still complain about sore nipples, achy shoulders, wrists, forearms, necks, and backs when keeping their hand below the baby's ears in the 

Cross Cradle Hold as well as reporting concerns about low weight gain for baby, restrictiveness, dependence on pillows, and failed lactation.

8. Some ask:  Why not latch on in the Cross Cradle Hold position and then switch to the Cradle Hold position?

Lactation literature teaches that the Cross Cradle Hold Position is 'better for head control' than the time-tested, effective Cradle Hold.

And while holding the back of baby's head or neck in the Cross Cradle or Football Hold positions to lift him to the breast may look like it offers more head control, the newborn reflex called the Tonic Labyrinthine Reflex (TLR) is not being taken into consideration. This reflex aids in the birthing process and lasts for a few months after birth. 

This reflex causes the baby to turn towards whatever touches his face or head. The Cross Cradle Hold with the mom's hand on the back of baby's head triggers this reflex. Baby turns away from the breast towards the hand on the back of his head, or will bob on and off the breast, or will latch but not suck well. This often causes latch on problems, sore nipples, etc.

And whether the mom holds baby's head or neck, moms get sore wrists and arms from holding a baby in the Cross Cradle Hold for the length of time it takes a baby to nurse.

Caution: In HSH positions; the Cross Cradle Hold, Football Hold, and the Log Hold, Mom's hand on the back of baby's head triggers the Tonic Labyrinthine Reflex (TLR) in baby's early months. 

This often causes latch on problems, sore nipples, low milk supply, insufficient weight gain, and premature weaning.

For more about Sore Breasts and Sore Nipples see

Sore Breast Help and Sore Nipple Help.

See the difference? In the Cradle Hold Position, baby's head rests on top of mom's elbow area at nipple level. Baby is an active partner in latching as he can make any needed latch adjustments with his head. 

Mother is not lifting baby's head to her breast with her hand as in the

HSH positions.

9. Baby's mouth often closes on the nipple, causing pain, when using an HSH position.

When using the Cross Cradle Hold, Football Hold or Log Hold (HSH) positions, mothers struggle to determine when baby's mouth will be open wide enough and for long enough to latch effectively. 

In an HSH position, the mother is the one who determines when baby's mouth is open wide enough to latch. As baby roots towards the nipple, his mouth could close at any moment ending with a poor latch, as the hand on the back of his head is simultaneously triggering him to push back towards the hand. 

If the baby closes his mouth on the nipple and does not get all the nipple and some of the areola (the darker skin around the nipple), tissue damage can occur, contributing to sore nipples. 

In the Cradle Hold position, the baby is an active partner in the latch on process. He is the one who does the final reach from mother's arm to the breast, with mouth open wide.

Mother's arm gives perfect support for baby's head in the Cradle Hold position. Baby's head is at the correct level for the nipple. He is an active partner in the latch on process, making any needed adjustments with his head for an effective latch.

10. Cause of Nipple Soreness

Mothers using HSH positions often complain of nipple soreness.

The repeated pulling on and off from the breast by the baby can cause nipple soreness. 

Tissue damage can occur when mother is lifting baby's head to her breast and baby doesn't open his mouth wide enough. Then he may clamp down on just the nipple.

Trying to keep the baby's mouth open wide enough and for long enough when latching is difficult in the HSH holds because the hand on the back of the head is stimulating baby to push back toward the hand, thus causing the baby to close his mouth and turn away from the nipple. 

Mothers report feeling their baby was refusing to nurse or was having a 'latch on problem'.

In the Cradle Hold position, baby is an active partner in latching on. From mother's arm, baby helps by reaching his head towards the nipple, properly flanging out his lips (not curling them in). 

Mother doesn't have to guess when his mouth is opened properly, he will keep it open because the only thing stimulating him is the nipple on his lips. He is not being distracted by a hand on the back of his head. 

11. Breast Soreness 

Some mothers complain of breast tenderness where they hold the breast in the Cross Cradle Hold position.

12. Pain Exhibited by Baby in the Cross Cradle Hold Position

Babies born with forceps or with vacuum extraction often exhibit pain when nursed in the Cross Cradle Hold.

These babies settle calmly into nursing in the Cradle Hold Position.

In the Cross Cradle Hold, mother's fingers may press on sore spots from the forceps or vacuum.

To learn how to breastfeed naturally see Breastfeeding Positions that Help.

To prevent or heal from breastfeeding problems also see

Product Cautions and Technique Cautions.

13. THE LAID BACK NURSING POSITION OFTEN CAUSES PROBLEMS.

The Laid Back Nursing Position often causes problems that lessen the chance of an effective, natural breastfeeding experience.

We do NOT recommend the Laid Back Nursing Position.

This position makes it difficult for many newborns to latch effectively with their wobbly heads.

It is not as comfortable for mom or baby as the Cradle Hold or Lying Down Nursing positions.

Instead of the Laid Back Nursing position, we recommend the Lying Down and Cradle Hold positions.

Not recommended: Laid Back Nursing Position

 as it often causes latch on and other difficulties

Instead we recommend the Cradle Hold and Lying Down Positions for comfortable and effective breastfeeding.

For information on the problems caused by and a history of the 

Laid Back Nursing Position, see Laid Back Nursing Position.