Breastfeeding – Positions and Support

May 21, 2019

Antenatal classes ? – check. Reading lots of pregnancy, birth and parenting books? – check. Breastfeeding classes? Hmmm!

For such a natural and precious part of being a mother, breastfeeding isn’t something you can really ‘learn’ or know how to do until your beautiful babe arrives and is safely in your arms. Here’s the incredible thing; babies are born with a survival instinct that means they know how to breastfeed; and they’re often much better at it than we are (at least initially). Try to remember that when learning any new skill, practice makes perfect; but there are a few tips and positions I’m about to share with you to assist you with mastering the art of breastfeeding. 



Environment and Set- up

Ideally lying down. A relaxed, familiar feeding setup is going to promote a more enjoyable experience for you and baby. Bed, couch or floor, pillows are great;  whether you use a boomerang pillow, cushions or a special nursing pillow, supporting your baby helps optimise their positioning on the breast and reduces unnecessary strain on your neck, shoulders and back. Be prepared with snacks and water on hand, as well as a tv remote or your phone close by. If you can get organised go to the toilet before you lie/sit down to feed! You don’t want that awful feeling of being desperate to go when the baby takes ages to feed or has fallen asleep and you don’t want to move for fear of waking them. This is a great time to do your pelvic floor exercises though! Ha you thought you got out of it didn’t you!!!


Latch

If you can take ‘baby to breast’ and not ‘breast to baby’. When you bring baby to the breast their head will be tilted back slightly with the chin elevated and nose close to the breast. Ideally you can see and hear rhythmic swallowing once the milk starts flowing after the let-down. If the latch is painful,  take baby off the breast and attempt to re-latch. I know painful, but worthwhile in the long run !!??!!


Hydrate

Drink plenty of water! Breast milk is approximately 90% water and breastfeeding will make you thirsty. Hydration = good for milk supply, not to  mention your overall well-being. It is especially important to drink enough to replace lost fluids through sweat or exercise. Research suggests a small amount of caffeine is considered safe while breastfeeding. I know huh……. argghhh. But on this one I think it is a trial and see. If you think your bub is more unsettled if you have a coffee … or two maybe reducing in the short term may enable more sleep for YOU and bub at night. 


Eat well (and enough) – Breastfeeding takes it out of you, literally. It is recommended that breastfeeding women add an extra 400-500 calories into their daily caloric intake, Guys that’s an extra chocolate bar!!! “Ohhh, really I should not eat that kit kat” – mmmm –“ maybe if I kept some healthy snacks on hand, I’d feel better for it in the end and hey it may help milk quality and supply as well”!!!


OK it’s a no brainer but OOOOhhh not so easy when I am deliriously tired and craving something!!!!


GIRL, get organised with healthy snacks on hand and stop the excuses!!!! Cos you will feel better.



Supply

If  you are concerned about low milk supply, speak with your GP for medical advice. Some women find lactation biscuits/balls effective, and there is a belief that brewer’s yeast, flaxseed and healthy fats are supply-promoting foods. This is however, not evidence-based theory; so it is worth speaking to a lactation consultant or dietitian prior to implementing any significant dietary changes.


Position

You will be guided by midwives and nurses, but we often find women are not taught to feed lying down. Breast size and baby size may impact position choice. Some breastfeeding positions to try include:


Side lying – Lying in bed or on a comfy couch with baby snuggled next to you not only promotes the bonding and skin-to-skin contact that boosts those breastfeeding hormones, but it gives you a chance to lie down and rest! For smaller breasted women, try feeding from the bottom breast, while larger breasted women may like to utilise gravity and feed from the top breast if baby’s head control and latch allows for this. This position is very relaxing and can be much more comfortable than sitting for some women, particularly those who have had a Caesarean delivery.


Semi-reclined - This is generally the first position used if baby is placed on your chest after delivery, so baby can ‘breast-crawl’ and enjoy that special first feed. This reclined position or even lying flat on your back may be useful if you have large breasts and a small baby, or a forceful let down.


Cradle - hold or cross body cradle hold. This ‘tummy to mummy’ position is very popular; but can be hard with a small newborn. Make sure you’ve got lots of pillows to support your back and under baby; and try not to spend the entire time looking down or with your shoulders rounded and back hunched over. As beautiful as it is to watch them feed and to have baby look up at you, your neck and back muscles will very quickly get tired of this constant looking down, and with your hormones (Relaxing, in particular) affecting ligament laxity, this can result in ongoing neck/back pain or cause headaches. 


Rugby ball hold – The rugby ball hold (or football hold if you’re a keen AFL supporter) may be a nice position choice to use with a newborn, twins, following a C-section or if you’re a larger-breasted mum. Baby is tucked under your arm with feet towards the back of the chair or your body. Baby will feel safe nestled in to your body and you have the added benefit of being able to see baby’s face.


Upright or koala bear hold – When your baby is much heavier and wrigglier you may have to get creative with feeding positions! If your little livewire is too heavy to hold or gets reflux symptoms, this position may be beneficial. It can also be a discreet way of breastfeeding while out in public.


Dangle feeding – Some women report utilising gravity and dangle feeding in a kneeling position helpful for unblocking ducts and potentially preventing mastitis (although there is no published evidence for this). Baby lies on their back underneath Mum who ‘dangles’ over top and feeds in this fashion. This position may be a nice alternative but can place strain on the shoulders and arms if used for prolonged periods.



Hopefully the above tips and positions are of some assistance in terms of promoting an enjoyable breastfeeding experience for both you and your baby. Mums’ know best though, so if you have any concerns or questions, seek assistance from a trained medical professional or lactation consultant.







More from the blog

By Kylie Conway September 3, 2025
The Perimenopausal Changes No One Warns You About Perimenopause — the transition period leading up to menopause — is a natural phase in every woman’s life. While symptoms like hot flushes and mood swings are widely discussed, there are other, less talked-about changes that can have just as much of an impact on daily life. Let’s explore some of the more surprising changes to your bladder, bowel, and periods — and what you can do to manage them. Bladder: “Why Do I Always Feel Like I Need to Go?” If you've noticed you're heading to the toilet more often — or feeling an intense need to go, only to pass a small amount — you're not alone. As oestrogen levels decline, the tissues supporting the bladder and urethra can become thinner and less elastic, leading to: Increased bladder urgency More frequent urination A lingering sensation of not quite emptying What You Can Do Try not to respond to every urge straight away. Bladder retraining can help your body adjust and reduce the frequency of urgency over time. Avoid common bladder irritants that can make urgency worse. These may include: Coffee Alcohol Artificial sweeteners Fizzy drinks Spicy or acidic foods (depending on your individual sensitivity) Bowel: Slower, Smellier, and More Sensitive Digestive changes are also common during perimenopause. Hormonal fluctuations can slow gut motility, which may result in: Increased constipation New food sensitivities More noticeable (and often smellier) wind These changes are often unexpected but entirely normal. Supporting your gut health with fibre-rich foods, hydration, and regular physical activity can make a significant difference. Periods: Heavier, Irregular, and Less Predictable For many women, perimenopause brings changes to menstrual cycles well before periods stop altogether. You may experience: Heavier bleeding than usual Irregular cycles — sometimes longer, sometimes shorter Spotting or bleeding between periods Important: Any new spotting or unusual bleeding should be checked by your GP. While often harmless, it’s important to rule out any underlying issues. You Don’t Have to Just “Put Up With It” These changes are common, but that doesn’t mean you have to live with discomfort or uncertainty. At Pelvic Health Melbourne, we specialise in supporting women through perimenopause and beyond. We provide expert care to help you: Manage bladder urgency Reduce or eliminate after-dribble Improve bowel function Strengthen pelvic floor health What We Offer Personalised pelvic health assessments Evidence-based treatment plans tailored to your needs Compassionate, confidential care at every stage of menopause Book your pelvic health consultation today and take the first step toward feeling more in control of your body — and your life.
By Kylie Conway August 27, 2025
Male Pelvic Pain: Understanding the Many Faces of Discomfort Pelvic pain in men is a complex issue involving various muscles, nerves, organs, and psychological factors. Since the pelvic region houses key structures such as the bladder, prostate, urethra, bowel, and the pelvic floor muscles, pain may present differently depending on the underlying cause. Recognising the specific types of pelvic pain and related symptoms can help men seek appropriate care early and improve outcomes. Common Types and Examples of Male Pelvic Pain Prostatitis and Chronic Pelvic Pain Syndrome (CPPS) Pain Types: Dull aching in the lower abdomen, sharp stabbing pain in the perineum (the area between the scrotum and anus), burning during urination, and discomfort after ejaculation. Additional Symptoms: Urinary frequency and urgency, weak or interrupted urine stream, and sometimes flu-like symptoms in bacterial prostatitis. CPPS, a non-bacterial form, often features muscle tightness and nerve irritation causing persistent discomfort without infection. Pelvic Floor Muscle Tension and Spasms Pain Types: Intermittent or constant burning sensation deep in the pelvis, a "stuck" feeling during urination, testicular or penile pain not explained by infection. Often worsened by sitting for long periods, sexual activity, or stress. May also cause referred pain to the lower back, hips, or thighs. Pudendal Neuralgia (Nerve Entrapment) Pain Types: Sharp, burning, or electric shock-like pain primarily localised to the perineum and genital area. Pain often worsens when sitting on hard surfaces and improves when standing or lying down. May include numbness, tingling, or altered sensation around the genitals and anus. Urethral Pain Syndrome and Urethritis (Non-infective) Pain Types: Burning or raw sensation at the urethral opening, pain with urination, or persistent pelvic discomfort. This can happen without bacterial infection and is sometimes related to pelvic floor dysfunction or inflammation. Testicular Pain and Epididymitis Pain Types: Sharp or aching pain localised to one or both testicles, sometimes radiating to the groin or lower abdomen. May be associated with swelling, tenderness, or warmth. Causes include infection, trauma, or referred pain from pelvic floor muscles. Bladder Pain Syndrome / Interstitial Cystitis Pain Types: Persistent pressure, discomfort, or burning in the bladder and perineal region. Symptoms often worsen with bladder filling and improve after urination. May be accompanied by urinary urgency and frequency. Hernia-Related Pelvic Pain Pain Types: Dull aching or sharp pain in the lower abdomen, groin, or pelvic area, especially when coughing, lifting, or standing. Often associated with a noticeable bulge or lump in the groin. Irritable Bowel Syndrome (IBS) and Gastrointestinal Pain Pain Types: Cramping, bloating, and lower abdominal discomfort that can refer to pelvic areas. May be associated with bowel changes such as diarrhea or constipation. Bowel problems often coexist with pelvic floor dysfunction, complicating pain presentation. Musculoskeletal Pelvic Pain Pain Types: Aching or sharp pain stemming from muscles, ligaments, or joints of the pelvis and lower back. Causes include poor posture, pelvic instability, trauma, or overuse injuries. Pain may radiate into the groin, perineum, or thighs and can worsen with sitting, standing, or movement. Sexual Dysfunction-Related Pelvic Pain Pain Types: Pain during or after ejaculation, penile or perineal burning, and pain associated with erectile dysfunction. Often linked with pelvic floor muscle tension or nerve irritation. When to Seek Help Men experiencing any of the following should consult a pelvic health physiotherapist or healthcare provider: Persistent or worsening pelvic, perineal, testicular, or genital pain Pain worsened by urination, ejaculation, sexual activity, bowel movements, or sitting Difficulty starting or maintaining urine flow, weak or split stream Urinary urgency, frequency, dribbling, or incontinence Numbness, tingling, or unusual sensations in the pelvic or genital area Visible lumps, swelling, or signs of infection (fever, chills, burning urination) How Pelvic Floor Physiotherapy Can Help Pelvic floor physiotherapists specialize in diagnosing and treating pelvic pain related to muscle dysfunction, nerve entrapment, and biomechanical issues. They use techniques such as: Manual therapy to release muscle tension and trigger points Tailored exercises to strengthen or relax pelvic muscles Education on bladder, bowel, and posture habits Neuromodulation techniques like TENS or biofeedback Collaborative care with urologists, gastroenterologists, and pain specialists Early assessment and intervention can greatly improve pain relief, bladder and sexual function, and quality of life. Expert Tips for Managing Pelvic Pain at Home Maintain regular bowel habits to prevent constipation and straining Practice relaxation techniques and mindfulness to reduce pelvic muscle tension Avoid prolonged sitting or pressure on the perineum; use cushions and take breaks Stay hydrated and avoid bladder irritants like caffeine and alcohol Use warm baths or heat packs to relax muscles and improve circulation Engage in gentle stretching and low-impact exercise as advised by your physiotherapist At Pelvic Health Melbourne, all our physiotherapists are trained to help manage all types of pelvic pain men encounter. You don’t have to live with pelvic pain—help is available.
By Kylie Conway August 21, 2025
Varicosities During Pregnancy: What You Need to Know Pregnancy is an exciting time, but it also brings a number of changes to the body. One of the common issues many women experience is varicosities — swollen, twisted veins that develop just under the skin. While they can be uncomfortable, they are generally harmless and can often be managed with simple strategies. In this blog, we’ll break down what varicosities are, why they happen during pregnancy, the signs to look for, and what you can do to relieve symptoms. What Are Varicosities? Varicosities are veins that become enlarged and visible under the skin. They most often occur in the legs, but pregnancy can also lead to vulvar varicosities and rectal varicosities (commonly known as hemorrhoids). These veins can appear blue or purple and may bulge above the surface of the skin. Some women experience discomfort, while others may simply notice the cosmetic changes. Why Do They Happen in Pregnancy? Several factors during pregnancy contribute to the development of varicosities: Increased blood volume: During pregnancy, your body produces more blood to support your growing baby. This extra volume puts added pressure on your veins. Hormonal changes: The hormone progesterone relaxes the walls of your veins, making them more likely to swell. Pressure from the uterus: As your uterus grows, it presses on the pelvic veins, slowing circulation and increasing pressure in the lower body. Genetics: If your family members experienced varicose veins, you may be more likely to develop them as well. Common Types of Varicosities in Pregnancy Leg varicose veins – swollen, bulging veins that often appear on the calves or thighs. Vulvar varicosities – swelling and visible veins in the vulvar area, which can cause heaviness or discomfort. Hemorrhoids – varicosities in the rectal area, often made worse by constipation and straining. Signs and Symptoms Varicosities may present with: Blue or purple bulging veins Aching or heaviness in the legs or groin Itching, throbbing, or tenderness Swelling around the affected area Discomfort that worsens after standing or sitting for long periods Prevention and Relief Tips While varicosities can’t always be prevented, there are many ways to relieve discomfort and stop them from worsening: Move regularly: Avoid sitting or standing still for long stretches. Get up and walk around every hour. Elevate your legs : Resting with your legs propped up helps improve circulation and reduce swelling. Wear compression stockings: These provide support and assist blood flow back toward the heart. Stay active: Daily walks and gentle exercise promote circulation. Hydrate well: Adequate water intake helps prevent constipation, reducing the risk of hemorrhoids. Eat a high-fibre diet: Fibre-rich foods keep your bowels regular and prevent straining. When to Call Your Doctor Most varicosities are harmless, but it’s important to seek medical advice if you notice: Sudden pain or swelling in the leg Skin discoloration or ulcers around a vein Bleeding from a varicosity Signs of a blood clot (deep vein thrombosis), such as warmth, redness, or severe pain in the calf The Good News The reassuring news is that most varicosities improve significantly after delivery as blood volume and hormonal levels return to normal. Conservative measures are usually very effective, and in most cases, varicosities don’t cause complications during pregnancy or labor. Final Thoughts Varicosities are a normal and common part of pregnancy for many women. While they can be uncomfortable, they are usually temporary and manageable with lifestyle strategies. If you’re experiencing varicosities, talk with your physiotherapist or healthcare provider. They can help guide you with safe management strategies to keep you comfortable and reduce symptoms throughout your pregnancy.
By Kylie Conway August 6, 2025
Supporting Transmasculine and Transfeminine Clients Through Bottom Surgery: The Role of Physiotherapy Bottom surgery is a powerful and deeply affirming step for many both transmasculine and transfeminine individuals. Whether someone is preparing for vaginoplasty, vulvoplasty or phalloplasty, the journey is not just surgical—it’s physical, emotional, and functional. Physiotherapy can play a key role in optimising outcomes and supporting a safe, confident return to daily life. At our clinic, we work closely with clients before and after gender-affirming surgeries to ensure their pelvic and overall health is considered throughout their surgical journey. Pre-Surgery Preparation: Laying the Foundation Before surgery, our physiotherapy sessions focus on building a strong foundation. This includes: Understanding Your Body’s Baseline We begin by gaining a thorough understanding of your current: Bladder and bowel function – Are there any concerns with urgency, leakage, constipation, or straining? Pelvic floor tone and coordination – We assess whether your muscles are overactive, weak, or uncoordinated, which can impact recovery. Intimate or sexual function – If relevant and comfortable for the client, we explore areas of sensitivity, pain, or tension that may influence post-op outcomes. These baseline assessments guide us in creating a tailored prehabilitation program that optimises your function and supports a smoother recovery. Optimising Pelvic Health Pelvic health plays a crucial role in: Managing urination and bowel habits post-surgery Supporting circulation and tissue healing Reducing pelvic pain or tightness Preparing muscles for dilation (if applicable) We also look at core strength, breathing, posture , and general mobility —especially important for improving blood flow, wound healing, and reducing post-op complications. Post-Surgery Recovery: Gentle, Guided Support After surgery, our work shifts to supporting your healing and helping you return to your life with comfort and confidence. Wound Care & Scar Management We guide you through: Gentle scar tissue mobilisations (when appropriate) Promoting circulation to reduce swelling Supporting healing around graft or donor sites (e.g., arm, thigh) Dilation & Tissue Care For clients undergoing phalloplasty or metoidioplasty involving a urethral lengthening or neo-vaginal closure, pelvic physiotherapy may include: Education around dilation (where applicable) Pain management strategies Breathwork and relaxation techniques to reduce muscle tension Returning to Life and Movement We support: Safe return to walking, lifting, cycling, gym or sports Managing fatigue and pacing during recovery Addressing any bladder, bowel or sexual function changes We also hold space for the emotional aspects of recovery. This is a major life transition, and our approach is compassionate, gender-affirming, and always client-led. We Are With You All the Way Our goal is to make your body feel more like home. Whether you're months away from surgery or already on the other side, we’re here to walk beside you with skilled hands, open minds, and affirming care. If you’re considering bottom surgery or in the recovery phase, get in touch to see how pelvic physiotherapy can support your goals and wellbeing.