What is Sandwich Hold and Why is it important?
During the early days postpartum, infants often require more support to breastfeed successfully. Even good feeders need to be encouraged to achieve and maintain a deep latch for optimal feeding.
Newborns are all reflexes and instincts during their first weeks breastfeeding. They are responding to olfactory, visual, and sensory cues that help them locate the nipple. Babies are amazing little homing beacons considering how generally helpless they are. All the same, they still need help and support from their mothers to achieve a deep comfortable latch. We place a lot of emphasis on the position of baby and a nice wide mouth during latch on. The often overlooked piece is how to support the breast during feeds.
Think about your breast. Imagine it is a big round ballon and the knot at the end is your nipple. We want baby to come along with a big juice latch and take in NOT ONLY the nipple but a good amount areola and breast tissue. No matter how wide and juicy their proposed latch is, it is difficult to suck in a mouthful of that big round balloon. Most babies are inclined to skip the hassle and just slurp in the ballon knot (mom’s nipple) and feed away. This is problematic because it hurts like the dickens and ultimately it doesn’t have the same amount of milk transfer for the baby.
Now imagine your breast as a big round balloon and think about taking a handful to make a “bite sized” portion for baby. If baby is in football position under the right breast, the right arm is cradling baby and the right hand is supporting baby’s head. The left hand is cupping her breast in a “C” to make a sandwich bite for baby (four fingers on the bottom, thumb up by the nose).
Supporting the breast in this fashion helps baby get a big mouthful of breast tissue and not just hang on the end of the nipple. When baby is coming in for the latch, mom can use her breast supporting hand to position her breast and rub it against the infant’s nose until he responds with a big open mouth. Then the breast is plopped down on top of baby’s tongue and held firmly in place while the infant draws in a mouthful of tissue up into the palate and achieves a nice juicy latch.
Once the baby is feeding, mom can use this hold to administer some breast compression aiding in the milk flow to baby. Research studies indicate hand massage while feeding ALSO increases the milks overall fat content. Win, Win.
Some babies will require mother to maintain sandwich hold throughout the feed or they will loose the latch. As the infant grows, he should be able to maintain the latch on his own without hands on support from mom.
Sandwich hold can be use in any position. The key is that mom’s hold of the breast matches baby’s alignment. If you bring the sandwich in at the wrong angle it does not help baby. You don’t eat your sandwich vertically, you eat it horizontally. Orientation matters.
Another tip is to ensure that fingers are well space from the nipple allowing the infant enough space to get a deep latch. Too much pressure from mom’s fingers can also change the shape of the nipple and areola ultimately pulling the nipple out of the baby’s mouth. Mom’s breast hold should be widely space with a light hold.
Many women attempt to use the “V” or scissor hold to support the breast. While I think this hold works fine for older babies, it does not provide the same support for newborns. The “V” hold is too close to the nipple and ends up pulling the tissue from the baby’s mouth and does not provide enough support to help the baby maintain their latch.
Ultimately, sandwich hold is an important tool when learning to breastfeed a newborn. It can be the difference between your baby latching or not. Next time you go to breastfeed your newborn and your angling for a nice juicy latch, remember the boobie hoagie trick and give them a mouthful!