When you talk about positioning there are actually a lot of things to consider. I always say positions are a guide you have to tweak a position to make it work for yourself rather than trying to perfectly mimic a position that you saw someone else do or that you read in a book or something you saw on the Internet. It's very important that you actually tweak the position to work for you specifically you and your baby. People have often said to me " oh the cradle is my favorite position or the cross cradle or football is my favorite position". But I have found over the years that there are many things to consider when positioning a baby.
1. The position and comfort of the mother. Did mom have a c-section and she is laying on her back. Does she have a 3rd degree tear, an episiotomy or hemorrhoids that prevent her from sitting straight up.
2.The size of the baby. Large , Small, Long?
3.The size and shape of the breast. Round, Tubular, Triangular?
4. The type of nipple and its location. Does it point downward? Does it retract?
5. What side you are breastfeeding on. Oftentimes you may even have to use a different position on one breast than the other.
6. There may be an oral cavity issue like a tongue tied or bubble palate.
7.Where you're sitting or laying. What type of furniture you are using. Does your chair have arms?
8.You may need to consider the comfort of the baby in a special way, for example if the baby has a fractured shoulder or a twisted neck or clubbed feet or a circumcision.
9. The size of mom's fingers. The distance from her thumb to her index finger determines how well she's able to hold her breast during breastfeeding and how well she's able to position her baby. The amount of space from the wrist to the elbow makes a big difference, because if she has very large breasts she will not be able to use a cradle position, because she'll lose the stability of the baby's head as it moves further towards the wrist area.
10. Does Mom have a very long torso or is Mom obese and her breast lean to the side. Does Mom have a large tummy therefore eliminating the lap space that a pillow would have sat on.
My advice is be open-minded. Be comfortable, start with basic positioning and tweak it according to where you are and what works for you. The baby should always be tummy to tummy with Mommy no matter what position. You should start positioning with Mom's comfort. Once mom is comfortable and in a secure position, then you start to secure a position for the baby. But what you don't want to do is put Mom in a position or Mom get yourself into a position and then once you position the baby readjust your own position. You want to stay in the position that you start with during a latch so get comfortable. Get the baby into a good position right in front of the breast. Don't hold the baby by the neck. Support the baby's head. Don't lay the baby on the pillow, hold the baby and use the pillow for support. Don't hold the baby's arms behind them, no one wants to eat with their hand twisted behind them. Try to get the hands around the breast as if giving the breast a hug if possible. Some people like to swaddle the baby. But swaddles usually work more when babies are younger. And some babies just don't like being covered up. Try to give the baby a little skin. Skin-to-skin is always great and has continuous benefits for mom and baby. Once mom and baby are in a comfortable position. Hold the breast in a C or U shaped hold with fingers away from the nipple and areola complex, therefore not blocking the baby from getting a deep latch. Use an anatomical latch technique by positioning the baby chin to breast nose to nipple. Use the nipple to tickle from the nose downwards rolling out the bottom lip therefore causing the breast to land above the tongue and deep into the oral cavity.
I also teach what I call tickle back away which is; tickling the lip or nose area of the baby with the nipple to trigger rooting, yet, slightly backing away, and coming back to allow the baby to open wide. Once the baby actually gives you a nice wide open mouth with the tongue down allow the breast to land deep into the mouth above the tongue and get up to the pallet to trigger the suck reflex.