Health-and-Nutrition/C2/Cross-cradle-hold/English

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Visual Cue
Narration
Slide Number 1

Title Slide

Welcome to the Spoken Tutorial on Cross Cradle hold for breastfeeding.
Image: 5 breastfeeding holds-cross cradle, football, cradle, laid back and side lying holds.

Image: Mother is washing her hands.

Image: Cross cradle hold.

In this tutorial we will learn about-
  • Choosing the correct breastfeeding hold for a mother and her baby
  • Mother’s preparation before breastfeeding and
  • Step-by-step procedure for Cross Cradle hold.
Image: Cross cradle hold Let us begin.
Image: 5 common breastfeeding holds- cross cradle, football, cradle, laid back and side lying hold. Across the world, mothers breastfeed their babies using various types of holds.
Image: Mother is breastfeeding in cross cradle hold.

Image: Mother is breastfeeding in incorrect cross cradle hold. Her back is bent forward. Her hand is abducted from her body.

Image: Baby is crying on the breast.

The best breastfeeding hold for a mother and her baby is the one in which-
  • Both mother and baby are comfortable for the entire duration of breastfeeding
Image: Deeply attached baby in cross cradle hold.

Image: Bad attachment in cross cradle hold.

  • The baby is able to attach deeply to the mother’s breast
Image: Strong baby.

Image: Weak baby.

  • And get sufficient milk.
Image: Cross Cradle Hold. Let us learn about one of the holds called Cross Cradle hold.
Image: Cross Cradle Hold. Cross Cradle hold is the best hold to have-
  • full control of baby’s body
Image: U shape hold.
  • breast support
Image: Deeply attached baby in cross cradle hold.
  • and deep latching.
Image: Mother is washing her hands.

Image: Mother is showing dry and clean hands.

Before feeding her baby, the mother must wash and dry her hands properly.
Image: Mother is drinking a glass of water.

Image: Boiling water.

Image: Cold water.

Then she should drink a glass of boiled and cooled water.
Image: A 1 litre jug filled till 750 ml with breastmilk.
  • Lactating mothers produce 750 to 850 ml of milk per day on an average.
  • Therefore, they need to increase their daily water intake.
Image: Mother is sitting on the floor in cross legged position. Next, let’s discuss the position of the mother.
Image: Mother is sitting on the floor in cross-legged position.

Image: Mother is sitting on a bed in cross-legged position.

Mother should sit on the floor or on the bed in cross legged position.
Image: Mother is sitting on a chair with her feet flat on the ground.

Image: Mother is sitting on a chair with her feet not touching the floor.

Or on a chair with her feet flat on the ground.
Image: Mother is sitting on a chair with her feet not touching the floor.

Image: Mother is sitting on a chair with her feet flat on a stool.

  • If the chair is too high and her feet do not reach the floor
  • then, she can rest her feet flat on a small stool or pillows kept on the floor.
Image: Mother is sitting on the floor in cross legged position with her back straight.

Image: Mother is sitting on the floor with her back curved and shoulders elevated.

Image: Mother is sitting on a chair with her back straight.

Image: Mother is sitting on a chair with her feet on a stool and back straight.

Image: Mother is sitting on a chair with her back curved and shoulders elevated.

While sitting, she should ensure that -
  • Her back is straight so as to avoid back pain.
Image: Mother is sitting on the floor with her back straight.

Image: Mother is sitting on the floor with her back curved and shoulders elevated.

Image: Mother is sitting on a chair with her back straight.

Image: Mother is sitting on a chair with her feet on a stool and back straight.

Image: Mother is sitting on a chair with her back curved and shoulders elevated.

  • Her shoulders are relaxed and not elevated or curved
Image: Mother is sitting on the floor with her back straight.

Image: Mother is breastfeeding in cross cradle hold.

  • And this relaxed position is maintained throughout the feeding session.
Image: Mother has completely removed the cloth covering her breast. Mother should uncover the breast from which she wants to feed the baby.
Image: Mother has not removed her bra completely. She should ensure not to put pressure of her bra or blouse on the breast.
Image: Mother is holding her baby with her left hand. After sitting comfortably, bring the baby to the mother.
Image: Mother is holding the baby with her left hand. Mother should hold her baby's head with the hand opposite to the breast that she will feed from.
Image: Mother holding the baby with her left hand. The baby’s legs should be tucked under the mother’s armpit of the same hand.
Image: Mother is holding the baby with her left hand. The mother in this picture, will be feeding her baby from her right breast.
Image: Mother is holding the baby with her left hand. Therefore, the baby’s legs are tucked under her left armpit.
Image: Mother is holding the baby with her left hand. She is using the thumb and fingers of her left hand to hold the lower part of her baby’s head.
Image: Mother has kept a pillow beneath the baby on her lap. If the mother wants additional support to lift the baby-
  • she can keep a pillow under the baby on her lap.
Image: Mother is bending her back to bring the breast to the baby.
  • Remember, the mother should never bring the breast to the baby by bending her back.
  • This will make her uncomfortable and cause back pain.
Image: Mother keeps her back straight and brings the baby to her breast. She should always keep her back straight and elevate the baby to reach her breast.
Image: Mother’s thumb and fingers are placed behind the baby’s ears.

Next, let us see the correct position of mother’s thumb and fingers-

  • Mother’s thumb should be behind one ear, and rest of the fingers behind the other ear of the baby.
Image: Mother’s thumb has slipped to the baby’s neck. She should not move her fingers or thumb from behind the ear to the baby’s neck.
Image: Mother’s wrist is between the baby’s shoulders. Her wrist should rest between the baby’s shoulder blades.
Image: Mother’s palm is touching the back of the baby’s head.

Image: Mother’s palm is not touching the back of the baby’s head.


  • She should not apply pressure on the back of the baby’s head with her hand.
  • This will keep the baby comfortable while feeding.
Image: Mother is holding the baby in cross cradle hold. Next, let us learn how to position baby’s body correctly-
  • The baby’s stomach should gently press against the mother’s body.
Image: Baby is very close to the breast. Lesser distance between their bodies will reduce the baby’s effort to reach the breast.
Image: Deeply attached baby in cross cradle hold. And it will become easier for the baby to attach deeply.
Image: Mother is holding the baby in cross cradle hold. The second point in positioning is the baby’s body alignment.
Image: Adult is eating food with her head-neck-body in straight line. When we eat food, our head, neck and body are always in a straight line.
Image: Baby’s head neck and body are not aligned.
  • But, while breastfeeding, the baby’s head is often turned sideways by many mothers.
  • This will make feeding uncomfortable for the baby.
Image: Baby’s neck-head-body are placed in a straight line. Baby’s head, neck and body should always be in a straight line while breastfeeding.
Image: Deeply attached baby in cross cradle hold. This will make swallowing milk easier for the baby.
Image: Mother is supporting baby’s full body.
  • Now we come to the third point in positioning the baby’s body.
  • The mother should support the full body of her baby.
Image: Mother is not supporting the full body of her baby. Otherwise the baby will have to take a lot of effort to attach deeply to the breast.
Image: Baby’s nose is in line with the nipple.

Image: Deeply attached baby in cross cradle hold.

Image: Strong baby.

Image: Baby’s nose is not in line with the nipple.

Image: Deeply attached baby in cross cradle hold.

Image: Weak baby.

Next, let’s look at the position of the baby’s nose and chin-
  • Baby’s nose should be in line with the nipple.
  • And her chin should be forward and very close to the breast.
  • This will ensure that the baby takes in more of the lower part of the areola while latching.
  • And therefore, will use the lower jaw to drink more milk efficiently.
Image: Breast. Please note-
  • Areola is the dark area around the nipple.
Image: Cross cradle hold.

Image: Mother is holding her breast with her right hand in a U shape hold from below.

Image: U shape hold.


Now that the baby is positioned correctly, let us learn how to hold the breast-
  • Using the fingers of her other hand,
  • the mother should cup her breast underneath in a U shape hold.
  • The mother in this picture will use her right hand to hold her right breast.
Image: Clock drawn on the right breast. To understand the correct position of thumb and fingers-
  • Imagine the nipple to be the center of a clock on the mother’s right breast.
  • Mother should place her right thumb at 9’O clock position on this clock.
  • While her right index finger and middle finger should be placed at 3’O clock position.
Image: Mother fingers, holding the breast, are parallel to the baby’s lips. Both are vertical. The fingers should be always parallel to the baby’s lips.
Image: Adult is holding a vada pav or burger horizontally.

Image: Adult’s lips and fingers holding a vada pav or burger horizontally are parallel to each other.

Image: Adult is taking a big bite of a vada pav or burger while holding it horizontally.

Why?

Let’s understand this using a simple example.

  • When we eat a vada pav or burger, our mouth and lips open horizontally.
  • We hold the vada pav or burger horizontally to take a big bite.
  • Here, the thumb and fingers are placed parallel to the lips.
Image: Adult is holding a vada pav or burger vertically.

Image: Adult’s lips are perpendicular to adult’s fingers holding vada pav or burger vertically.

Image: Adult is trying to eat vada pav or burger while holding it vertically.

If we hold the vada pav or burger vertically, we won’t be able to take a big bite.
Image: Baby’s lips and mother’s fingers in U shape hold are parallel to each other. Both are vertical.

Image: Deeply attached baby in cross cradle hold.

Similarly, observe the direction of baby’s lips-

  • The lips are vertical here.
  • Therefore, the fingers and thumb should also be positioned vertically on the breast.
  • This will help the baby to take a big part of the areola in her mouth.
Image: Mother’s fingers are holding the breast in U shape hold at a distance of 3 fingers from the nipple.

Image: Deeply attached baby in cross cradle hold.

Apart from being parallel to the baby’s lips-
  • mother’s thumb and fingers should always be at a distance of 3 fingers from the nipple.
Image: Adult is trying to eat a vada pav or burger while holding it too close to the edge. Again, while eating a vada pav or burger,
  • If we hold it too close, our fingers will block our mouth from taking a big bite.
Image: Adult is trying to eat a vada pav or burger while holding it far away from the edge.
  • If we hold it too far away, it will not be shaped correctly to fit in our mouth.
Image: Adult is holding a vada pav or burger at the right distance.
  • Therefore, we hold it at the right distance to take a big bite.
Image: Mother’s fingers are holding the breast in U shape hold at a distance of 3 fingers from the nipple.

Similarly for the baby-

  • the right distance is of 3 fingers from the nipple, as shown in this picture.
Image: Mother’s fingers are holding the breast in U shape at a distance of 1 finger from the nipple.

Image: Poor attachment in cross cradle hold.

This distance will ensure that-

  • mother’s fingers do not block the baby from taking a big part of the areola in her mouth
Image: Mother is pressing only the nipple and drops of milk are coming out.
  • Mother does not compress only the nipple which will give very little milk
Image: Mother is compressing the breast at a distance of 3 fingers and more milk is coming out.
  • Mother compresses the larger milk ducts beneath the areola to express more milk out
Image: Mother’s is holding the breast at a distance of 5 fingers from the nipple.

Image: Poor attachment in cross cradle hold.

Image: Mother’s fingers are holding the breast in a U shape hold at a distance of 3 fingers from the nipple.

Image: Deeply attached baby in cross cradle hold.

  • And the breast is shaped correctly to help the baby attach deeply.
Image: Mother’s thumb is 3 fingers away from the nipple on the side of the breast where the baby’s nose is present. Mother’s thumb should be
  • 3 fingers away from the nipple on the side of the breast where the baby’s nose is present.
Image: Mother’s 2 fingers are at a distance of-
  • 3 fingers from the nipple on the side of the breast where baby’s chin is present.
And her 2 fingers should be at a distance of-
  • 3 fingers from the nipple on the side of the breast where baby’s chin is present.
Image: Uncompressed vada pav or burger.

Image: Compressed vada pav or burger.

Let’s go back to the example of vada pav or burger-

  • After holding the vada pav or burger correctly, we always compress it to take a big bite.
Image: Compression of breast in U shape hold from the bottom.

Image: Deeply attached baby in cross cradle hold.

  • Similarly, the mother should lightly compress her breast in a U shape hold from the bottom.
  • This will help the baby to take a big part of the breast in her mouth.
Image: Compression of breast in a V shape hold.

Image: Nipple feeding in cross cradle hold.

But remember,
  • Mother should not compress her breast in a V shape.
  • V shape compression will pinch the breast and cause nipple feeding.
Image: Equal compression of breast from both sides.

Image: Unequal compression of breast towards the right side.

Image: Unequal compression of breast towards the left side.

  • Also make sure that there is equal compression of the breast with the thumb and the fingers.
  • Otherwise the nipple will-

shift either to the right or the left side and lead to poor attachment.

Image: Mother is pushing her breast inside towards the baby.

Image: Mother is bringing the baby towards her breast.

Remember,
  • Never bring the breast to the baby by pushing it sideways towards the baby.
  • Always bring the baby towards the breast.
Image: Cross Cradle hold. Now, the baby is in Cross Cradle hold and ready to latch on for breastfeeding.
Image: Deeply attached baby in Cross Cradle hold.

Image: Baby attached only to the nipple in cross cradle hold.

The correct latching technique is explained in another tutorial in the same series.
Image: Cross cradle hold with both hands holding the baby. Once the baby is latched on correctly and if the breast is not too heavy then-
  • mother should release her breast from her hand and
  • bring her hand underneath the baby for support.
Image: Cross cradle hold with both hands holding the baby.
  • In this position, mother should bring both her arms very close to her body.
  • This will keep her comfortable during breastfeeding.
Image: 5 breastfeeding holds- cross cradle, football, cradle, laid back and side lying holds.

Image: Mother washing her hands.

Image: Cross cradle hold.

This brings us to the end of this tutorial.

In this tutorial we learnt about,

  • Choosing the correct breastfeeding hold for a mother and her baby
  • Mother’s preparation before breastfeeding and
  • Step-by-step procedure for Cross Cradle hold.
Image: Spoken tutorial logo.

Image: IIT Bombay logo.

This tutorial has been contributed by the Spoken Tutorial Project, IIT Bombay.
Image: NMEICT Logo.

Image: MHRD, Government of India logo.

http://spoken-tutorial.org

Spoken Tutorial Project is funded by NMEICT, MHRD, Government of India.

More information on this mission is available at this link.

Image: WHEELS Global Foundation Logo. This tutorial is partly funded by a generous contribution from WHEELS Global Foundation.
Image: Maa aur Shishu Poshan project logo. This tutorial is a part of Maa aur Shishu Poshan project.

The domain reviewer for this tutorial is Dr. Rupal Dalal, MD Pediatrics.

This is dietitian Tasneem Shaikh along with animator Shital Joshi from IIT Bombay signing off.

Thank you for joining.

Contributors and Content Editors

Bellatony911, Tasneemiitb