The gestalt method of fit and hold is only one part of the Neuroprotective Developmental Care (NDC) or Possums breastfeeding programs (under development as Breastfeeding stripped bare), but an important place to start. This version of the gestalt method of fit and hold for breastfeeding women has been available since 2016. I'm hoping that Breastfeeding stripped bare, the comprehensive NDC approach to breastfeeding and lactation, will be publicly available by the end of 2024. Key elements of the NDC breastfeeding work are also found in The discontented little baby book, and in my research publications, starting here.

Your baby has hardwired neurological reflexes that help him get started with breastfeeding. Your job is to switch these on, and then set up an environment in which you and your baby can lay down neurological pathways for enjoyable, effective breastfeeding through practice and experimentation.

A very dialled up sympathetic nervous system makes it difficult for baby's breastfeeding reflexes to switch on, or for baby to learn new things.

But there's often an element of eager dialling up when baby comes to the breast, especially in the early days, and we don't want to feel as though we always have to be taking baby away from the breast in order to dial her down, as that strategy too can backfire and worsen the whole situation.

One of the best ways of getting around this is to offer the baby the breast when she is still quite content, rather than waiting for her to dial up with hunger. You can't go wrong offering the breast whenever you think it might work.

It's important never to pressure your baby, though, just to offer and notice what happens.

Selected references

Douglas PS, Keogh R. Gestalt breastfeeding: helping mothers and infants optimise positional stability and intra-oral breast tissue volume for effective, pain-free milk transfer. Journal of Human Lactation. 2017;33(3):509–518.

Douglas PS, Geddes DB. Practice-based interpretation of ultrasound studies leads the way to less pharmaceutical and surgical intervention for breastfeeding babies and more effective clinical support. Midwifery. 2018;58:145–155.

Douglas PS, Perrella SL, Geddes DT. A brief gestalt intervention changes ultrasound measures of tongue movement during breastfeeding: case series. BMC Pregnancy and Childbirth. 2022;22(1):94. DOI: 10.1186/s12884-12021-04363-12887.