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  • An evolutionary bodywork approach helps women and their babies fit together in pain-free, enjoyable breastfeeding
  • About experimentation and workability in breastfeeding
  • The three views of a stable fit and hold (in photos)
  • Talking through the basic principles of the gestalt method using a knitted breast

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  • PBL Foundations
  • S3: Fit and hold: #1 breastfeeding superpower
  • CH 3: What is the gestalt method of fit and hold?

An evolutionary bodywork approach helps women and their babies fit together in pain-free, enjoyable breastfeeding

Dr Pamela Douglas1st of Sep 20232nd of Jan 2026

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Gestalt: a whole that is more than the sum of its parts

The gestalt method is built on the belief that you are the expert on your own baby, your body, and your breastfeeding experience - but that there are some things you have the right to know, which give you the best chance of success as you experiment your way through. These things become particularly important if breastfeeding challenges come up.

The gestalt approach to helping with fit and hold in breastfeeding is a genuinely holistic form of bodywork, which I refer to as evolutionary bodywork. It's developed from three decades of my clinical experience as a breastfeeding medicine physican and lactation consultant, and drawing on ultrasound and MRI studies which elucidate the biomechanics of infant suck.

You've probably heard the terms 'latch and positioning' or 'attachment and positioning' used elsewhere. I find 'fit and hold' an easier, friendlier phrase for the same thing.

Normal mother and baby anatomies are highly diverse. The gestalt method of fit and hold in breastfeeding considers the many different factors which interact together to result in either enjoyable, pain-free breastfeeding - or breastfeeding problems.

The gestalt method of fit and hold repairs breastfeeding problems

The gestalt method of fit and hold empowers you to:

  • Switch on your baby's inbuilt breastfeeding reflexes

  • Experiment with the fit between your own and your baby's unique anatomies, to find what works

  • Create ease and comfort for your own body

  • Manage the incredibly powerful effect of breastfeeding problems on both the baby's and your own psychological states.

In the video below, Renee Keogh RN IBCLC NDC Educator gives you an overview of the gestalt method.

What are the four steps of the gestalt method?

The steps to achieving easy effective pain-free breastfeeding are

  1. Understanding the biomechanics of effective milk transfer

  2. Preparing your body and mind for relaxed and comfortable breastfeeding

  3. Switching on your baby's breastfeeding reflexes

  4. Applying the power of micromovements.

WARNING: If your baby has health problems or weight gain problems, or if you have health problems that are affecting lactation, it is important that you seek the help of an appropriately qualified health professional. This program does not replace the care of your health professional.

Recommended resources

How babies breastfeed: the biomechanics of infant suck (video and animation)

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.

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Next up in What is the gestalt method of fit and hold?

About experimentation and workability in breastfeeding

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I invite you to experiment with the four steps of the gestalt method of fit and hold, and to discover what works for you and your baby.

Fitting your baby to your breast is like the rest of parenting: approximate, and imperfect. Things usually don't come together ideally all at once. We find ourselves settling for what's workable at any moment in time, which is how we develop resilience.

So as you experiment with fit and hold, remember to aim for workability, not perfection.

Our bodies are all quite unique, and it can take time to sort out how to fit your own and your baby's unique anatomies together. Over time, with experimentation and practice, most women…

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Possums acknowledges the traditional owners of the lands upon which The Possums Programs have been created, the Yuggera and Turrbal Peoples. We acknowledge that First Nations have breastfed, slept with, and lovingly raised their children on Australian lands for at least 65,000 years, to become the oldest continuous living culture on Earth. Possums stands with the Uluru Statement from the Heart.