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.

Video 1

This woman in the video above still has nipple pain. You can see how the baby's lips are visible as he feeds. She brings him in a little, but his face is still not as deeply buried as you might want if the nipple is to be really well protected. We suggest a rib-cage wrap, with the head not against the upper arm but resting on her forearm, so that she can use the forearm as a lever to control micro-movements.

Video 2

The woman in the video above has not quite created an adequate landing pad for the baby - her upper arm is very close to her nipple. Also the baby is not flat against her body, and as a result he is unable to contact the breast with his chin, which would help him get located.

Her hand is probably pushing a little on the back of his neck, which babies don't like. However, this mother-baby pair work it out in the end!

For some babies, these things that interfere with the capacity to fit onto the breast may prove insurmountable, unless the woman knows how to change them.

Video 3

You can see in the video above that the mother hasn't really created a landing pad for the baby's face-breast bury. Also, the little one can't get oriented. If she was to smoosh his little baby into her breast up above the nipple and areola, he would start bobbing and seeking the nipple and she could just use her forearm to lower him down then, mouth over nipple and bring him on.

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.