This article follows on from the story of how Janine (and two other generous-breasted women) used fit and hold strategies to help with breastfeeding problems, found here.

Photo 1: not enough exposure of the landing pad

The photo below shows the fall of Janine's left breast. She has her bra rolled tightly inwards and tucked up high where her breast meets her rib-cage, which partly lifts and exposes the landing pad.

However, you can see that it could be challenging bringing her baby to the breast for a deep face-breast bury, because of the way the landing pad of her breast rests very close to her tummy. Breastfeeding problems (like nipple pain, or baby fussing at the breast) might arise from this very common kind of breast-belly contour (although there aren't any problems, then you don't need to change anything). Her baby don't just need a deep face-breast bury - baby's shoulders need to sit in a plane that is straight on (not curved away over her tummy), so that the baby doesn't need to rotate his head and neck to feed.

When Janine's baby is snuggled in closely, there is a rotation or twist of her baby's little spine and neck, because there isn't enough room to fit in the whole of her body and shoulders in close to her mother's body without twisting (or rotating) baby's neck, spine or pelvis. A similar biomechanical challenge can occur with diverse breast shapes and sizes, including petite breasts, and relates to breast-tummy contour.

The result for this mother is nipple and breast tissue drag, accompanied by persistent nipple pain and damage.

Photo 2: using a rolled up face washer to better expose the landing pad

Because Janine already uses her bra in daily life to help expose the landing pad, as above, we found that the smaller facecloth (white) tucked in tightly on top of the bra, helped to better expose the landing pad.

A larger rolled up facecloth proved too big, because it slipped out when we experimented with it. We don't want a rolled up facecloth to either fall out or impinge upon the landing pad! Perhaps when Janine is not wearing a bra, the larger rolled up facecloth will be best. She will go home and experiment, now that she understands what she's trying to achieve.

Other resources listed below in Possums Breastfeeding & Lactation show you how the facewasher, folded in half, is being rolled, and what to watch out for. The cloth

• Needs to be rolled up very tightly, and

• Shouldn't protrude much beyond the width of the breast, or it might get in the way and make it harder for baby to snuggle in very close to your body and find a stable position.

Recommended resources

PBL Intermediate

Janine and two other generous-breasted women demonstrate fit and hold strategies which they found helpful

How to roll up a facecloth for better exposure of your breast's 'landing pad' (+ when this doesn't work!)

Things to watch out for if you're experimenting with a rolled up cloth under your breast + a word about the 'breastfeeding buddy' product

Sally shows why it helps to notice your breast-belly contour (as well as the direction your nipples look) as you prepare to breastfeed

Why it's often best not to shape your breast with your hand though some women need to

Eight-week-old Jamal who'd previously been unable to feed from his generous-breasted mother has a long drink at her breast then falls asleep in our consultation

Woman-centred language and weight-inclusive care of breastfeeding and lactating women

What does the research tell us about approaches to fit and hold currently used for breastfeeding support?