 Hello everyone, so now it is going to be part 4, we already discussed about you know 45 points of counselling cross griddle hold. Now I would like you to watch our tutorial, health spoken tutorial that we have created on cross griddle hold and latching you know. This tutorials are animated of course you have watched earlier also and I would like you to kind of understand each and every point you know we have shown very explicitly how to hold the baby, how to latch the baby, exactly how to you know press the breast all that points that I discussed in earlier parts here now it is in the form of tutorial do understand it do learn on life babies on of course initially impressed model and all practice it then of course practice on life babies and mothers if you have anybody who is probably you know breastfeeding right now is having difficulties or any mothers who are planning or will be delivering in next you know few months or so, so do you know practice you know once your baby is delivered okay and let me know if you have any question my team will be more than happy to answer them thank you so much. Welcome to the spoken tutorial on cross griddle hold for breastfeeding. 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 griddle hold. Let us begin. Across the world mothers breastfeed their babies using various types of holes. 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. The baby is able to attach deeply to the mother's breast and get sufficient milk. Let us learn about one of the holes called cross griddle hold. Cross griddle hold is the best hold to have full control of baby's body breast support and deep latching. Before feeding her baby the mother must wash and dry her hands properly then she should drink a glass of boiled and cooled water lactating mothers produce 750 to 850 millilitres of milk per day on an average therefore they need to increase their daily water intake. Next let's discuss the position of the mother. Mother should sit on the floor or on the bed in cross legged position or on a chair with her feet flat on the ground. 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 pillow skipped on the floor. While sitting she should ensure that her back is straight so as to avoid back pain. Her shoulders are relaxed and not elevated or curved and this relaxed position is maintained throughout the feeding session. Mother should uncover the breast from which she wants to feed the baby. She should ensure not to put pressure of her bra or blouse on the breast. After sitting comfortably bring the baby to the mother. Mother should hold her baby's head with the hand opposite to the breast that she will feed from. The baby's legs should be tucked under the mother's armpit of the same hand. The mother in this picture will be feeding her baby from her right breast. Therefore the baby's legs are tucked under her left armpit. She is using the thumb and fingers of her left hand to hold the lower part of her baby's head. If the mother wants additional support to lift the baby she can keep a pillow under the baby on her lap. Remember the mother should never bring the breast to the baby by bending her back. This will make her uncomfortable and cause back pain. She should always keep her back straight and elevate the baby to reach her breast. 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. She should not move her fingers or thumb from behind the ear to the baby's neck. Her wrist should rest between the baby's shoulder blades. She should not apply pressure on the back of the baby's head with her hand. This will keep the baby comfortable while feeding. Next let us learn how to position baby's body correctly. The baby's stomach should gently press against the mother's body. Lesser distance between their bodies will reduce the baby's effort to reach the breast and it will become easier for the baby to attach deeply. The second point in positioning is the baby's body alignment. When we eat food our head neck and body are always in a straight line. But while breastfeeding the baby's head is often turned sideways by many mothers. This will make feeding uncomfortable for the baby. Baby's head, neck and body should always be in a straight line while breastfeeding. This will make swallowing milk easier for the baby. Now we come to the third point in positioning the baby's body. The mother should support the full body of her baby. Otherwise the baby will have to take a lot of effort to attach deeply to the breast. 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. Please note areola is the dark area around the nipple. 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. 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. The fingers should always be parallel to the baby's lips. Why? Let's understand this using a simple example. When we eat a varapa or burger our mouth and lips open horizontally. We hold the varapa or burger horizontally to take a big bite. Here the thumb and fingers are placed parallel to the lips. If we hold the varapa or burger vertically we won't be able to take a big bite. Similarly observe the direction of the 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. 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. Again while eating a varapa or burger if we hold it too close our fingers will block our mouth from taking a big bite. If we hold it too far away it will not be shaped correctly to fit in our mouth. Therefore we hold it at the right distance to take a big bite. Similarly for the baby the right distance is of 3 fingers from the nipple as shown in this picture. This distance will ensure that mother's fingers do not block the baby from taking a big part of the areola in her mouth. Mother does not compress only the nipple which will give very little milk. Mother compresses the larger milk ducts beneath the areola to express more milk out and the breast is shaped correctly to help the baby attach deeply. Mother's thumb should be 3 fingers away from the nipple on the side of the breast where the baby's nose is present and her 2 fingers should be at a distance of 3 fingers from the nipple on the side of the breast where the baby's chin is present. Let's go back to the example of varapa or burger. After holding the varapa or burger correctly we always compress it to take a big bite. 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. But remember mother should not compress her breast in a V shape. V shape compression will pinch the breast and cause nipple feeding. 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 to the left side and lead to poor attachment. Remember never bring the breast to the baby by pushing its sideways towards the baby. Always bring the baby to the breast. Now the baby is in cross cradle hold and ready to latch on for breast feeding. The correct latching technique is explained in another tutorial in the same series. 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. In this position mother should bring both her arms very close to her body. This will keep her comfortable during breast feeding. This brings us to the end of this tutorial. Welcome to the spoken tutorial on breast feeding latching. In this tutorial we will learn about Correct latching technique for deep attachment of the baby to the breast and breast feeding frequency. Before we begin please note that for effective breast feeding correct latching is most important. Poor attachment of the baby's mouth to the breast will allow only nipple feeding. This will give very little milk to the baby. Whereas deep attachment of the baby to the lower part of the areola of the breast will give sufficient milk to the baby. Please note areola is the dark area around the nipple. Now let us begin. To start with the mother should hold her baby in a suitable breast feeding hold. These holds are explained in detail in other videos of the same series. This tutorial will be explained using the cross cradle hold. Remember positioning the baby correctly is necessary for successful latching and breast feeding. In this picture the mother is holding the baby correctly in the cross cradle hold and the baby is ready to latch on for breast feeding. Before latching it is important that the baby opens her mouth widely like a yawn. Why? Let's understand this by looking at an adult eating vada pao or burger. We open our mouth wide to take a big bite of the vada pao or burger. Similarly a wide open mouth will help the baby to take a big part of the breast in her mouth. To encourage the baby to open her mouth widely mother should lightly brush her nipple against baby's upper lip till she opens her mouth widely. Be patient. Sometimes it may take a few seconds to two minutes for the baby to open her mouth widely. Remember for any breast feeding position mother's fingers and thumb holding the breast should always be parallel to the baby's lips. When the baby opens her mouth widely her lower lip should be at the base of the areola and the nipple should be aimed towards the top of her mouth and not the middle of her mouth. Now mother should quickly put her breast in the baby's mouth. She should press the baby's chin into the breast first by slightly bending baby's head outwards. She should not bend her back or push her breast to reach the baby's mouth. Bring the baby to the breast by a gentle push from behind the baby's shoulders. The most important point in latching is lower part of the mother's areola should be in the baby's mouth. This will help the nipple to reach a comfortable area in the baby's mouth. Baby should be pressing her tongue against the part of the areola near her lower lip. This will compress the larger milk tucks and more milk will come out. Next step is to check whether the baby is attached deeply to the breast. To ensure deep attachment mother should look for the following signs. Baby's mouth is wide open. The part of the areola visible near the baby's upper lip is more than that near the baby's lower lip. Baby's lower chin is completely embedded into the mother's breast. Baby's jaw drops distinctly as she swallows milk. And the baby's lower lip is curled in the outward direction. Although it mostly gets hidden in the breast in a very well attached baby. In such cases lightly press the breast near the lower lip of the baby and check if the baby's lower lip is curled in the outward direction. Next look at the baby's nose. If the baby's nose is pressed against mother's breast then mother can bend baby's head slightly outwards so that the baby's chin is pushed further into the breast and the baby's nose and forehead are pulled away from the breast. Doing so will deepen the baby's attachment to the breast. Do not pull the baby's entire face away from the breast. This can cause nipple feeding. Remember breast feeding should be comfortable for the mother. She should not feel pinching, pulling or rubbing on her nipple. If breast feeding is painful for the mother then the baby is probably not well attached. Let's look at one of the common reasons for poor attachment. Many mothers pinch their areola to put only the nipple in the middle of the baby's mouth. Here the baby's mouth is not wide open. Baby gets attached only to the nipple. Here an equal part of the areola is seen near the upper and lower lip of the baby. Baby's chin is off the breast. Baby has a continuous fast sucking pattern of drinking milk. While sucking baby's cheeks dimple. Her jaw does not drop distinctly as she swallows milk. And mother's nipple gets pinched and pressed against the hard part of the baby's mouth. This is painful for the mother and may injure the nipple. Also during nipple feeding baby cannot get milk from the larger milk ducts beneath the areola. Therefore the baby does not get sufficient milk. If the baby is feeding only from the nipple then mother should put her clean little finger inside the corner of the baby's mouth. She should use it to release the baby's pull on her nipple. Then she should reattach the baby on the same breast ensuring a good latch. After proper latching mother should ensure that the baby gets both for milk and hind milk adequately. For milk is the watery milk stored in the front part of the breast. It is made up of water and protein. It is necessary for baby's growth and for making the baby strong. Hind milk is the thick milk stored in the back part of the breast. It is mainly made up of fats. It is necessary for baby's brain development and weight gain. To ensure that the baby gets both for milk and hind milk mother should feed the baby from one breast completely before offering the other breast. To check whether she has fed the baby from one breast completely mother should express milk from that breast with her hand. If thin watery milk comes out of the breast or if there is good flow of thick hind milk on expression then mother should reattach her baby to the same breast. When the flow of thick hind milk reduces to a few drops on expression with hand it means that mother has fed the baby from that breast completely. But before offering the other breast mother should encourage the baby to burp by making the baby sit on her lap then slightly bending the baby's torso forward and cupping the baby's jaw with her hand. Baby should burp within 2-3 minutes. If there is no burp in the next 5 minutes it means that the attachment of the baby to the breast was very good. The baby has not taken in excess air in her stomach while feeding. Now the mother should offer her other breast to the baby. If the baby's stomach is full she may not feed from the other breast. But mother should always offer both breast to the baby for feeding. She should let the baby make the final decision. If the baby goes to sleep while breast feeding mother should wake her up by gently tapping the sole of the baby's feet or gently tickling the baby's back or by making the baby sit in the position shown for burping. Along with the right technique breast feeding frequency is also important. Mother should breastfeed her baby at least 12 times in 24 hours out of which she must breastfeed at least 2-3 times in the night. To offer breast milk to the baby mother should look for baby's hunger signals like stirring, mouth opening, head turning, bringing her hand to mouth, sucking fingers and stretching her body. If the baby starts crying for breast milk then it means that it is too late. Please note there is a rapid increase in the baby's growth around 2 weeks, 6 weeks and 3 months of age. And the baby will require more milk. Also mother's breast milk output will increase if the baby is fed more frequently. Therefore mother should feed more often during such rapid growth periods. Remember breast milk is the best nutrition for the baby for the first 6 months of life. And good attachment is the key to successful breastfeeding. This brings us to the end of this tutorial. Thank you for joining.