Breastfeeding can present some unique challenges to the larger breasted woman—from difficulties latching her baby comfortably in traditional positions, to finding nursing bras, pump flanges or nipple shields in larger sizes. This article shares tips for breastfeeding with large breasts and looks at common concerns larger breasted women can have when breastfeeding.
Breastfeeding positions for larger breasts
As each mother and baby’s anatomy are slightly different, a breastfeeding position that works for one may not work for another, whatever the size of breast. See Breastfeeding Positions for Newborns for general information on positions and see our tips for the larger breasted mother below.
General positioning tips
- Supporting the breast throughout a feed with your thumb above the breast and fingers below it takes the weight of the breast (often called a “C-hold” because the hand makes a C shape around the breast). This helps prevent the weight of the breast from pulling out of your baby’s mouth causing him to slip into a shallow latch or let go of the breast altogether. Supporting the breast also prevents a heavy breast from pressing on baby’s chest 1.
- Nose to nipple. General advice to position your baby nose to nipple before he gapes to latch, may be difficult for the larger breasted woman if she cannot see her nipple without lifting or adjusting her breast. Be aware that moving a breast far to the left or right from its natural resting place may mean it tends to pull out of your baby’s mouth during a feed when it tries to return to its usual position. Supporting the breast through the feed can help with this.
- Pillows and stools. A commercial breastfeeding pillow is unlikely to be needed to lift your baby to breast height in cross cradle or cradle hold if your breasts hang low in your lap, but pillows can be useful to support your arms or back. Choose a chair without arms and enough space to get comfortable. Bending the knees slightly and resting your feet on a low footstool can also be helpful.
#1 Rugby hold
In rugby (clutch or football) hold, baby is supported under mother’s arm at breast height. Depending on her natural breast height a mother may or may not need to lift her baby on a pillow so that baby’s nose is level with the nipple prior to latching.
- Advantage: This position leaves hands free to help shape the breast for an assisted latch or to support the breast throughout the feed.
- Disadvantage: A heavy breast should not rest on your baby’s chest—but this could be an issue in rugby hold. Adjust your baby’s position as needed or support the breast throughout the feed.
#2 Cradle hold
A modified cradle hold with baby supported on mother’s forearm or wrist area can work for some mothers and leaves the opposite hand free to help shape the breast. Your baby’s arms can cradle the breast or one arm might reach around your waist.
- Advantage: In this position your lap or tummy can often support your breasts so that you can concentrate on keeping baby close with nose level to nipple before he gapes wide to latch on.
- Disadvantage: It may give you less control for helping baby latch.
#3 Laid back positions
In laid back or reclining positions a baby is supported by the mother’s body in full body contact. Baby could be lying at almost any angle that works, including sitting astride his mother’s thigh (called a laid back straddle hold). Laid back positions and some skin-to-skin contact can often help a baby use his feeding reflexes for self-latching. However there are pros and cons to this position for a mother with large breasts.
- Leaning backwards into your chair opens up the space in your lap for your baby.
- Leaning backwards can allow breast tissue to flatten slightly so that it falls away from a baby’s nose instead of surrounding it.
- The weight of the breast is not on baby’s chest.
- Leaning back too far may mean that your breasts flop to the sides of your body into your armpits which can make latching more difficult.
- Laid back positions may feel more awkward for a larger breasted woman as she may not be able to see how her baby is latching behind the curve of her breasts.
In the following video, lactation consultant Nancy Mohrbacher chats to a larger breasted mother as she breastfeeds in a laid back or reclining position. The position seems to work well for this mother as her body supports her breasts. Some mothers may find they need to support their breasts with their hands in this position, or that the position doesn’t suit them.
#4 Cross cradle
Cross cradle involves supporting your baby across your body using the opposite arm to the breast that is being fed from—with your hand across baby’s shoulders. Your other hand is free to shape and support the breast for the latch.
- Advantage: Cross cradle can give often give good control for an “assisted latch” (see below).
- Disadvantage: Cross cradle can pose a challenge for a larger breasted mother if her arms cannot reach around baby and breast.
Side-lying can be a comfortable position and the nipple is likely to be at a good height for baby to latch.
- The weight of the breast is supported by the mattress.
- Some larger breasted women can breastfeed from both the upper and lower breast from a side-lying position without switching sides.
- Some mothers have found sitting at a table to breastfeed, where the table supports both baby and the weight of the breast, recreates a side-lying position without lying down.
- It can take a little practice to latch a baby lying down with any sized breast. Latching baby in a semi laid back position and then sliding down with baby and breast in the same position can work for some mothers.
If you are still finding positioning difficult, seek help from a breastfeeding specialist such as an IBCLC lactation consultant.
Latching to a larger breast or nipple
As with latching to any other sized breast, your baby needs to have a big deep mouthful of breast tissue as well as the nipple. See our latching tips for general latching ideas. By “flattening” a large breast with your fingers you can make it a little easier for your baby to latch.
Shaping the breast for an assisted latch
- Holding the breast with a C-hold (thumb above the breast, fingers below) or scissors hold (the breast is held between two fingers) helps flatten the breast into a smaller “sandwich” which can help baby get a deeper latch. Be sure to make the breast smaller not deeper—flatten the breast just as you might flatten a big salad filled sandwich or burger in a bun before you take a bite. Keep your fingers sufficiently far from the latch so your baby can get a big mouthful of breast.
- A rolled cloth or towel placed under the breast may lift a heavy breast high enough for baby to latch or alter the shape of the breast to help latching. Sometimes the cup of a nursing bra can be tucked under the breast to provide support or some mothers have made a breast support from a loop of stretchy material (eg the leg from an old pair of tights). Worn around the neck like a necklace your breast can be slipped into the “sling” created.
Latching to a large nipple
Large nipples can be problematic if they fill baby’s mouth without leaving room for breast tissue behind the nipple. This will cause painful, sore nipples and will not stimulate your milk supply. It is by stimulating the breast tissue behind the nipple that your baby can drive the milk supply properly. Nipples 22mm or larger can often be challenging to a newborn baby. In time baby will grow and his mouth will better fit the nipple.
Until baby’s mouth has grown (a week or two can make a big difference), a mother can hand express or pump and feed her baby her own milk. Choose a pump that offers a range of sizes for the nipple tunnel:
The flange is the part of the pump that is held to the breast and the opening is called the nipple tunnel. If the nipple tunnel is too small your nipple may rub along its sides or get wedged, this can cause cracking at the base of the nipple. If the nipple tunnel is too large, too much areola may be pulled into the tunnel to rub along the sides, causing pain and trauma. Pump manufacturer Ameda has a guide to getting the right flange fit. Most pump companies offer a variety of flange sizes for example see Ardo Breast Pumps, Ameda Breast Pumps and Medela Breast Shield Fitting. You may need a different size for each breast.
Flat nipples or “disappearing nipples”
If breasts get engorged, nipples can quickly flatten out and literally seem to disappear making it extremely difficult for your baby to latch. Shaping the breast, pumping a little to bring out the nipple, or reverse pressure softening can help. See Engorged Breasts and Breastfeeding With Inverted Nipples and Flat Nipples for further information.
Nipple shields for larger nipples
Nipple shields tend to come in sizes that cater for average nipples. See Nipple Shields Good or Bad? for information about sizes and brands of nipple shield.
#1 Are my breasts a suffocation risk?
Some mothers may feel concerned that their breasts could be a suffocation risk for their baby, either from the weight of the breast on their baby or a concern that baby can’t breathe easily when buried in a large soft breast. Always check your positioning very carefully while breastfeeding and note the following tips:
- Leaning back slightly can allow the breast tissue to fall away from a baby’s nose and with baby in a prone position (on their tummy) the weight of the breast will be under baby not on top.
- Holding or supporting the breast will take the weight off a baby in cross cradle or rugby hold and will also allow some breast shaping to ensure your baby’s nose is free.
- Where breasts are very soft and large, a baby’s nose can be kept clear of breast tissue by pressing a thumb into the breast adjacent to their nose.
#2 Will large breasts mean too much milk?
Not necessarily, breast size is mostly determined by the amount of fatty tissue in the breast, not by the milk making glandular tissue. Therefore a large breast is not necessarily an indicator of a breast with a larger milk making capacity compared to a smaller breast 2. A large breast is also not necessarily one with a larger storage capacity of breast milk.
Plenty of milk
Some mothers with large breasts will have plenty of glandular tissue and lots and lots of milk. They may feel quite swamped with milk, finding it leaks and spurts like a tap. They may find they keep getting engorged and avoiding blocked ducts and preventing mastitis can seem like a losing battle if a baby can’t keep up with the flow.
- To help your supply regulate to your baby’s needs, have a look at Oversupply of Breast Milk.
- Expressing enough milk to stay comfortable and ensuring your baby finishes the first breast before offering the second is usually helpful.
- Regular massage of any areas of the breast that are not getting fully drained will help avoid engorgement. With moderately large or pendulous breasts the lactation tissue may be further back in the breast and harder to get to for hand expression, massage or pump.
Overweight or obese women with larger breasts and a body mass index (BMI) greater than 26 may be at risk of delayed onset of lactation or a low milk supply 3 4. They may have other challenges associated with obesity such as increased risk of caesarean and postpartum oedema which can affect breastfeeding too 5. For further information about obesity and milk supply see No Breast Milk After Delivery. To ensure breastfeeding gets off to a good start, hand expressing within the first hour of birth can help with milk supply and contact an IBCLC lactation consultant or breastfeeding specialist.
For information about about milk supply for mothers who have had breast implants see Breastfeeding With Implants.
#3 How can I breastfeed in public?
Larger breasted ladies may feel they have to expose more of their body than they are comfortable with when breastfeeding—making breastfeeding in public daunting for them. Wearing under layers, large stretchy vests that can be pulled down to keep a tummy covered or a man’s vest with arm holes large enough to bring a breast through may be helpful. If the rugby hold works well for you, some mothers use their baby changing bag or a rolled up coat to rest the baby on instead of taking a pillow everywhere they go.
#4 Where can I find a good nursing bra?
It can be a challenge to find a good fitting maternity bra in larger sizes. It is important that bras fit properly during lactation so that any seams or edges are not cutting into breast tissue and are well back in the arm pit behind the glandular tissue. Anything cutting into the breast including underwired bras could be a risk factor for mastitis or blocked ducts.
- Some mothers have converted their favourite non-maternity bra into a nursing bra (you can search online for ways to do this).
- Shopping online may offer more choice than department stores. Larger sizes are stocked by bras4mums (UK), bravissimo.com and amplebosom.com.
A large breasted mother may feel more comfortable at night if she wears a bra. Be wary of wearing a bra at night that is too tight or cuts into the breast tissue as this could cause blocked ducts or mastitis. Look for a lightweight stretchy cotton sleep bra that holds breast pads in place if needed and provides gentle support.
#4 Why am I getting rashes and itches?
Mothers with larger breasts may find they get very hot and have heat rashes or outbreaks of thrush in the folds beneath their breasts. And some mothers find stretch marks on their breasts can itch. Cotton bras and fabrics next to the breast can help with air circulation along with keeping the area cool, clean and dry.
#5 How much bigger will breasts get during lactation?
Some mothers find their breasts increase about two cup sizes during pregnancy ready for breastfeeding. Others may note a size increase of five cup sizes or more giving rise to unexpectedly large, or larger, breasts. In most cases after lactation, breasts will return to their original size, some may be a little smaller or larger.
Rarely, a mother experiences something called gestational gigantomastia—extreme breast tissue overgrowth during pregnancy. This can make breastfeeding difficult or even impossible because of the size and weight of the breasts. Breasts can spontaneously return to normal size after the birth but in some cases surgical intervention by breast reduction may be needed 6 7.
Considering breast reduction
For women considering breast reduction, breastfeeding after breast reduction surgery is possible. Whether or not a mother can make a full supply of breast milk after surgery will depend on the type of surgery involved and how much functional tissue was removed. A comprehensive website on breast reduction surgery is BFAR.org.
Breastfeeding with large breasts can present a few extra challenges for mother and baby. However, with good breastfeeding help to find the right position, or a little time for a baby’s mouth to grow to fit the breast, mother and baby can soon master breastfeeding.