Positioning for Breast and Bottle Feeding in Infants and Young Children

Midline positioning or alignment of head, trunk and limbs enhances safety and efficiency of feeding (Redstone & West, 2004). In order to ensure that the environment is conducive for learning positive cues for eating, the infant should ideally be held by a parent in a secure hold that allows for eye contact when being breast, bottle or tube feed, as this is the most natural environment to be fed in at this age.

There may be some situations however, where the infant requires more supportive positioning. Specialized equipment such as a Tumble Form may be considered.

It is also important to consider the ergonomics of the parent feeding the child. They also need to well stabilized at the hip, trunk, shoulders, and arms to prevent fatigue, pain, and injury.

Wrapping vs non-wrapping:

  • wrapping provides midline support, however temperature needs to be considered, e.g. if the infant is too warm when wrapped, they may become sleepy, and wrapping becomes a strong cue for sleep time
  • consider just wrapping the infant’s top or bottom half if level of alertness is a concern
  • side-lying for bottle feeds may assist with midline organization, control of flow of fluid and control of potential pooling of fluid