I wonder if part of the desire to nurse lying down involves a sense of control 
and autonomy that the baby feels. When babies nurse lying down I think that 
there is a tendency to snug them in lower on the body, by holding their middle 
or upper back or even not holding them at all. If a woman has a fast MER or 
the baby is congested or refluxing or has an earache (which hurts every time 
they swallow), it seems to me that more control  over their head and the 
ability to release the nipple and back away from it, has to increase their 
comfort level with nursing. It also would account for why it would happen with 
the third or fourth baby as women often have fairly spectacular milk supplies 
at this point in their nursing careers. One thing I see over and over in my 
practice is women with fast flows misinterpreting their babies struggles at the 
breast. They have been told or read about getting a deep latch and that they 
have to snug the baby in. Baby will struggle against the fast flow and fuss and 
the mother will think "Oh I have to snug him in farther, he has a shallow latch" 
and push the baby's head in and hold it firmly to their breast. I can't imagine 
how frustrating and potentially terrifying this must be to a little baby. It's like 
the infant equivalent of waterboarding. Invariably when we adjust the 
woman's position, lean her back or lie her down and allow baby to take control 
the nursing situation improves. 

I also think that many babies love things to be the same and predictable. 
There is a family story on my husband's side about my nephew eating at my 
inlaws house and they served him dinner with two things on the plate. And he 
said "But I always get free fings (three things)". I think that there is a subset 
of babies who when they discover something they like, do not want to be 
flexible about it. If they like lying down, then by golly they will eat lying down.

Lastly, the older baby who insists on being fed lying down with a mother who 
has a normal flow may just be saying "This is my time, pay attention to me!! 
Don't talk on the phone, don't read, don't do anything but invite me into your 
world, your breasts, yourself"

Kathy Lilleskov RN IBCLC 

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