Brenda,
During the years I spent as a hospital LC, I figured out a position that
worked pretty well for obese moms and post-Cesarean moms, but it requires the
mom to sit in a chair at her bedside.  (Most of them are more comfortable in
a chair instead of in bed anyway.)

Here is how it works for the right side.  Place mom's chair with its right
arm next to the bed.  With mom in the chair, push the bed flush against the
chair arm and lower it to the level of the chair arm.  Lay the baby on the
bed on his side, with mom's hand supporting his neck and shoulders.  Tuck a
rolled baby blanket or towel or washcloth, whatever is the right size, under
the breast to lift it so the nipple is at the level of the baby's mouth.  Mom
steers the breast with her left hand and steers the baby's top end with her
right hand.  The bed holds the rest of the baby's body securely, so mom
doesn't have to worry about supporting that too.

If her breasts are really pendulous, so that her nipples normally rest in her
lap, she might do better in a chair without arms, and with the bed low enough
to bring the baby down to nipple level instead of trying to prop the breast
up to baby level.

It's useful to position the chair in the middle of the bedside, not at the
head.  This leaves room for the helper to get behind the chair or to sit on
the bed behind the chair in case more coaching is needed.

Depending on the contour of the breast and the direction that her nipple
points, the baby's body may be positioned at any angle necessary.  By this I
mean that, while we normally think of the football hold placing the baby's
body along a line at 90 degrees to a line drawn between the mother's
shoulders, if the breast is very rounded, the baby's body might need to be
more nearly parallel to her shoulders, with his legs pointed away from the
mother's right side instead of along her side toward her back.  That's the
beauty of letting the bed hold the baby up; you can orient the baby in any
direction.

To nurse on the other side, the mother stands up, her helper reverses the
chair, and she sits down.

Looking ahead to when she goes home, where there's no adjustable bed, here
are some thoughts.
1. Get the dad or other family support people involved.  They can figure out
a way to rig up a nursing corner at home, maybe using a stack of boxes beside
a chair.
2. Once the baby has got the idea about how to latch on, he may be able to
accommodate even if the positioning isn't quite as perfect.

Good luck.

Chris Mulford
Swarthmore, Pennsylvania
northeastern USA

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