I am a stickler for the head extension. I really don't like when the baby is
flexed. I explain to the  parents that the head extension puts the chin into
the breast so the jaw and tongue can work the breast, and tips the nose back
so the baby can breathe, and also 'opens up the breathing pipe and
swallowing tube.' Depending on the client, you could say the trachea and
esophagus. Of course you can demonstrate or have them flex/extend.
I also find the hardest position for new moms to achieve good extension is
the traditional cradle hold. One thing I show them is this: I hold the baby
in the cradle hold, I show how the head is usually way past the breast and
baby will have to look down (flex) to get to the breast. Also almost all
hungry babies will root on my upper arm when I'm holding them in cradle, and
I show mom how he is rooting and extending searching for the breast (try
it!). I say look how he is extending his head searching for the breast, so
let's use the cross cradle.
I'm not opposed to the cradle, but have had much much more success helping
moms and getting the babes to latch right away using football or cross
cradle in the early days.

Laurie Wheeler, IBCLC, MN, RN
New Orleans Louisiana, s.e. USA

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