Helpful Hints for Proper Latch

Breastfeeding

Proper positioning will help the infant to latch on correctly. This, in turn, will help the infant suck effectively, with his jaws compressing the area behind the nipple on the areola (dark brown area). It will also prevent sore nipples, which are usually caused by incorrect positioning of the baby at the breast.

Try the following tips:

• When putting the infant to the breast, the mother should be in a comfortable position and the infant should be lying on his side facing the breast (tummy-to-tummy), so that he does not need to turn his head to nurse. The baby's head and body should be properly supported.
• The mother should support her breast using the "C Hold" - her fingers on the bottom and her thumb on the top of the breast. The thumb and fingers should be well back from the areola. The new mother should not support the breast between the index and middle finger, known as the "scissors or cigarette hold," as this distorts the shape of the nipple, making it difficult for proper latch-on. Once she becomes more experienced with breastfeeding, the mother may use the scissor hold.
• The mother should lightly tickle the baby's lips with her nipple until he opens his mouth wide.
• When the baby's mouth is opened wide and the tongue is down, the mother should quickly center her nipple in his mouth and draw him toward her.
• At least 1½ inches of the breast tissue behind the nipple should be in the infant's mouth. Both lips should be turned out forming a V-shape, not rolled over the gums. The tongue should be curved around the breast, cupping it and extending over the gum line.
• The chin and the tip of the baby's nose should be touching the breast.
• If the mother is concerned about the baby being able to breathe while breastfeeding, she can be instructed to lift her breast slightly with her hand that is holding the breast or move the baby's bottom closer to her, forming a C shape around her body. This should allow space for the baby to breathe.

Once the baby begins to nurse the mother should

• Check that the jaw moves in a rhythmic motion.
• Make sure that no clicking or smacking sounds can be heard during suckling.
• Check that no drawing in (dimpling) of the cheeks can be seen.

If the mother feels pain while breastfeeding, she should interrupt the feeding and start again. The mother should insert her little finger into the side of the baby's mouth between the gums and gently pull down on the lower jaw to break the suction between his mouth and her breast. Pulling the baby off the breast without breaking suction can be quite painful and may cause nipple soreness.

Before Latching:

• Have nipple and baby's nostrils in line.
• Hold baby along the back with the opposite arm from the breast being nursed.
• Support baby's head, but do not push it in against breast.
• Tilt baby's head back slightly.
• Wrap baby's body and legs in close around mother.
• Tickle baby's upper lip with nipple, then pull away slightly.

Latching:

• When baby's mouth is open wide and tongue is forward, quickly move baby onto breast using the base of mom's hand on the baby's back and shoulders. (See figure below.)
• Touch baby's chin and lower jaw to breast first.
• Aim lower lip as far from base of nipple as possible so tongue draws LOTS OF BREAST in mouth.
• Move baby's body and head together.
• Once latched, baby's top lip will be close to nipple and the mother's areola shows above the lip (unless the woman has a small areola). Keep baby's chin close against breast.

Pointers for Mom:

• Mother's Posture is straight, back is well-supported, trunk facing forward, lap flat.
• Baby's body comes up to breast from below - upper eye makes contact with mother's eyes; baby is not quite tummy to tummy. A pillow may help to support baby.
• Support breast by raising breast slightly with fingers placed flat on chest wall and thumb pointing up.
• Bring baby to breast, not breast to baby.

Mom should avoid:		Correct Latch Positioning
X	Chasing baby with her breast.
X	Flapping her breast up and down.
X	Aiming her nipple to center mouth.
X	Twisting her body towards baby.
X	Holding her breast close to the areola or covering the areola with her fingers.
X	Moving baby onto her breast without his mouth wide open.
X	Holding her breast away from baby's nose.

POSITIONS FOR BREASTFEEDING

The most important factor to consider when determining the position in which to breastfeed is comfort. The two most popular positions used for breastfeeding are lying down and sitting up. These positions are shown in below.

Lying Down	Mother lies with her knees slightly bent.
	Pillows support her head, back, and upper leg.
	While on her right side mother: -- places her right arm under her head and left arm supports the baby's head and neck. OR -- places her right arm under the baby's head so the baby's head lies in the crook of her arm or along the back of his body supporting him.
	The infant should be lying on his side parallel to the nipple, facing the breast, tummy-to-tummy. The baby may need to be placed on a pillow to raise him to the right level.
The lying down position works well if mom finds it too painful to sit, wants to rest when breastfeeding, has large breasts or had a cesarean birth. This position is also great for nighttime feedings!

Sitting (cradle or madonna position)	Mother sits up straight with her arms and back well supported. A pillow may be placed under the infant to raise him to breast level.
	The baby's head is placed in the crook of her arm and his bottom is supported with her hand. His lower arm should be placed around her waist, not pinned between baby and mother, and his body should be turned "tummy-to-tummy" with hers.
	Arm or rocking chairs are comfortable with this position. A footstool may help reduce stress to mom's back.
The cradle position works well after mom is comfortable with breastfeeding

Sitting - Cross cradle position	Mother sits up straight with her arms and back well supported. A pillow may be placed under the infant to raise him to breast level.
	While the baby nurses from the left breast, the mother's right arm lies along the baby's back and her hand supports the baby's neck and head. With her left hand, the mother may choose to support her left breast or she may support the baby's head in the crook of her arm.
	The infant should be lying on his side parallel to the nipple, facing the breast, tummy-to-tummy.
The cross-cradle position works well if mom is learning to breastfeed or has a small baby.

Football hold	To nurse on the right breast, mother holds baby's head in her right hand so that he faces the nipple. She supports the baby's body with her right forearm and his body is positioned along her right side.
	The baby's bottom should touch the chair or bed and his legs should extend backward or upward, if necessary. The baby's mouth should be at nipple level. A pillow may be needed to raise the baby to the correct level.
	Turning the baby slightly inward toward the mother's side may be more comfortable and easier for mother and baby.
The football position works well for mothers who have had a C-section, are learning to breastfeed, have large breasts, have flat or sore nipples, or have premature or small infants.