Position your baby so that nursing is comfortable for your breast and your body. A nursing session may take a short time or up to an hour, and you will have to repeat about 10 times (or more!) during a 24 hour period. Therefore, avoiding muscle strain will be of great benefit.
More importantly, a good latch always begins with a position that is comfortable for the birthing parent and stimulates baby’s breastfeeding reflexes. A good latch will ensure that baby gets enough milk from your breast and does not hurt or damage your nipple. It will also ensure that you maintain an ample milk supply.
Steps to achieve a correct latch:
Step 1 Start with getting yourself into a comfortable position. Make sure your back and entire body is well supported. Use a foot stool if that makes you more comfortable. Pillows can be used to prop up birther’s arms and elbows.
(Please note that normally the baby should not be supported by the pillow. Instead, support the baby by your arm and support your arm with a pillow)
Step 2 Ensure correct positioning of the baby. Place the baby at your breast. Pay attention to baby’s spine, which should be straight (ear, shoulder and hips are all in one line) with their tummy touching yours. There should be no gaps between you and the baby. Provide support to you baby’s head by supporting their back and shoulders with the palm of your hand.
Make sure that your nipple is at the level of baby’s nose (not the chin). This will allow baby to sniff your nipple, tilt their head slightly back, and approach your breast with their chin first, (if baby is positioned too far to the side, they will have to tuck their chin leading to an incorrect latch).
Step 3 This step is only necessary for some, not all. Those with large breasts, large areola, flat nipples, etc. may benefit. If need be, shape your breast with your fingers. Place hand and fingers flat on ribcage, index finger in the crease under your breast. Your breast will rest between thumb and fingers, your thumb will be parallel to baby’s upper lip.
Squeeze breast (hold breast like a sandwich) to make an oval that will go corner to corner across baby’s mouth. It is very important that your thumb and index finger stay the nipple and upper lip just above the nipple, far away from the areola, even if the areola is very large. If your fingers are on the areola, they will be in baby’s way and will prevent the baby from getting the correct latch. Again, only if needed, shape your breast for latch on. If baby’s mouth doesn’t open on its own, touch the nose lightly with the inner side of the breast.
Step 4 Watch for baby’s signs. Being well-supported and having contact with your breast will stimulate baby’s reflex to breastfeed. Again, make sure that your nipple is at the level of baby’s nose. Your baby will “sniff” the nipple. Their head will tilt slightly back. The rooting reflex will cause baby’s mouth to open wide with a relaxed jaw and tongue down. Remember, your baby’s chin should be the first to make contact with your breast; baby’s tongue will extend over the bottom gum. Once the tongue senses the breast, it will cup it. At this point, the lower lip will mover over the nipple and close just about the base of the nipple – creating an off-center latch. At this point, bring the baby’s back and shoulders extra close.
Step 5 Learn your baby’s feeding pattern. At the very beginning of feeding, baby will suck to stimulate the milk let-down. You will notice short, chopping jaw motions. Once the milk starts flowing, (usually, within the first minute or two) the suckling will change to slow, deep, steady jaw motions of about one per second. You may observe jaw hesitation or hear tiny “keh” sound when baby swallows, usually with every 1-3 jaw strokes.
After a few minutes, the flow of milk will slow down and you may notice occasional jaw rests or a return to the short stroke until the next milk let-down, which is again followed by more deep, steady strokes.
You may have several let downs of milk during each breastfeeding session, although you are most likely to feel only the initial milk let-down.
Once your baby is latched well, slowly relax your breast hand, shift arms to a cradle hold, or continue to hold breast with opposite hand if you find it necessary.
Let your baby nurse until they are satisfied and come off the breast themself or fall asleep. Frequent, effective milk removal is key to a good supply.
©2006 Diane Wiessinger, MS, IBCLC www.normalfed.com
Edited by Cheryl Bradshaw BSN, RN, IBCLC