7 Criteria of the Proper Latch
These step by step directions for latching on baby to the breast will prevent sore nipples and frustration.
Offering the Breast to the Baby
First Steps in Latching OnOnce the mother has brought the baby to the breast, she needs to hold the breast and offer it to the baby by using either the “"C" hold or the "U" hold with her hand.
C HoldTo make the "C" hold, place your thumb at the 12:00 position and the other fingers below the breast so that the hand is making a C shape. Keep the hands on the rib cage so that none of the fingers get near the areola. If a woman has large breasts, it may be necessary for her to bring her bottom fingers forward slightly in order to support the weight of the breast. However, she should be certain that the fingers on the bottom are well behind the areola.
While making the C shape with her hands on the breast, the mother should then compress the breast tissue by bringing her fingers and thumb together. Now, the breast is no longer a round shape but more the shape of a flying saucer or hamburger.
In fact, Diane Wiessinger is a lactation consultant who uses the analogy of a sandwich or burger when latching on the baby. Imagine the compressed breast as a burger, with the buns and meat running parallel to the floor. That is okay for someone sitting or standing upright. But imagine someone approaching the burger from a side lying position. The position of their mouth and the position of the sandwich would be perpendicular.
U HoldIn the same way, the person offering the breast to an infant in a cross hold or cradle hold with their hands in a "C" position will have their breast perpendicular to the baby’s mouth. In such cases Diane recommends the "U" hold, which is easily accomplished by turning the hand 90 degrees so that the thumb and fingers are on opposite sides of the breast, and the opening of the "U" is upward. Then, when the mother compresses the breast tissue to offer it to the baby in a cross hold or cradle hold, it will match the position of his mouth.
Now, as you are holding your left breast in the "U" position with your left hand, and the doll in your right hand, bring the doll towards the left breast at approximately the 7:00 mark on the breast.
Bring the Baby to the BreastThe next step in latching on the baby is to bring the baby to the breast.
Using another food illustration, imagine the breast as an ice cream cone, with the cherry on top as the nipple. If you were the one eating the ice cream, you would not want to bring the cone to the mouth head on, with the cherry going straight towards the middle of the mouth. Instead, picture bringing the edge of the cone towards the bottom lip and then pulling the cone downward so that the bottom lip folds outward. At the same time, the cone is tilted towards the mouth and you open wide to make sure the cherry lands in your mouth.
Okay, that may not be exactly how we eat an ice cream cone, but it helps to picture how the baby approaches the breast. In a smooth motion, the baby is brought to the breast so his lower lip is flanged outward by the breast tissue, and as the breast and nipple are rolled towards him, he opens his mouth wide. The baby’s natural reaction to having his lip touched is to open wide, and the mouth will go up and over the nipple.
It is essential that the baby does not "nibble" onto the nipple when latching on. That’s a sure recipe for sore nipples in the coming days! When the mouth is open wide, the nipple and all or most of the areola will be inside the mouth. The baby should not "suck"” at the nipple the way a person might suck at the end of a straw. Instead, the gums of the infant will compress the sinuses located behind the nipple and under the areola, causing the milk in the sinuses to flow out. In fact, if the mother were to put her fingers around the sinuses (in many women this may be the area where the areola and flesh-colored skin meet) and press the fingers and thumb inward, she will see drops of milk appear. This is the same thing we want the baby to do with his or her gums.
How to Know If Your Baby Is Latching On CorrectlyNow, with the breast in the baby's mouth, double check to make sure it is placed to meet the following criteria:
Re-Position Until It Is RightIf the latch does not meet all seven conditions above, the baby needs to be repositioned on the breast.
First, break the suction by placing a finger near the corner of the baby’s mouth and pressing downward on the breast tissue. You may slide the finger slightly into the baby’s mouth. Once the suction is broken, pull the baby’s head away from the breast slightly.
The baby may smack her lips wondering where the nipple has gone. Reassure her that it is still near by touching the breast to her lips. Again, bring her to the breast with the lower lip touching first. When she does open wide, draw her back to the breast. There is no harm in repeating this numerous times in order to get her to make the perfect latch. Minutes spent now will prevent tears of frustration later. And remember, the colostrum tasting newborn is far more patient with this process than the milk-ravenous baby a week from now. So it is helpful to take all the time necessary to get it perfect at the beginning.
Once the baby is on the breast, she should begin nursing. Her mouth will close, compressing the milk sinuses. She then will open her mouth which allows the milk to flow in. There will be a pause as she swallows. The pattern you will see as you observe the baby’s mouth is Close-Open-Swallow-Close-Open-Swallow. This indicates that the baby is latched on to the breast and is successfully extracting and swallowing breastmilk.
See more information on breastfeeding latch.
Download our Brochure on Proper Technique for Latching On
Use our Correct Breastfeeding Latch brochure as a hand out to verify the baby is latching on correctly. This is can be used in the first days of breastfeeding.
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Enhancing Birth Breastfeeding and Bonding
By Karen Newell Copyright 2011 - 2012 Better Childbirth Outcomes - All Rights Reserved
Camp Hill, Pennsylvania, USA