Getting Started: Position and Latch

How a Baby Breastfeeds

When a baby uses a bottle, he uses his cheeks to create suction to remove the milk. (Try sucking on your thumb and notice how your lips become pursed and your cheeks cave in.) However, when a baby breastfeeds his cheeks are relaxed and his mouth is wide open while his tongue and lower jaw massage the milk from the breast. (Try sucking on your forearm and notice how your jaw moves and your cheeks relax.)

As the baby nurses, a muscular wave starts at the tip of the baby’s tongue and moves backward. This rhythmical rolling action of the tongue and jaw massages the breast, squeezing the milk that lies in tiny pools beneath the areola into the nipple.

To be effective, the baby needs to take more than the nipple into his mouth. He needs to get far enough onto the breast so that his lower jaw and tongue can massage the pools of milk that lie in the lower part of the areola. If he is on well, less of the areola will be visible below the lower lip than above his top lip.

Poor Latch

Poor Latch -- lips are <90° angle, lower lip is just below nipple.

Good Latch

Good latch -- lips are >120° angle, lower lip covers more areola.

If the baby sucks on the nipple only, he will suck on the nipple like a pacifier without drawing out milk. Sucking on the breast as on a bottle does not really work because the pools of milk are not being massaged into the nipple.

Also, when the baby sucks on the nipple only, it may be painful for the mother because the tongue and jaw, instead of massaging the breast, are rubbing the nipple and making it sore.

Remember that pain is really a sign that something is wrong. Nature would not design a system where it hurts to feed a baby.


The First Few Days After Birth: Two Reasons to Nurse Right Away

 

There are two reasons to give a baby lots of practice during these first three days.

First, it will be easier for him to learn how to latch on when the breasts are soft; second, the breasts need to be stimulated by his nursing to produce enough milk for later.

The system nature has designed for learning breastfeeding makes a lot of sense. A baby is born with extra protective stores of water and nutrition, so that he will only need the small amount of colostrum (early milk) that his mother has available for him during the first few days. Since her milk production is not fully established, a mother’s breasts are still soft and the baby can easily learn to latch on correctly. A typical baby will need a little hands-on help at first.

 


A Good Position for You and Your Baby

Holding baby with fingers in "C" shape

  1. Sit straight up in your (comfortable) chair. Place the pillow on your lap.  Have a glass of water within easy reach. Put on some relaxing music.
  2. Put your baby on the pillow. Take off his wraps so he’s easier to manage and stays awake.
  3. When nursing with your right breast, hold your baby with your left arm. With his bottom tucked under your elbow, place your left arm along his back. With the palm of your hand on the baby’s upper back and shoulders, your thumb and index finger should make a comfortable “C” around the base of his skull.
  4. Lying horizontally on the pillow, with his head at the same level as his bottom, your baby should be tummy to tummy with you with his nose opposite your nipple. (Any higher up and you will be forcing him to flex his neck to nurse.)

The Perfect Point for a Perfect Latch-On

Correct Latch: With his head tipped up, the baby reshapes the breast in his mouth.The baby’s tongue can now massage the area of the breast below the nipple, which is drawn back to the perfect point.

Here’s a valuable tip!

When a baby is latched onto the breast perfectly, the tip of your nipple will be at the PERFECT POINT. 

Imagine a line from the tip of your baby’s nose to his ear lobe. Right at the midpoint of that line, far back towards the root of the baby’s mouth, is the PERFECT POINT.

When your nipple is at the PERFECT POINT, your baby will have latched on to the right part of the breast, the lower areola. A further benefit is that your nipple will be protected from the rubbing motion of the tongue.

Nipple trauma resulting from a poor latch, where baby is sucking on the nipple instead of massaging the breast below the nipple.


Holding and Shaping the Breast for Easy Latch-On

A “U” hold to sandwich the breast to fit easily into the baby’s mouth.

  1. To shape the breast for easy latch on, place your left hand below your left breast with your thumb at the 3 o’clock position and your index finger at the 3 o’clock position. You will be compressing your breast in a “U” hold. (You may find it helpful to place band aid markers so that you can feel as well as see the right placement spots — make sure the markers are at least one or two inches away from the areola.)
  2. Keep your index finger and thumb at least one or two inches back from the areola and the rest of your hand close to your body. That way your fingers and hand won’t be in the way of your baby.
  3. Compress (gently squeeze) your breast with these two fingers, making a shape that will fit in the baby’s mouth. You will be narrowing the width of the areola, making it an oval shape. When the areola is deeply wrinkled, there will be more “give” to the nipple. A partner can help you shape the breast by holding the breast (far back from the areola) from above, with fingers parallel to the baby’s lips. This works well for even a tiny baby.
  4. Your fingers should be parallel with the baby’s lips. In this way, the oval shape of the breast should be parallel and not at an angle to the baby’s lips. Think of how you hold a sandwich parallel to your lips before you take a bite.

A “U” hold to sandwich the breast to fit easily into the baby’s mouth.

NOTE: If you shape your breast incorrectly by making a “C” instead of a “U”, the shape of the breast will not fit the baby’s mouth. This would be like trying to take a bite of a sandwich held vertically rather than horizontally.


Latching On

Good latch

  1. Gently touch your baby’s upper lip with the nipple.
  2. Wait for him to drop his jaw and tip his head up as he searches for the nipple.
  3. Bring him to the breast at the moment his mouth is wide open. (Bring the baby to the breast, not the breast to the baby.)
  4. Bring him to the breast in such a way that his lower jaw is far below the nipple, NOT at the base of the nipple.
  5. Get the nipple far back in the mouth, right at the PERFECT POINT. His chin, not his nose, should be pressed into the breast.

Once He Latches On

  1. Continue to hold onto the compressed breast until your baby has started sucking.
  2. After the baby begins nursing and seems to be latched on the right way, you can relax your fingers on the breast.
  3. If your baby is holding the breast in his mouth without a problem, you can slide your left hand out from below the breast and bring your arm to a comfortable place under his head.
  4. Holding your baby close to you, sit back and put your feet on the stool.


CAUTION: If at any time your nipple starts hurting, that probably means he has slipped off the right latch on position and has started sucking on the nipple only. Take your baby off by pulling the corner of his mouth to break the suction, and try again.

 

This material was developed by Jane Morton, MD and produced for educational purposes only.  Reproduction for commercial purposes is prohibited.  Utilization and copying of the materials to improve care of pregnant women and their newborns is encouraged with proper citation of source.

Copies of the video "Breastfeeding, a Guide to Getting Started" may be purchased.

Please visit www.breastmilksolutions.com for more information.