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Breastfeeding Position and Latch



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this video has been developed to teach

you how to position and latch your baby

for effective breastfeeding while your

baby's at SickKids before feeding

observe your baby for the following

feeding cues the early cues are stirring

mouth movements and head turning towards

what is touching the face the mid cues

are stretching increasing physical

movement and hand to mouth the late cue

is a crying agitated baby take the time

to calm your crying or agitated baby

before you attempt the latch there are

many different breastfeeding positions

the best position is the one that feels

most comfortable for you and your baby

breastfeeding may take time to learn

every feeding attempt at the breast

should be seen as a positive step in

developing a breastfeeding relationship

if you have difficulty latching while at

SickKids lactation consultants are

available by referral for extra support

and tail breastfeeding is established

pumping will need to be maintained and

coordinated with feeding attempts it is

recommended that pumping be done

immediately after the feed so that a

full breast is offered to your baby

however there are some exceptions when

partial pumping before the feed is

recommended this could be the case if

you have a large milk supply and or if

your baby is just beginning to

breastfeed breastfeeding signs and

screens are available for your use to

ensure privacy during the feed gowns can

be worn as sweaters for comfort a

breastfeeding pillow or folded blanket

can be used to bring the baby up to your

breast level if the baby's temperature

is stable it is recommended to feed in

just a diaper to allow for skin-to-skin

contact this may also help keep the baby

more alert and awake throughout the feed

if an accurate estimation of intake of

the breast is required

please see the video on test weights

taking the time to position the baby

well will lead to a better latch and

more effective feeding for any position

the following are important you should

be sitting comfortably with your back

well supported and relaxed baby's

shoulders and body are supported with

your hand and arm baby's head is at your

breast level baby's ear shoulder and hip

are in alignment baby needs to be tummy

to tummy with you except when you use

the football hold your nipple should be

pointed towards the baby's nose with the

chin coming to the breast first if this

is not the case move the baby not the

breast this will allow for proper

positioning of the nipple in the baby's

mouth which results in a more

comfortable latch and effective

compression of the milk ducts to

positions that work well for babies who

are first learning to breastfeed are the

cross cradle and the football hold cross

cradle is the most common breastfeeding

position because it provides the baby

with the most support and assistance to

latch see how the parent is sitting

comfortably and while supported the

breastfeeding pillow raises the baby to

the breast level so that the parent

maintains good posture and the baby is

well supported the baby is on its side

completely facing the parents body with

the year shoulder and hip aligned

notice the skin-to-skin contact the baby

is supported by the arm opposite to the

breast being used the back and the

bottom are supported with the forearm

and the neck and the shoulders are

cradled with the hand do not hold the

back of the baby's head as this puts the

baby in a difficult position to latch

the head is slightly tilted back so that

the baby is coming to the breast chin

first this is often referred to as a

sniffing position the parents other hand

is supporting the breast and if

necessary the breast can be shaped to

help the baby latch for latching

difficulties try shaping the breast to

match the baby's mouth hold and squeeze

the breast by placing the thumb and

finger

far enough back from the areola the

darker area around the nipple so that

they are not interfering with the latch

the breast is squeezed and narrowed

enough for the baby to latch easily this

is often referred to as a sandwich of

the breast football hold is another

common position and may be more

comfortable after cesarean section more

pillows or blankets may be required

there must be adequate room for the

baby's legs behind the parents back

this may mean moving forward and to one

side of the chair there are two

variations the baby can be lying on

their back or on their side either way

the baby is tucked and close to the

parent

see how the baby's neck and shoulders

are well supported with the parents arm

and hand

notice how the baby has the nipple

opposite the nose for effective latching

the head is slightly tilted back so that

the baby is coming to the breast chin

first if needed the parent has a hand

free to support or sandwich the breast

the cradle hold is usually used for

babies who are latching well and

required less support and assistance to

feed the baby may be transitioned into

the cradle position after latching in

the cross cradle position the baby's

body is still completely facing the

parent skin-to-skin the baby's neck is

supported in the crook of the parents

elbow and the forearm supports the back

with the hand at the baby's bottom or

hips the other hand can be used to

support or sandwich the breast

if extra support is required with

positioning and latching there are

specialized positions and techniques

available please put in a referral for a

lactation consultant remember the right

position is whatever is most comfortable

for you and your baby and allows for a

good latch and effective breastfeeding

try different positions to see what is

best

once the baby is in the correct position

a good latch is more likely to encourage

baby to latch hand Express the drop of

milk to give your baby a taste stroke

your baby's upper lip with your nipple

to encourage rooting and a wide-open

mouth

remember to break the contact between

the nipple and the baby's upper lip to

encourage the baby to tilt the head

upwards and open the mouth wider wait

for a wide-open mouth as if the baby is

yawning then bring the baby to the

breast chin first do not stretch the

breast or bring the breast into your

baby's mouth

make sure the tongue is down and over

the lower gum line if your baby is

crying the tongue will be touching the

roof of the mouth and it makes it hard

to latch in this case you need to calm

the baby before latching usually

offering a clean finger to suck on for a

moment will work otherwise bring the

baby upright onto your chest

skin-to-skin and Stroke the back gently

once the baby is latched look for the

following a wide-open mouth the angle of

the corner of the mouth should be

greater than 130 to 150 degrees and the

corners of the mouth don't touch the

baby's chin is touching the breast the

baby comes to the breast chin first the

head is slightly tilted back and the

nose is not touching the breast the

latch is asymmetrical this means that

more of the areola can be seen above the

baby's top lip then below the bottom lip

the lips are flanged out

you

for latching difficulties try sandwich

in the breasts breastfeeding should not

be painful the tip of the nipple needs

to be where the top of the mouth becomes

soft run your tongue along the roof of

your mouth to where it becomes softer to

feel how far back this is when the latch

is not deep enough the baby has the

nipple at the front of the mouth

compressing the nipple between the

tongue and the hard palate this can be

painful and may cause damage to the

nipple as well as decrease the amount of

milk flow to the baby see the difference

in the milk flow when the areola is

compressed rather than just the nipple

to break the latch place the finger into

the corner of the baby's mouth and

gently push the jaw down

how do you know when to switch breasts

switch breasts when effective swallows

are no longer observe to ensure that

your baby gets more of the calorie rich

milk that is found closer to the end of

the feed

remember to pump immediately after feeds

if breastfeeding is not yet established

to protect the milk supply

to ensure your baby is feeding

effectively please see the video on

breastfeeding and take assessment to

learn how to know if your baby is

drinking and if milk at the breast