The way a baby attaches to the breast (latches) is important. If a baby has only got the nipple in his mouth, without a good mouthful of breast tissue, it will usually feel uncomfortable for the mother and the baby may struggle to get a full supply of milk. A deeper latch with a big mouthful of the breast as well as the nipple, will ensure mother’s nipple falls deep in the baby’s mouth where it will not get rubbed against the roof of baby’s mouth or by his tongue. With a deeper latch, breastfeeding is comfortable, nipples are not sore, and the milk-making tissue in the breast can be stimulated to make a full milk supply.
This article shares my favourite tips for helping a baby to attach deeply and comfortably to the breast. For ways to position your baby before the latch see Breastfeeding Positions for Newborns or try watching some of these Breastfeeding Videos.
Find a breastfeeding specialist
The best way to get help with latching your baby to the breast for feeding is to have a face-to-face session with a breastfeeding specialist such as an IBCLC lactation consultant. An IBCLC will be able to suggest different positions and techniques based on yours and your baby’s anatomy. Your IBCLC can share breastfeeding tips before your baby is born so that you know what to expect or, if your baby has already arrived they can help you to get breastfeeding running smoothly and avoid sore nipples or painful feeds.
Skin-to-skin contact involves holding your baby without clothes or blankets coming between you. One of the many benefits of skin-to-skin is that it can help a newborn baby use his natural instincts and feeding reflexes to help him latch deeply on his own. Holding your baby in skin-to-skin contact for a whole sleep cycle, not just for feeding, can be helpful too. See Why Skin-to-Skin? for further information on the benefits of skin-to-skin.
Latching tips before the feed
Early feeding cues
Signs that a baby is getting hungry are known as feeding cues. Early feeding cues include a baby sucking his fist or fingers, and your baby turning his head side-to-side with an open mouth as he searches for the breast (sometimes called rooting). A late feeding cue would be when your baby cries out loud. Offer the breast when your baby shows early feeding cues; it is much easier to feed a calm baby than one who has to get upset first and scream to get fed.
When sitting or reclining ensure that your back is supported and check that your baby is well supported too. If your baby doesn’t feel secure he might wave his arms about during latching; you might feel like he is “fighting the breast”. He may try to hang on with his lips or clamp down on the breast with his jaw if he doesn’t feel safe; this may cause pain for you and lip blisters for him. See Breastfeeding Positions for Newborns for helpful ways to hold your baby whether sitting, reclining, standing or lying down. Bear in mind a breastfeeding pillow can lift a baby too high at the breast, see Do I Need a Breastfeeding Pillow? for more information.
If a breast is very full or heavy
If your breasts are very full or engorged, this can make it difficult for your baby to attach to the breast. Expressing a little breast milk by hand or with a breast pump can soften the breast or try reverse pressure softening—a technique to temporarily move fluid deeper into the breast away from the nipple. If a breast is very large or heavy, the weight of it can tend to pull the nipple from baby’s mouth so that they keep slipping into a shallow latch. It’s Ok to support the breast through a feed if this makes breastfeeding more comfortable. For help with engorgement see Engorged Breasts.
Let baby use their hands
Some mothers may feel that their baby’s hands or arms are getting in the way of latching. They may be tempted to move those little hands out of the way or cover them with mittens. However, a baby’s hands can help him find, move and shape the breast to help him latch successfully 1 see Scratch Mittens and Breastfeeding. Finding positions that allow a baby to use his hands and cradle or hug the breast in his arms can be helpful. Christina Smillie compares covering hands in mittens with blindfolding a baby 2.
Latching tips for a deep latch
Nose to nipple
- Hold your baby close to your body in one of the Breastfeeding Positions for Newborns so that his nose is just level with the nipple (“nose to nipple”) before he opens his mouth to take the breast. This helps your baby to attach with more of the breast beneath the nipple in his mouth than the breast above it.
- Make sure your baby’s head and neck are in a straight line; it is very difficult for a baby to swallow if he has to turn his head to the side to breastfeed.
Don’t hold the back of your baby’s head
- A baby needs to be able to tip his head back slightly as he opens his mouth wide to attach to the breast. If your baby can feel your hand holding the back of his head, it may prevent him from tipping his head back and can trigger a reflex to push his head against your hand. This will move him away from the breast instead of towards it.
- Supporting your baby with a hand behind their shoulders rather than with a hand on the back of their head helps your baby to latch more easily. If you feel your baby’s head needs more support, try reclining more so that their weight is fully supported on your body.
Shaping the breast
- Shaping or flattening the breast to fit your baby’s mouth can make it easier to get a deep latch (just as you might flatten a big sandwich full of salad with your fingers before taking a bite). Some mothers shape the breast by cupping their thumb and fingers around the breast (sometimes called a “C” hold or “assisted latch”) while others use two fingers in a “scissor hold”.
- Keep your fingers well away from the nipple if you do shape the breast so you don’t stop your baby getting a deep mouthful of breast.
- You can gradually let go of the breast once baby has grasped a big mouthful of breast tissue. Some mothers may prefer to continue to support the breast during the feed particularly if they have larger breasts.
Video clip, shaping the breast
The following video clip from the International Breastfeeding Centre shows an “assisted latch” where the breast is shaped slightly to make an easier latch. Notice how baby is latched to more of the breast below the nipple than above it and that the mother’s and helper’s hands are far back from the nipple.
Baby 28 hours old assisted latching
- Wait for your baby’s mouth to gape really widely as he searches for the breast. A wide gape helps your baby to get a deeper mouthful of breast tissue as well as the nipple. At the moment when his mouth is widest, bring him closer into the breast towards the underside of the nipple with a little push to his shoulders (not by pushing the back of his head).
- A reclining position with your baby on his tummy promotes the feeding reflex to search for the nipple with a wide mouth. In other positions make sure your baby can feel your skin with his face so he knows to start searching and opening his mouth.
- Remember to bring baby to the breast rather than leaning forward to put your nipple in his mouth.
Bottom lip turned out
When latched correctly you probably won’t be able to see your baby’s lower lip at all as his chin will be buried in the breast. If breastfeeding is comfortable it doesn’t matter that you can’t see your baby’s lower lip and it is best not to disturb the latch by keep trying to look. However, if breastfeeding isn’t comfortable, you or a helper could gently lift the breast to see what the latch looks like. If the bottom lip is tucked in it can often be encouraged out by pressing gently on baby’s chin as he feeds without taking baby off the breast. The top lip rests on the breast, neither turned in nor particularly turned out.
Helping your baby to latch, summary videos
The following video by Global Health Media has a lovely summary of latching tips.
And here is another short clip called The Basics of Latching from Breastfeeding Medicine of Northeast Ohio
In laid-back or reclining positions, babies can often move to the breast and latch quite naturally without your having to worry about “nose to nipple” or “bringing baby to breast”. There are several examples of babies self-latching straight after birth in the following video clip from the Global Health Media Project. Notice how the babies use their hands to help themselves latch. See Why Skin-to-Skin? for further information.
Variations in anatomy
If you have flat or inverted nipples it can be a little more difficult for your baby to latch, see Breastfeeding With Inverted Nipples and Flat Nipples for further help. Larger breasted women can find more latching tips in Breastfeeding With Large Breasts.
Good positioning and attachment (latching) are very important for breastfeeding to run smoothly. Breastfeeding is not supposed to hurt. If after trying these latching tips and reviewing other breastfeeding positions you are still finding breastfeeding painful, see Why Does Breastfeeding Hurt? and contact your breastfeeding specialist for help to find the cause.