Latching-On Checklist ... for the Early Days

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your view of latch-on, baby at left breast

____ Baby is interested, even if still very sleepy: wiggles, hands go to mouth, mouth moves

____ Clothing out of the way– yours and baby’s

____ Make yourself comfortable holding baby’s head at the natural level of your nipple

  • Footstool?  Back support?  Arm rest?  If lap pillow used, it should support your arm, not the baby. 

____ Support your Baby

  • Baby’s weight is supported mainly by your torso and arm, not your lap.

  • Baby is horizontal, with head, chest, navel, and knees all facing you.

  • Baby’s chin not tucked; nose near your nipple, not chin near nipple.

  • Your hand supports base of baby’s head; fingers don’t touch cheeks or press on back of head.

  • Baby’s lower body pasted to your torso, body to body.

____ Stablize your breast

  • Hand and fingers flat on ribcage, index finger in the crease under your breast.

  • Rotate hand so that breast rests in U between thumb and fingers – thumb and fingers point up.

  • Bring fingers onto breast only if needed to stabilize it.

  • Squeeze breast to make a sandwich oval that will go corner to corner across baby’s mouth.

  • Index finger well away from areola – farther away than you think is necessary. 

____ Beginning of latch-on

  • Angle nipple away from baby’s mouth, so mouth faces the inner side of the breast, not the nipple.

  • Land baby’s lower lip well away from the nipple, farther away than it will end up.

  • If baby’s mouth doesn't open on its own, dab it lightly with the inner side of the breast.

____ Latch-on

  • Use breast to pry baby’s mouth further open, roll breast onto baby’s tongue, not against tongue.

  • Move breast or baby so that baby’s upper lip goes “around the corner” of your nipple. At that time,

  • Bring baby’s shoulders extra close (don’t press on head. Bring shoulders close, head will follow).

____ Comfortable?

  • If not, press breast below lower lip to exaggerate the lower-jaw part of the sandwich shape,

  • OR, take baby off (slide finger into corner of mouth between baby’s gums) and start over

  • Baby’s cheeks should touch breast, hiding mouth.

  • Corner of baby’s mouth, if you could see it, is very wide, about 140 degrees, not a mere 90 degrees.

  • Lower lip, if you could see it, is rolled back toward the chin.

  • Lower lip, if you could see it, is farther from nipple than upper lip is.

  • If you tug carefully at corner of lower lip, baby’s tongue is visible cupping breast.

  • Baby’s head is slightly tipped back, in the position your head assumes when you sniff.

  • Chin is firmly planted on breast, nose is usually only lightly touching or is free of breast. 

____ Effective Nursing

  • Short, chopping jaw motions to start the milk, then…

  • Slow, deep, steady jaw motions, about 1 per second.

  • Jaw hesitation or “hic” sound when baby swallows, usually with every 1-3 jaw strokes.

  • Occasional rests or return to short strokes, followed by more deep, steady strokes

  • Offer “on whim” – baby’s or mother’s – which will probably be 1-12 times every 2-3 hours during the day, less often at night.  Frequent, efficient milk removal is key to a good supply.

© 2000 Diane Wiessinger, MS, IBCLC  136 Ellis Hollow Creek Road  Ithaca, NY  14850