A Latching-on Checklist

BABY IS INTERESTED, even if still very sleepy: wiggles, hands go to mouth, mouth moves

CLOTHING OUT OF 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 supported mainly by your torso and arm, not your lap
Baby 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

STABILIZE 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 140û, not a mere 90û
Lower lip, if you could see it, is rolled back toward 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.