BREASTFEEDING MANAGEMENT INFORMATION

When Latching

Instructions

Push baby's bottom into your body with the side (the side of your baby finger) of your forearm. This will bring him towards your breast with the nipple pointing to the roof of his mouth
Mother's hand under the baby's face, palm up.
Head supported but NOT pushed in against breast.
Head tilted back slightly.
Baby's body and legs wrapped in around mother.
Use your whole arm to bring the baby onto the breast, when mouth wide.
Chin and lower jaw touch breast first.
WATCH LOWER LIP, aim it as far from base of nipple as possible, so tongue draws lots of breast into mouth.
Move baby's body and head together - keep baby uncurled.
Once latched, top lip will be close to nipple, areola shows above lip. Keep chin close against breast.

Wide Mouth / Gape

Need mouth wide before baby moved onto breast. Teach baby to open wide/gape :

move baby toward breast, touch top lip against nipple
move mouth away SLIGHTLY
touch top lip against nipple again, move away again
repeat until baby opens wide and has tongue forward
Or, better yet, run nipple along the baby's upper lip, from one corner to the other, lightly, until baby opens wide

Mother's View While Latching Baby

Move baby not breast

Mother's View of Nursing Baby

Recommendations for the Mother

sit with straight, well-supported back

trunk facing forwards, lap flat Baby's position before feed begins

on pillow can be helpful,
nipple points to the baby's upper lip or nostril

Baby's body

placed not quite tummy to tummy, but so that baby comes up to breast from below and baby's upper eye makes eye contact with mother's

Support breast

and firm inner breast tissue by raising breast slightly with fingers placed flat on chest wall and thumb pointing up (if helpful, also use sling of tensor bandage around breast)

Move baby quickly on to breast

head tilted back slightly, pushing in across shoulders so chin and lower jaw make first contact (not nose) while mouth still wide open, keep baby uncurled (means tongue nearer breast) lower lip is aimed as far from nipple as possible so baby's tongue draws in maximum amount of breast tissue

Cautions Mother needs to AVOID

pushing her breast across her body
chasing the baby with her breast
flapping the breast up and down
holding breast with scissor grip
not supporting breast
twisting her body towards the baby instead of slightly away
aiming nipple to centre of baby's mouth
pulling baby's chin down to open mouth
flexing baby's head when bringing to breast
moving breast into baby's mouth instead of bringing baby to breast
moving baby onto breast without a proper gape
not moving baby onto breast quickly enough at height of gape
having baby's nose touch breast first and not the chin
holding breast away from baby's nose (not necessary if the baby is well latched on, as the nose will be away from the breast anyway)

When Latching. Revised December 13, 2002.
Written by Jack Newman, MD, FRCPC ©2003
This handout may be copied and distributed without further permission, on the condition that it is not used in any context in which the WHO code on the marketing of breastmilk substitutes is violated

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