Breastfeeding checklist: How to get a good latch

What is a latch, anyway?

With breastfeeding, it refers to how the baby fastens onto the breast. How your baby latches is actually more important than how you hold your baby. (There is a reason why it's called breastfeeding, not nipplefeeding!) According to Your Guide to Breastfeeding (PDF file, 3,041 KB), by the Office on Women's Health, a good latch means that the bottom of your areola (the area around the nipple) is in your baby's mouth and your nipple is back inside his or her mouth, where it's soft and flexible. A shallow, or poor, latch happens when your baby does not have enough of your breast in his/her mouth or is too close to the tip. A shallow latch causes your already-sensitive nipple skin to press against the bones in the top of the baby's mouth. That can cause your nipple to get sore, crack, and bleed. So how do you know if you and your baby have a good latch? Here are some guidelines:

Check your position.

Both you and your baby need to be comfortable. Although it takes practice to get a good latch, you should never have to work hard to stay in the right position while your baby is breastfeeding. You can only know which nursing hold works best for you and your baby through trial and error. For some common nursing holds and latching techniques, download the It's Only Natural How-to fact sheet (PDF file, 1.4 MB). But whatever the position, you should be relaxed with your baby snuggled close, belly-to-belly with you, so your baby doesn't have to turn his or her head to the side.

Not sure if your baby is positioned right? Here are two easy tricks:

Look for your baby's belly button. If you can see the belly button while your baby's latched, the baby's not comfortable enough to latch well. Scoot your baby's body inward a little so that the belly button is facing toward you.
Look around. If you can chat and use your hands without concentrating on holding your position, that's a good position for a latch.
Check your nipples. The sensitivity of the skin on your nipples and breasts helps your breasts respond to your baby and know how much milk to make. When the baby is latched correctly, the bottom part of the areola is also in his or her mouth. But a shallow latch, even if it doesn't hurt right away, will start to hurt soon. And your baby has to work harder to get the milk out.

Not sure if baby's latch is too shallow? Here are two easy tricks:

Are you in pain? If the pain lasts longer than a few seconds, the latch is probably too shallow. Gently break the suction by placing a clean finger into your baby's mouth and help your baby latch on again.
How's your nipple? When the baby unlatches, look down. Your nipple should look the same or slightly longer. Pain or pinching is a sign of a poor latch.

Could my baby be toungue-tied?

Sometimes, a baby's tongue is stuck to the bottom of the mouth by a band of tissue, which means the baby can't open his or her mouth wide enough to get a good latch. Checking for tongue-tie isn't a standard newborn test. If your baby isn't latching on well and doesn't seem to be gaining weight, see your baby's doctor or nurse and ask about this. Fortunately, it's a very simple fix. Once tongue-tie is treated by a medical professional, breastfeeding improves.

Check your comfort. Both you and your baby should be comfortable both during and after feedings.

During feeds — A little bit of discomfort right at first is okay. But if your baby has been at the breast more than a few seconds and it still hurts, or if you find yourself using the breathing they taught you for labor and delivery to get through pain, that's not good. Take your baby off, look at how you're positioned, and try again. Your baby needs a good latch to get maximum milk, and you need a good latch for minimum discomfort.
Between feeds — You might sometimes feel your breasts getting fuller when it's time for a feeding. Some moms can feel a tingling sensation in their breasts just by thinking about their baby or hearing another baby cry. You may even leak a little milk between feedings. These are normal signs. But if your breasts feel painful, achy, itchy, hot, or burning, or you feel a hard lump that can't be massaged out, call a doctor or nurse right away. These can be signs of an infection. Regardless of the diagnosis, even if you're prescribed medication, keep breastfeeding. Why? Continued breastfeeding keeps the milk moving through the breast, which helps the healing process and speeds recovery.

Sometimes, even when you do everything right and the latch looks good, you may still experience pain. Remember, pain is a red flag. So seek help from a breastfeeding expert, doctor, or nurse.