1.  Latching On

2. Goals and Objectives  Demonstrate proper positioning of an infant on the breast.  Identify 3 ways to assess an infant’s latch.

3. Set Up  Get comfortable  Sitting, lying, standing  Pillows to support mom  Liquids nearby

4. Positioning  Support the whole baby  Avoid twisting  Baby should face the breast  Bring the baby to the breast not the breast to the baby  Skin to skin

5. Positions  Tummy to tummy  Football  Side lying  Saddle

6. Tummy to Tummy  AKA Cross cradle, cradle hold  Baby on side  Facing breast  45degree angle  Head in crook of elbow  Elbow supported

7. Football  Baby’s tummy against mother’s side  Baby facing breast  Body supported by crook of elbow  Head and neck supported by hand

8. Side Lying  Mother lying on side  Baby lying on side  Facing mother’s breast  Head supported by arm

9. Lying Flat  Mother lies on back  Infant on top of breast  Good for PM feeds  Gravity slows the flow

10. Saddle  Only for older infants  Must be able to sit unaided  Baby straddles mother’s leg  Mother puts arm around baby’s waist

11. Multiples

12. Twins  One at a time to start  Both at once when established  Football or saddle hold

13. Getting Latched  Rooting  Open wide  Tongue down  Take in areola

14. Anatomy of a Latch

15. Anatomy of a Poor Latch

16. Breathing on the Breast

17. Assessment  Watch first  Ask mom  Look from all angles  Listen

18. What You’ll See  More areola above mouth than below  Lower lip rolled out  Mouth wide open  Chin touching breast

19. Signs of a good feed  Rhythmic sucking  Audible swallows  Feels comfortable  Stays latched  Switch when baby drops off

20. Assisting  Ask first  Tell her what you see  Explain the correction  Have mother do the work  Stay positive!

21. Demonstration

22. Last Thoughts  Questions?  Take home points…