Nose to nipple: a step-by-step guide to a comfortable latch

It is four in the morning, the lamp is on low, and your baby is turning her head from side to side, mouth open like a little bird. You have watched videos and read leaflets, but in this moment it feels as if you are both learning a new language. You are. A good latch is a skill, not an instinct you either have or lack, and most mums and babies need practice and help to get it right. Here is a simple step-by-step guide to bring to those early feeds.

Why the latch matters

When a baby latches well, she takes a big mouthful of breast, not just the nipple. This helps her get milk efficiently and protects your nipples from damage. A shallow latch is one of the most common reasons for sore, cracked nipples and for babies who seem hungry all the time. The good news is that small adjustments often make a big difference.

Step by step

1. Get yourself comfortable first. Sit back with your back supported, or lie on your side. Have water within reach. Use pillows to support your arms, not to hold the baby up to the breast for you.
2. Bring baby close, tummy to tummy. Her head, shoulders and body should be in a straight line, so she does not have to twist her neck to feed.
3. Start nose to nipple. Position her so that your nipple points towards her nose, not her mouth. Her head should be free to tilt back slightly.
4. Wait for the wide mouth. Let her smell and feel the breast. Gently brush your nipple against her top lip to encourage her to open wide, like a big yawn.
5. Bring baby to breast, not breast to baby. When her mouth is wide open, move her onto the breast with your hand behind her shoulders, chin leading. Her bottom lip should land well away from the nipple.
6. Check the signs. Her chin touches your breast, her cheeks look full and rounded rather than sucked in, and you can see more of the darker skin above her top lip than below her bottom lip.
7. Listen and watch. After a few quick sucks, the rhythm usually changes to slower, deeper sucks with pauses, and you may hear or see swallowing.

How it should feel

The first few seconds can feel strong or tender, especially in the first days. But the feed should not be painful throughout. If it pinches or hurts after the first moments, slide a clean little finger into the corner of her mouth to break the suction gently, and try again. Coming off and starting again is not failing. It is how latching is learned.

Signs feeding is going well

• Your baby feeds often, usually at least eight times in 24 hours in the early weeks.
• She seems content after most feeds and comes off the breast by herself.
• After the first few days, she has plenty of wet nappies and her poos change from dark and sticky to yellow.
• Your midwife or health visitor is happy with her weight.

When to ask for help

Ask your midwife, health visitor or a lactation consultant to watch a feed if:

• feeding hurts throughout, or your nipples are cracked, bleeding or squashed out of shape after feeds
• your baby is very sleepy and hard to wake for feeds, or rarely seems satisfied
• you are worried about wet or dirty nappies
• you wonder whether your baby might have a tongue-tie

Get urgent medical help if your baby is floppy, unusually hard to wake, not feeding, has very few wet nappies, looks yellow and very sleepy, or has a fever. Trust your instinct; you know your baby.

Held as you hold

Can a woman forget her sucking child, that she should not have compassion on the son of her womb? yea, they may forget, yet will I not forget thee. (Isaiah 49:15, KJV)

God chose the picture of a nursing mother to describe his own unforgetting love. In the middle of the night, as you guide your baby's mouth for the twentieth time, you are living out an image God uses for himself. And even when you feel clumsy and tired, you are remembered too.

A prayer for our feeds

Lord, give me patience with myself and with my little one as we learn this together. Bring me the right help when I need it. Thank you that you never forget me, even at four in the morning. Amen.