Breastfeeding Attachment and Positioning

Behavior: Mother helps baby become well attached at the breast.

• Good attachment is important to enable the infant to suckle effectively, remove milk efficiently, and stimulate an adequate supply. Poor attachment results in incomplete removal of milk and can lead to sore nipples, inflammation of the breast, and mastitis.

• Signs of good attachment:
  - More areola (dark area around nipple) is visible above the baby's mouth than below
  - Baby's mouth is wide open
  - Baby's lower lip is curled outwards
  - Baby's chin touches the breast
  - Baby takes slow deep sucks, sometimes pausing
  - Suckling is comfortable and pain free

• If any one of the above signs is not correct or if there is pain or soreness, this indicates that the attachment is poor and needs to be corrected.

• To ensure good attachment or to correct poor attachment, the baby needs to be well positioned.
  - Baby's head and body are straight, not bent or twisted
  - Baby faces the breast, starting with the nose opposite the mother's nipple so that the baby reaches up to take the breast (baby should be able to look up at the mother's face, not flat to her chest or abdomen)
  - Baby is close to the mother
  - Baby's whole body is supported, not just the head and shoulder

• To achieve good positioning mother should be relaxed and comfortable, sitting or lying down, with her back supported.

• To attach the baby, the mother touches the baby's mouth with her nipple, aiming it at the roof of the baby's mouth. When the mouth is open wide, she moves the baby quickly onto it. If there is still soreness or if the baby does not suckle effectively, she tries again.
  
  

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