The document discusses important steps for establishing correct breastfeeding from the beginning. It outlines infant feeding cues that mothers should learn to recognize like rooting and lip smacking. Getting the baby to latch on properly is crucial and involves positioning the baby's body against the mother's with the baby's head facing the breast. Ensuring correct latch helps avoid problems like nipple damage or poor milk transfer that could lead the mother to stop breastfeeding. Hospital practices like immediate skin-to-skin contact and keeping mother and baby together support correct latch.

1. Helping with a Breastfeed-
Step 5

2. Objectives

3. Getting breastfeeding
correct from the
beginning is crucial to
long-term breastfeeding
success!

4. Infant Feeding Cues
All infants exhibit feeding cues which mothers
can be taught to recognize.
Early feeding cues are subtle and include
Bringing hands to mouth or cheek and trying to
suck on them
Rooting
Lip smacking, mouthing, tongue protrusion

5. Crying
Crying is a late feeding cue.
When crying is seen, earlier
feeding cues have been
missed.
It is much more difficult to
feed an infant who is crying.

6. Recognizing Correct Latch-On
Correct latch involves three aspects:
1. Baby’s body position
Ventral surface of infant to ventral surface of mother
Baby’s lower arm around mother’s trunk or hugging the breast
Baby’s head should not be turned away from the breast, but looking
at the breast.
Never push the baby toward the breast.

7. Correct Latch-On II

8. Correct Latch-On III

9. Suckling Behavior at the
Breast
Average newborn swallow is 0.6 ml at the
breast.
Stomach size is very small. Parents and
health care providers should have realistic
expectations regarding the volume the
newborn stomach can hold at each feed.
With time, the amount of milk per suck
increases.
Changes in suck-swallow ratios relate to
availability of milk via flow

10. Suckling
The nipple should not move in and out of the
baby’s mouth during suckling.
The mother of an infant with poor suck may be
advised to hand express or pump for extra
stimulation to increase milk production.

11. Potential Problems
Associated with Incorrect
Latch-On
Babies not suckling well at discharge are less
likely to continue breastfeeding long-term.
Engorgement and poor milk supply may result
from inadequate breast emptying due to
incorrect latch-on.
Nipple damage may result from incorrect latch-
on.

12. Potential Problems II
Lengthy feedings caused by poor milk transfer
may leave mother with sense of inadequacy and
failure and/or a desire to discontinue
breastfeeding.
An association has been found between the use
of analgesia/anesthesia and delay of effective
sucking.

13. Birth Routines Associated
with Correct Latch-On
Uninterrupted skin-to-skin after birth
Breastfeeding within the first hour of life
Rooming-in 24 hours a day with minimal separation during
stay
Knowledgeable observation of feedings with guidance for
correct positioning and latch-on
Frequent nursing “on cue”