Courtesy Dr. William Sears & Martha Sears, RN, IBCLC
with La Leche League International, including the Manual Expression of Breastmilk: Marmet Technique

Latching the baby on correctly is the key to a pleasant, rewarding breastfeeding experience. Nursing behaviour patterns are established early. Once set, bad habits are difficult to correct. Make sure you and your baby get off to a good start. A variety of reading materials and videos are helpful, but there is nothing like hands-on assistance from an experienced health care provider. Do not hesitate to ask for help the first few times.

Step 1
For most women, sitting up in bed or in a comfortable chair is easiest for breastfeeding. Make sure you are relaxed before you put the baby to breast. Use pillows on your lap, under your arms and behind your back. Putting your feet on a footstool to raise your knees slightly above your hips will eliminate back strain and put your body at the right angle.

Make sure your baby is comfortable and feels secure and supported. Cradle the baby in your arm at the level of your breast with his head and shoulders supported by your forearm just below your elbow, with your other hand holding his bottom. The baby should be turned toward you, chest to chest, his head and trunk in a straight line, so that he does not have to strain or turn his head to attach to the breast. Tuck the baby's lower arm into the pocket between the two of you; if necessary, hold his upper arm down gently with the thumb of your supporting hand. Be careful not to tilt the baby's head down, as it will be difficult for him to swallow in that position. A very slight extension of the baby's head, with his chin touching your breast, will help keep his nose clear without your having to press on your breast tissue.

Positioning Styles

Proper positioning is important for prevention of sore nipples.
The proper way to hold the baby is chest-to-chest, at the level of the breast. Baby's head should be in the crook of your arm and your hand should hold baby's buttocks.
The football hold is a good position for latch-on problems, or for premature or Caesarean birth babies.
The lying down position is especially useful after a Caesarean birth.

Two alternative positions are the clutch (football) hold, and lying down. The clutch is especially helpful if you are having difficulty getting the baby attached to the breast or if you have had a Caesarean birth.

Step 2
Hold your breast with your fingers underneath and thumb on top, making sure all of your fingers are placed well away from the areola. It is sometimes helpful if you roll your nipple between your fingers for a couple of seconds to help it become more erect. Then manually express a couple of drops of Colostrum to entice the baby to take the breast. A woman with large breasts may find it comfortable to help support the weight with a rolled washcloth or diaper under the breast.

Step 3

The key to successful latch-on and preventing nipple soreness is to teach your baby to take a large portion of the areola into his mouth.

Latching the baby on.

Tickle baby's lower lip with your nipple until he or she opens wide.

Once baby's mouth is opened wide, quickly pull baby onto your breast.

Baby should have as much areola (the dark area around nipple) in his or her mouth as possible, not just the nipple.

Your milk collects in the pockets located beneath the areola. To empty these reservoirs effectively, the baby's mouth must be positioned over them. If the baby sucks only on the nipple, little milk will be drawn out, and you will become quite sore. If your baby doesn't latch-on properly right away, continue to encourage him to open his mouth wide and then pull him close to you again. Do not be afraid to repeat these steps several times until your baby gets the idea.

If you feel any pain after your baby starts sucking rhythmically, stop, and break the suction by inserting your finger into the corner of his mouth between the gums, then try again. Latch-on discomfort is common in the first week or two, while the baby is learning correct positioning and sucking. Take a deep breath, relax, and enjoy breastfeeding!. Grab a little catnap while you are at it !