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How can I get my newborn to latch on?
Q: My daughter is a week old and I’m having a hard time getting her to latch on while breastfeeding. What can I do to get her to latch on and stay on?
Diana Brooklyn
A: Diana, it’s great that you’re giving your baby the advantages of breastfeeding—the best nutrition, protection from illnesses and close physical contact with you. Even though breastfeeding is a natural human instinct, that doesn’t mean we magically know how to do it from the start. It can take several weeks for both mothers and babies to learn the basics. You often need to experiment with different positions so you can figure out how to best hold your baby and make sure your breast and nipple are in her mouth properly, and your baby can learn how to latch on and suck well.

There are different positions for breastfeeding, known as the cradle hold, cross cradle hold, football hold and side lying positions. You can see photos and detailed descriptions of these at www.laleche.org/FAQ/positioning.html. Try each of the positions and figure out which works best for you and your baby. Some mothers prefer one position; other mothers alternate among the different positions.

Here are a few tips for latching on:
  • Make sure your baby’s head is comfortably positioned at your breast. Bring your baby’s head up to your breast by supporting the back of her head, neck and shoulders with your hand and arm. Use pillows under your arm to help lift her up high enough. Make sure her face is directly facing your breast and her body facing your body. Her neck should be straight forward, not twisted, which is the best position for her to latch on, suck and swallow.
  • With your free hand, hold your breast with your thumb on top and four fingers below the breast, back away from the areola (the dark part around the nipple). Tickle your baby’s lower lip with your nipple. This will get her to open her mouth. If her mouth is still closed, tickle the lip with the nipple again while you gently press down on her chin with your forefinger.
  • When her mouth is open very wide, as if she’s yawning, gently squeeze your breast with your thumb and fingers to make your nipple and areola stand out more. Then quickly bring her mouth chin-first around your nipple and areola. Make sure your nipple is deep in her mouth with her lips almost to the outer edge of your areola—this is very important because her sucking needs to press on the milk ducts underneath the areola. Her chin should be touching your breast and her nose should be just touching or nearly touching your breast.
  • Look for signs that your baby is latched on and sucking well: her jaws should move up and down and she should swallow every few sucks. If you feel discomfort or pain, it may mean that your baby is not latched on correctly. Gently detach your baby by sliding a finger into her mouth to break the suction. Don’t pull her off directly since this can hurt. Then try the latch-on again from the start.
Sometimes newborns latch on and start sucking well but fall asleep quickly. If your baby starts falling asleep before she’s finished feeding stimulate her sucking by gently tugging at your nipple or stroking her around the mouth. Or wake her up by playing with her feet or partially undressing her.

It can feel frustrating in the first few weeks as you’re learning to breastfeed. But trust that you are doing something good for your baby and yourself. Try to have patience and ask for help right away. Some breastfeeding difficulties are caused by problems (e.g., improper positioning, flat or inverted nipples, engorged breasts, cracked or sore nipples or “tongue-tied” baby), which can be helped. Get in-person guidance. See your pediatrician, nurse specialist, lactation consultant or La Leche League volunteer (visit www.laleche.org to find local contacts in the United States and many other countries).
Karen Sokal-Gutierrez M.D., M.P.H. Pediatrician