Good attachment starts with the parent, not the baby: relaxed shoulders, well supported, not leaning forward. Support the baby's weight with a cushion, aim the nipple up towards the nose rather than straight at it, catch early feeding cues so you aren't rushing, and try laid-back feeding. Pain or nipple trauma is the clearest sign that something needs changing.
Here are five things I look for when doing a feeding assessment, and the changes that make the biggest difference.
1. Sit comfortably
What I'm looking for when I do a feeding assessment is that the breastfeeding parent is not hunching their shoulders and not leaning forward. If their body is scrunched up and uncomfortable, they end up carrying all that tension. What we want is for the parent to feel relaxed, with their shoulders dropped.
2. Use a cushion
When you're holding baby in a cradle or cross-cradle position, support the bottom end of the baby with a cushion or pillow. This helps the parent hold and support the baby's neck and shoulders, and keep baby pressed firmly against the body, without having to support their whole weight.
This is particularly good for babies who were heavy at birth, or older babies who may be starting to move away from the breast because of their weight. It's also great for parents who simply find it difficult to hold a baby for long periods.
3. Nipple to nose — pointing up, not straight at it
We often hear "nipple to nose" when supporting good position and attachment, but what that actually means is putting the nipple right at the tip of the baby's nose — coming up from underneath, as if pointing up the nose, not just pointing straight at it.
This matters because as the baby tilts their head back, the nipple then goes much further back into the roof of the mouth. That makes feeding more comfortable and avoids pain or nipple trauma.
4. Be patient
Breastfeeding your baby is a new experience, even if you've done it before. It's a new baby, and your body may have changed during pregnancy. It takes time to learn together.
I often see parents rushing to get their baby onto the breast — usually because they're anxious the baby is hungry and don't want them to wait. This often means the baby's mouth is not as wide as it could be.
If you take a little extra time, and catch their early feeding cues, you have time to work out how to get them into that optimal position comfortably. If we try to latch a baby when they're displaying frantic late cues and are really, really hungry, they won't have as much patience as you do.
5. Laid-back feeding
This is a great position at all ages and stages, but I find it isn't often suggested in the early days — partly because it's tricky to do sitting up straight in a chair.
I recommend that parents move to the front of their chair or sofa, so there's more space to lean back. Place the baby in the middle of the breasts so their body is supported on the parent's body, and let gravity do its job. Babies will tend to find their own way to the breast — we just need to support them in place and lean back so it's comfortable.
Common questions
How do I know if attachment is wrong?
Pain, or any nipple damage or trauma, is the clearest signal. Cheeks sucking in at the sides and lots of noise during a feed are also signs the latch isn't as deep as it could be.
Should the nipple point at the nose or the mouth?
At the nose, coming up from underneath. That way, when the baby tilts their head back, the nipple reaches far back into the roof of the mouth.
What is laid-back breastfeeding?
A reclined position where the parent leans back and the baby lies on their body, supported by gravity. It works at all ages and stages and is often more comfortable than sitting upright.
About the author
Charlotte Treitl is an International Board Certified Lactation Consultant and a Babyem tutor, supporting families with infant feeding and teaching practitioners how to assess and improve feeding.
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