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Breastfeeding

Breastfeeding attachment

Time to read: 3 min.

For most mums, breastfeeding is a learned skill. Mums may therefore require breastfeeding latch tips and assistance with positioning and detaching their baby during breastfeeding. Optimal breastfeeding attachment, or latching, aims to ensure an adequate transfer of milk – and therefore sufficient drainage of the breast for continued milk supply – and prevention of nipple pain. The overall aim for good attachment is to have the whole nipple and as much areolar/breast tissue as possible in the baby's mouth.

Breastfeeding attachment methods

A traditional position for breastfeeding latch or attachment is as follows: the mum sits upright or lies on her side, with the baby positioned facing the breast. The baby's nose is positioned close to the nipple, with their neck slightly extended and their shoulders and hips in alignment. In this position, leading with their chin and with a wide mouth gape, the baby can attach to the breast.

When the baby is learning how to breastfeed and latch, the mum can hold or support the breast during the attachment process. Commonly used techniques to hold the breast include the C-hold (using one hand, four fingers are placed underneath the breast and the thumb is placed on top of the breast).

At the end of the feed, the baby may spontaneously detach, and if not the mum may break the vacuum or suction by inserting her finger gently into the corner of the baby's mouth.

Another method for latching and positioning has been described as promoting a primitive neonatal latching reflex. This involves mums lying in a semi-reclined position and allowing the baby to self-latch after being placed on the mum's abdomen. It has been suggested that this method of latching is more innate for both mum and baby than a learnt technique.

Signs of a good breastfeeding latch

If the baby is latched well, their chin should be touching the breast, with their mouth wide open and their lips turned out. The baby will begin sucking with a mixture of short and long bursts, with periods of pausing. In addition, the mum should not experience pain before, during or after feeds.

If there is an incorrect latch, the baby may make clicking noises, their lips may be curled inwards or they may frequently move their head. The mum may also experience nipple pain. Long-term problems resulting from incorrect latch could include nipple trauma and pain, low milk supply and poor weight gain in the baby.

Preparation for storage

Breast milk retains most of its immunological properties in glass or hard plastic containers that do not contain polyethylene. In addition, containers made with Bisphenol A (BPA) are no longer used for baby bottles because of its adverse effects. As there may be some concerns about glass breaking, ideal containers for milk storage are therefore food-grade hard plastic, made without BPA, with leak-proof lids. Clean, aseptic or sterile containers may also be acceptable.


Storage place

Room temperature 
16 °C to 25 °C
(60 °F to 77 °F)

Refrigerator 
4 °C (39 °F)
or colder

Freezer
-18 °C (0 °F )
or colder

Previously frozen
breast milk thawed
in the refrigerator

Safe storage

time

Up to four hours is best

Up to six hours for milk expressed under very clean conditions*

Up to three days is best

Up to five days for milk expressed under very clean conditions*

Up to six months is best

Up to nine months for milk expressed under very clean conditions*

Up to two hours at room

temperature

Up to 24 hours in the refrigerator

Do not refreeze

*Guidelines for expressing milk under very clean conditions:

Before expressing breast milk, mothers should wash their hands with soap and water or an alcohol-based hand sanitiser. The pump parts, bottles and pumping area must be clean. Breasts and nipples do not need to be washed before pumping.

Use of a medical grade refrigerator with temperature uniformity and constant temperature monitoring is recommended.

These storing and thawing breast milk guidelines are a recommendation. National and hospital internal guidelines and standards may deviate.

References

American Academy of Pediatrics and The American College of Obstetricians and Gynecologists. Breastfeeding Handbook for Physicians 2006).

Colson, S.D., Meek, J.H. & Hawdon, J.M. Optimal positions for the release of primitive neonatal reflexes stimulating breastfeeding. Early Hum Dev. 84, 441-449 (2008).

Cadwell, K. Latching-On and Suckling of the Healthy Term Neonate: Breastfeeding Assessment. J Midwifery Womens Health. 52, 638-642 (2007).

Henderson, A., Stamp, G., Pincombe, J. Postpartum positioning and attachment education for increasing breastfeeding: a randomized trial. Birth 2001;28(4):236–42.

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