A baby needs to be attached properly in order to suckle effectively. This is where the problem lies especially for inexperienced mothers. When not properly attached there are quite a number of problems that can arise. Sore nipples to the mother, inadequate nutrition for the baby, frequent demand for food by a frustrated baby and undue emotional stress from an equally frustrated mother.

So what is the right way for the baby to attach to the breast so as to suckle effectively?

The points to notice are:

  • Much of the areola (the black part around the nipple) and the tissues underneath it, including the larger ducts, are in the baby’s mouth;
  • The breast is stretched out to form a long ‘teat’, but the nipple only forms about one-third of the ‘teat’;
  • The baby’s tongue is forward over the lower gums, beneath the milk ducts (the baby’s tongue is in fact cupped around the sides of the ‘teat’, but a drawing cannot show this);
  • The baby is suckling from the breast, not from the nipple.

The four signs of proper attachment are:

  • More of the areola is visible above the baby’s top lip than below the lower lip;
  • The baby’s mouth is wide open;
  • The baby’s lower lip is curled outwards;
  • The baby’s chin is touching or almost touching the breast.

Poor attachment

When the baby is poorly attached, only the nipple is in the baby’s mouth, not the underlying breast tissue or ducts. The baby’s tongue is back inside his or her mouth, and cannot reach the ducts to press on them. Suckling with poor attachment may be uncomfortable or painful for the mother and may damage the skin of the nipple and areola, causing sore nipples and fissures (or “cracks”). Poor attachment is the common cause of sore nipples and may result in inefficient removal of milk and apparent low supply.
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