Latch and positioning: getting breastfeeding right

You are sitting in a hospital chair at 2 a.m., your newborn is on your breast, a midwife is repositioning your arm for the fourth time, and you are not entirely sure any of this is working. Latch and positioning are skills. They take practice, and the first week is almost always harder than the books suggest.

The good news: once you and your baby have figured it out together, a well-latched feed is comfortable, efficient, and takes no conscious effort. Getting there is the hard part.

What "latch" actually means

The latch is the way your baby attaches to your breast. A shallow latch — where the baby grabs mainly the nipple — compresses the nipple between their hard palate and tongue and causes pain. It also squeezes the milk ducts inefficiently, so the baby works harder for less milk.

A deep latch means the baby has taken a wide mouthful of breast tissue, not just the nipple. The nipple sits far back in their mouth, near the junction of the soft and hard palate, where it is not compressed during sucking. This is comfortable for you and effective for the baby.

Signs of a good latch

• Mouth wide open — at least 100–140 degrees¹
• More areola visible above the top lip than below
• Lips flanged (turned) outward, not tucked in
• Chin pressed into the breast, nose clear or just touching
• Cheeks round and full, not sucked in
• You can hear swallowing (a soft "ca" or "kuh" sound), especially after let-down
• No nipple pain beyond the first few seconds of attachment

A small amount of discomfort at the very first latch-on of a feed can be normal in the early weeks as the nipple adjusts. Pain that lasts the whole feed, leaves the nipple misshapen (flattened, lipstick-shaped, or blanched), or causes cracking and bleeding is not normal and needs attention.²

Signs of a poor latch

• Nipple pain throughout the feed
• Clicking or smacking sounds (suggests the tongue is losing suction)
• Baby's cheeks sucked in
• Baby feeding very frequently but seeming unsatisfied
• Nipple looks pinched, flat, or white after feeds

How to break the latch safely

Never pull the baby off without breaking the suction first — this drags the nipple and causes damage. Slide a clean finger into the corner of the baby's mouth, between the gums, to release the seal, then ease the baby back.

If the latch feels wrong from the first moment, break it and try again. It takes longer in the short term and saves pain in the long term.

Positioning options

There is no single correct position. The right one is the one where the baby is well latched and you are not uncomfortable. Most people rotate through a few across the day.

Cradle hold

The baby's head rests in the crook of your arm on the same side as the feeding breast. Their body lies across your lap, tummy to tummy. Good for older babies who have more head control, but can make it hard to guide a newborn's head.

Cross-cradle hold

The baby lies across your lap as in cradle, but your opposite arm supports their head. This frees your breast-side hand to shape the breast and guide the latch. Most lactation consultants start here with newborns.

Football (underarm) hold

The baby is tucked under your arm like a rugby ball, their legs behind you, your hand supporting their head. Useful after a caesarean section (no weight on the incision), for large breasts, or with a premature baby. Also helpful for twins feeding simultaneously.

Laid-back (biological nurturing) position

You recline at roughly 45 degrees, and the baby lies tummy-down on your chest. Gravity holds them against you. This position activates the baby's feeding reflexes and can be particularly helpful if they are struggling to latch, or if your let-down is fast and they are choking on the flow. Many people find it the most comfortable overnight position when propped against pillows.

Side-lying

Both you and the baby lie on your sides, facing each other. The baby feeds from the lower breast. Useful at night and during recovery from a difficult birth. Take care not to fall asleep if it is not a safe sleep environment.

Shaping the breast

If your breast is large or very full, you may need to shape it to give the baby something to latch onto. Use a "C-hold" or "U-hold" — thumb on one side, fingers on the other — keeping your fingers well behind the areola so you are not inadvertently pushing them toward the front. Compress gently to make the breast match the orientation of the baby's mouth.

When latch pain needs professional help

Some tenderness in the first week can be normal as your nipples adapt. These situations warrant same-day contact with a midwife, health visitor, or IBCLC (International Board Certified Lactation Consultant):

• Pain throughout every feed by day 5–7 with no improvement
• Cracked, bleeding, or blistered nipples
• Nipple that looks white, blue, or blanched after a feed (may indicate vasospasm)
• You suspect thrush (burning nipple pain, pink or shiny skin, or shooting pain between feeds)
• Baby is showing signs of not getting enough milk — fewer wet nappies, poor weight gain, persistent unsettled behaviour

The AAP recommends that all breastfeeding mothers receive support from a trained professional in the immediate postpartum period.¹ If hospital support felt rushed, community midwives and lactation consultants are available after discharge.

When to call your pediatrician

Same day:

• Pain throughout every feed past day 7 with no improvement
• Cracked or bleeding nipples not healing
• Nipple blanching (going white or blue) after feeds
• Baby showing clicking sounds during feeds and poor weight gain — possible tongue tie

Routine appointment:

• Persistent latch concerns beyond two weeks that are not resolving with positioning changes
• Nipple pain you cannot trace to a cause

Go to A&E or call 999:

• Signs of nipple infection: spreading redness, warmth, swelling, or pus
• Baby lethargic, grey, or not waking for feeds

Tracking feeds in PooPeeMilk

Logging each feed — which breast, how long, what time — gives you a concrete record to share with a midwife or lactation consultant. PooPeeMilk makes it easy to spot if feeds are consistently very short (possibly from breaking off due to pain) or if one breast is being avoided.

← Back to the complete guide: Breastfeeding: the complete guide

Also in this cluster: Is my baby getting enough milk? · Low milk supply · Cluster feeding

Sources

• AAP. "Breastfeeding and the Use of Human Milk." Pediatrics 150(1), 2022. https://publications.aap.org/pediatrics/article/150/1/e2022057988/188347/Breastfeeding-and-the-Use-of-Human-Milk
• NHS. "Sore or cracked nipples when breastfeeding." NHS.uk. https://www.nhs.uk/conditions/baby/breastfeeding-and-bottle-feeding/breastfeeding-problems/sore-or-cracked-nipples/