With the breast in a natural position and  baby in a cross-cradle hold and
mother shaping the breast with her free hand in a U hold, I've been telling
mothers that the nipple should point to the upper lip, tickle lightly - like
a feather - over and over while she tells the baby to open and waits
patiently until baby opens wide, then she lets the breast rest on the bottom
lip and tongue so the weight causes an even wider gape, then the hand on the
baby's shoulder girdle presses firmly, so the baby's chin plunges deeply
into the breast.  This process places the nipple deep in the mouth.  I
explain that these are coordinated movements that she will need to practice
over and over again until she and baby get it right. I tell her not to be
afraid to break suction as many times as necessary  and start over.    In
the beginning, I say, it seems like mom is doing all the work but after baby
experiences a few  excellent latches consistently the baby seems to prefer
the better latch and begins to help.

Some LCs put on lipstick and use a balloon  to show the centered latch, then
the off-centered. This clearly shows a larger lipstick ring after the
off-centered presentation.  I have sometimes made a fist and used the
knuckle of my index finger to represent the nipple to demonstrate this.

Hope this helps,

Anne Grider, IBCLC, LLL
Marietta, GA

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