0

1

2

L

Latch

• Too sleepy or reluctant
• No Latch achieved

• Repeated attempts
• Hold nipple in mouth
• Stimulate to suck

• Grasps breast
• Tongue down
• Lips flanged
• Rhythmic sucking

A

Audible Swallowing

• None

• A few with stimulation

• Spontaneous and intermittent <24 hours old
• Spontaneous and intermittent >24 hours old

T

Type of Nipple

• Engorged
• Cracked, bleeding, large blisters or bruises
• Severe discomfort

• Filling
• Reddened/small blisters or bruises
• Mild/moderate discomfort

• Soft
• Tender

C

Comfort

• Inverted

• Flat

• Everted (after stimulation

H

Hold (positioning)

• Baby requires wrapping
• Pillow required for support
• Mother learning skills

• Minimal support required
• Mother gaining confidence

• No assist from staff
• Mother able to position/hold infant
• Mother and baby relaxed
• Mother competent