BE03: Positioning and Latch of the Baby to the Breast Workbook Page 1

BE03: Positioning and Latch of the Baby to the Breast

Workbook
Activity 3.1
Practice sketching the breast, detailing the milk ducts and the areola until you can do a reasonable representation in a
hurry. When you are proficient this diagram can be used to easily describe to a mother why the baby needs to have so
much breast tissue in the mouth, and about where she will need to get his bottom gums.
Alternatively, do a good drawing and have it laminated to keep in your pocket or on your desk for frequent referral when
teaching latching.

Activity 3.2
Find a diagram of the bones of the cranium. Print it out and label the bones.
List the facial bones and what they form

What is another name for the mandible? What is the joint at which it joins the cranium?

Activity 3.3
List cranial nerve number, name and function involved in infant feeding. Place (M) for motor/movement and (S) for
sensory/feeling next to each one.
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Activity 3.4
List the 5 facial muscles involved in suckling. Note their function beside each.

List 6 important features of the oral cavity

Activity 3.5
Read the article you accessed, noting the important points and considering how you could apply this information in your
practice.

Activity 3.6
Using the knowledge you have gained about optimal breastfeeding environment and infant and maternal behavior, fill in
the physiological and neurological reasons for each of the mother and baby benefits.
BABY How does this happen?
thermoregulation
increased oxygenation
regulates heart rate
reduced crying
lowered cortisol
stabilises blood glucose
ability to self-latch
co-ordinated suckling
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MOTHER How does this happen?

increased oxytocin
regulates temperature
improves milk production
stimulates right brain activity
easy bonding with baby
less breastfeeding problems
increased confidence

Activity 3.7
Describe each of the following:
a stable base

proximal stability

midline symmetry

Use one sentence to describe how each of the above requirements can be provided in these positions:
mother semi-reclined immediately post-birth

mother co-sleeping and breastfeeding

mother breastfeeding twins together

mother using the cradle hold

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Activity 3.8
After successfully arranging the sequence of actions an infant takes prior to latching in the quiz, transcribe that
sequence here.

Activity 3.9
Describe the physiology of the milk ejection reflex.

Activity 3.10
Write a summary of 4 things that you have learned about oxytocin.

Write a summary of 8 things you have learned about milk ejection and the MER.
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Activity 3.11
Ask permission from two mothers to closely observe them feeding their babies. One mother should be breastfeeding,
while the other mother should be bottle feeding. Both infants should be at least a week old and competent feeders.
Be aware of and describe the general interaction between mother and baby eg. talking, smiling, eye contact, cuddling,
attitude to infant/mother, degree of relaxation, etc.

Describe the feeding cues each baby exhibited. What caused the mother to start feeding her baby?

Compare and describe the attitude of the babies during the feed.

Note the differences in jaw action and the movement of the baby's cheeks.

Can you see the tip of the babies' tongues while feeding? With the mothers' permission and without disturbing the
feeding infant, gently move the bottom lip downwards to look for it. Describe what you observe.

• Estimate where the bottle nipple is in the baby's mouth by observing where his lips are on the teat when it is taken
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out of his mouth.

• Recall from your lectures and describe where the tip of the mother's nipple is in the other baby's mouth.
• Using the knowledge you have gained from your readings, describe what will be happening in each infant's mouth.

Watch the suck patterns in both babies initially, as the feed progresses, then again near the end of the feed. Record
your observations.

Why was each feed terminated and how long did each feed take?

What behaviour did the babies exhibit after the end of the feeding?
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Comment on any other similarities and differences you noted.

Activity 3.12
Refer to the second photograph in your notes. Draw a sketch of this nipple damage. This damage has occurred as a
result of poor latch. With your knowledge of breast anatomy, infant oral anatomy and correct latch sequence, describe
the likely immediate and longer term outcomes of this type of nipple damage for the mother and baby.

Activity 3.13
Apply your knowledge of normal breast anatomy and the physics of infant suck to the potential problems of inverted
nipples. What physiological functions of the breast may be hindered by inverted nipples?

How will the infant's suck change, or be challenged, by inverted nipples?

Draw a sketch of how it might look on an ultrasound of the baby breastfeeding.

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Activity 3.14
Using the headings suggested in this topic list the 5-step consultative process, explaining each step in your own words.

Activity 3.15
Choose 3 mother and baby dyads. Ensure that you are able to make a full assessment of the mothers' breasts, the
babies' general condition and an oral assessment of each of the babies. Write down your findings under the headings
listed in the course.
Observe a breastfeed and offer relevant suggestions - no matter how small or large.
Obtain the mothers' permission to follow up (even if that is not usually your role where you work) in 1-2 weeks and note
the relationship between your original observations and the outcome of the breastfeeding relationship.

Activity 3.16
Under the headings below, describe the normal features and variations or abnormalities you may observe during a
breastfeeding assessment. Apply the knowledge you now have of anatomy, physiology and neurobehavior in your
considerations.
At this stage of your studies you may not be able to complete the 'variations/abnormal'. Keep this workbook activity so
that you can add to it as you study BreastEd courses BE04, BE07 and BE09.
Normal Variation / Abnormal
Breasts
Nipples
Baby's muscle tone
Baby's head and neck
Baby's mouth
Baby's reflexes
Suck/swallow pattern
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Activity 3.17
In order of importance, list the priorities for treating common breastfeeding problems caused by poor latch.