Latch-on and sucking checklist:
* You see the pink of baby's lips. This tells you that baby's lips are turned outward rather than tucked tightly inward.
* There is a tight seal between the baby's mouth and the areola. Baby has a good mouthful of breast.
* Much of the areola (at least a one-inch radius) is inside baby's mouth. As the baby is sucking, you do not see the base of your nipple, but only the outer part of your areola.
* Baby's tongue is between the lower gum and your breast. If you pull down gently on baby's lower lip, you should be able to see it. With a good latch-on, baby's tongue extends over the lower gum, forming a trough around the nipple and cushioning pressure from the jaw.
* Baby's ears are wiggling. During active sucking and swallowing the muscles in front of baby's ears move, indicating a strong and efficient suck that uses the entire lower jaw.
* You hear baby swallowing. During the first few days after birth, baby may suck 5 to 10 times before you hear a swallow. That's because colostrum comes in small amounts. You may have to listen carefully to notice swallows. After your milk has "come in," swallowing will be obvious. After the baby's initial sucking has triggered the milk ejection reflex, you should hear a swallow after every suck or two. This active sucking and swallowing should continue for five to ten minutes on each breast.
* Milk does not leak much from the corners of baby's mouth. Baby swallows the milk instead.
* You don't hear clicking sounds, which would indicate that baby does not have his tongue positioned correctly and is latched on incorrectly.
* You do not see dimpling (the middle of baby's cheeks caving in) during sucking. This would indicate that the baby has a poor seal on the breast and is breaking suction as he moves his gum and tongue. Pull baby off and try latching on again.