When BF counsellors are trained they are taught first about attachment and positioning -this is one of the main reason Mums have problems in the beginning. It's hard to describe in written word, but this is the info they give to Mums with pain during or after a breastfeed.

For latching on, follow this (adapted from BfN handout) - read it through first, then get someone to go through point by point and try it out, checking and rechecking:

Your posture:
back supported, shoulders over hips, lap flat or knees slightly raised (use footstool or yellow pages etc), use opposite hand / arm to the breast you will be feeding from to support baby's neck, shoulders etc. So, are you sitting comfortably? Make sure you are sitting or lying comfortably, with plenty of cushions etc if required to prop your back or support baby's head, a drink, a snack and the remote controls! The more relaxed you are, the easier it is for your milk to be released.

Baby's position:
spine in line (head not dipped, drooping curled or turned), nose naval and knees all facing same direction, facing and at the same height as mother's nipple, supported at that level as appropriate (you might need rolled up towel or pillow here as well as for you in first section), hands free or one arm held down and under by mother (with her free hand, same side as breast) or wrapped by sides. In many cases where there is pain, the baby is also being held too high up, so try to relax and lower baby so your arm is resting on your lap, rather than trying to raise things up with pillows! It's best to use the same arm as breast to get baby positioned well at first - so if you are feeding on the L breast then hold baby with palm of L hand on baby's shoulder blades and length of L arm running down baby's body. This is known as the 'cross-cradle' hold.

Approach:
baby supported by hand and arm not just hand, baby close to mother - wrapped around and legs tucked under arm if nec (wear baby 'like a belt', under arm 'like bagpipes'), nothing pushing baby's head or restricting movement forwards or back, start with baby facing cleavage, move baby sideways from cleavage, towards nipple. Stop when baby's nose is in front of nipple. You may have to pull baby's feet further round your body to do this if using the traditional 'cradle hold', thereby moving baby more central. Hold baby round the shoulders but support the head – if you try to push baby's head to you, they will push back against your hand.

Attachment:
wait for wide open mouth (baby should have to tilt head back): tongue to be down and just appearing above lower gum margin. Move baby in towards body, not mouth towards nipple, so that lower jaw approaches first, and top lip last. The top lip should be latching on just over the nipple, with the lower lip as far away and taking in as much of the darker area (the areola) as possible - this is called an asymmetric latch. Make sure that the baby's chin is well into the breast, but the nose is free. There should be no pain or discomfort, though if you have had damage you may be able to feel it - but not as PAIN.

Suckling should follow the pattern (which may be repeated during the feed) of rapid shallow suckling then deeper, steadier suckling, occasional set of suckling with pauses / swallows, baby coming off breast - and at this point check that nipple shape is unchanged though nipple may be enhanced / bigger of course, but there should be no 'pointiness', or white patches at the end.

Signs baby is positioned correctly:
* when baby latches on, if you can see a bit of the areola at the top of their mouth that is fine, as long as all or most of the lower areola is in their mouth;
* baby's ears may move slightly as they massage the breast and swallow milk;
* there's no clicking noise;
* baby is swallowing deeply: if they stops swallowing they may be asleep (in which case tickle the feet or blow on the face) but if they still swallows but doesn't suckle now and then, its because they have massaged the breast enough to stimulate a milk 'let down' and the milk is released so baby needn't suckle for a little while!