The LATCH Scoring System

LATCH helps medical professionals with the assessment of breastfeeding and subsequent evaluations can be used for charting progress. The acronym LATCH denotes each of the key areas of breastfeeding, as identified in the 1994 study by Jensen et al:

L for infant’s ability to latch onto the breast;

A for the presence of audible swallowing of the infant at the breast;

T for mother’s nipple type;

C for mother’s sense of comfort;

H for holding, e.g. breastfeeding position used by the month;

The composite score ranges from 0 to 10 and must be obtained through the assessment of the observer at mother’s bedside for all 5 key areas of breastfeeding. It can vary from feeding to feeding and tends to be higher in the case of mothers with previous breastfeeding experience.

The score has been praised for using a holistic approach that incorporates both mother and infant contribution.

The original study also provides a set of standardized questions that can help the caregiver with a systematic approach to gathering information:

“L” (latch-on): How easily did your infant grasp your breast? Did it take several attempts?

“A” (audible swallowing): Did you hear your infant swallow? How frequently did you hear it?

“T” (type of nipple): Do your nipples stand out or do they flatten easily?

“C” (comfort): Are your nipples tender? Are your breasts becoming full and heavy?

“H” (help/holding): Did someone help you put the infant to breast? Would you like help with the next feeding?

LATCH scores identify areas of needed intervention and help with their reporting in a straightforward mode. If required, the medical professionals can them assign priorities for said intervention.

The score has yet to be tested in longitudinal studies, to evaluate the hypothesis of correlation between in-hospital scores and actual or perceived breastfeeding success.

The LATCH breastfeeding assessment has been identified as a relevant predictor for the duration of breastfeeding followed caesarean and vaginal delivery.

References

Original reference

Jensen D, Wallace S, Kelsay P. LATCH: a breastfeeding charting system and documentation tool. J Obstet Gynecol Neonatal Nurs. 1994 Jan;23(1):27-32.

Other references

Cakmak H, Kuguoglu S. Comparison of the breastfeeding patterns of mothers who delivered their babies per vagina and via cesarean section: an observational study using the LATCH breastfeeding charting system. Int J Nurs Stud. 2007 Sep;44(7):1128-37. Epub 2006 Jul 11.

Riordan J, Bibb D, Miller M, Rawlins T. Predicting breastfeeding duration using the LATCH breastfeeding assessment tool. J Hum Lact. 2001 Feb;17(1):20-3.