Objective To evaluate whether latch on day 2 of life is affected by nipple length or infant mandibular proportions, maternal age, parity, previous breast feeding experience, and early placement at the breast.

Methods Prospective data on 204 lactating mothers of a healthy term singleton infant (normal pregnancy, labor and delivery) on day 2 after delivery. Exclusion: preterm and postterm infants, maternal treatment with antidepressant, anticonvulsants, or magnesium sulfate, previous breast surgery, opiates for analgesia; infants with major congenital malformations, or neonatal complications. Anthropometrics included: inter-nipple distance, nipple length, and horizontal and vertical diameters; cup size (best fit to a lactation bras); infant goniomaxillary length/gonio-mandibular length (GMxL/GMnL) ratio and intercommissural distance. A latch score was performed after measurements. Data collected included gravidity, parity, gestational age, previous breast feeding experience, and early breast feeding (<2 hours after delivery). Backward stepwise regression analysis was used to study the combined effect of several independent variables upon latch score.

Results In regression analysis taking latch score as the dependent variable, and gestational age, breast feeding experience, cup size, nipple length, early placement at the breast, intercommissural distance, and GMxL/GMnL ratio as independent variables, the variables that remained significant in the final analysis were nipple length (p<0.001), breast feeding experience (p<0.001), and early placement at the breast (p<0.05), which contributed respectively 16%, 7%, and 3% to the general variance of the latch score.

Conclusions Relatively long nipple, breast feeding experience, and early placement at the breast confer a latching advantage at breast feeding initiation.