L-A-T-C-H-E-S *
Breastfeeding Assessment Tool,
for the First 4 weeks

Designed for moms to use "at home"-- Not recommended for use in the first 48 hours



 
 
 

SCORE  VALUE
1
2
3
A B C D E F
L
Latch
Too sleepy or reluctant

No latch achieved

Repeated attempts.

Holds nipple in mouth.

Stimulated to suck.

Grasps breast. 
Tongue down. 
Lips flanged
Rhythmic suckling
           

Audible Swallowing
None
A few with stimulation
<  24 hours old
spontaneous and intermittent

>24 hours old
spontaneous and intermittent

           
T
Type of Nipple
Inverted
Flat
Everted after stimulation.
           
Shape of nipple
(after feeding)
Pinched, creases or blanched white
Not round misshapen or change in color
Round normal color
           
C
Comfort Level
                 
- - - Breast 
Breast engorged, rock hard or large lumps
Filling- breast becoming firmer
Small lumps (1 cm) from milk glands
Breasts soft
heavy
           
- - - Nipple
Nipples cracked,
Bleeding, Large blister(s) and/ or Bruise(s)
Nipples reddened small blister(s) and/or bruise(s)
Nipples intact
           
- - - General feeding
Severe discomfort
Mild/Moderate Discomfort
Nipples Slightly tender
           
H
Hold
Positioning
Full assist (second person latches baby on and holds infant at breast)
Minimal assist (Needs help with pillows positioning latch-on)
No Assistance (Mother able to position and hold infant)
           
E
Elimination
                 
- - - Urine 
 Diaper dry or dark urine
Diaper damp. 
Urine light yellow.
Diaper wet. 
Urine light yellow or clear.
           
- - - Stool

Size

No stool or thick dry stool.
Small stool (smaller than quarter sized)
Stool (Larger than quarter sized)
           
 - - - - Stool

Color

N/A
Less than 3 days: Dark Black
3 to 5 days: tan or brown
> 5 days: yellow and liquid
Less than 3 days: Dark Black Green

3 to 5 days: tan or brown

> 5 days: yellow and liquid

           
S
Satiation
Crying, fussy, rooting after feeding, or didn't actively nurse 10 minutes
After 5 days of age takes longer than 45 to 60 min to feed
Awake, rooting after feeding.
Few swallows heard or needed to be stimulated to stay awake for feeding
Awake for feeding then relaxes and falls asleep at breast after 10 to 15 minutes of active nursing with frequent swallows.
           
Score this feeding            

 
 

Score Key

*Adapted from: Jensen, Deborah. Shiela Wallace and Patricia Kelly.  "LATCH: A Breastfeeding Charting System and Documentation Tool."  JOGNN (1994) 23:27-32.

Copyright 1999 Marie Davis, RN, IBCLC 

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Last reviewed: Saturday, September 11, 2010