Breastfeeding the Latch Scoring System

Breastfeeding The LATCH scoring system and prediction of breastfeeding duration. (Original Research). Savitri P. Kumar, Roberta Mooney, Linda J. Wieser and Suzanne Havstad. Journal of Human Lactation 22.4 (Nov 2006): p391(7). Due to the negative risk factors associated with not breastfeeding babies, including flat/inverted nipples, greater use of non-breast-milk fluids, pacifier use, prolonged second stage of labor, and delayed onset of lactation. hunger, slow weight gain, failure to thrive, starvation, and even death, the U.S.

Healthy People 2010 have set the goals to increase the breastfeeding initiation rate to 75%, the six -- month breastfeeding rate to 50%, and the 12-month rate to 25%. In the past, these goals have been attempted with varying success rates. This study tested how effective educating new mothers about latching in the time spent after birth in the hospital (from 48 to 96 hours depending on natural or caesarian birth).

Will healthcare workers know how well a mother will or not be able to breastfeed based on the degree of the baby being able to suck on the breast or LATCH. The LATCH Scoring System was designed in 1994 to assist the healthcare provider in evaluating the breastfeeding techniques of mother/infant dyads. This tool provides for systematic documentation and standardized communication. In 1997, Adams and Hewell established reliability of the LATCH tool for professional assessment of breastfeeding, by using direct observation rather than videotape assessment tools.

This prospective study was conducted from January to October 2003 at an urban hospital with a delivery rate of ~2500/year. When the expectant mothers arrived at the labor, delivery, and recovery suite, they were asked whether they planned to breastfeed. Duration of anticipated breastfeeding was not asked. After birth, the mother and baby stayed for two hours in the delivery suite following a vaginal delivery, or in the postoperative recovery room following a cesarean delivery. During this period, breastfeeding and skin-to-skin contact were attempted whenever possible.

Two hundred fifty (250) were enrolled, resulting in a 79% agreement to participate rate. A board-certified lactation consultant trained all nurses in the use of the LATCH tool and assessed their competency with this tool. The LATCH scoring system was incorporated into the newborn flow sheet for easy documentation. LATCH scoring was performed at least once per eight-hour shift during the mother's hospital stay. Data were collected on the following variables: maternal age, gravidity, parity, ethnicity, level of education, mode of delivery, type of anesthesia, and LATCH scores.

For the newborn, birth weight, gestational age, and 1-minute and 5-minute Apgar scores were recorded. Post-discharge phone calls were made on day four and at week six. Each participant was asked if she was still breastfeeding at the time of the phone call. For data analysis, exclusive and partial were combined as "breastfeeding," whereas token and none were combined as "not breastfeeding." Telephone interviews could be conducted for 182 (73%) participants on day four and 188 (76%) at six weeks.

The results showed that LATCH scores were higher among women breastfeeding than those who had weaned. Using receiver operating characteristic curves, a score of 9 or above at 16 to 24 hours was the most discriminate of the 5 time periods examined. In addition, mothers who met this criterion were 1.7 times more likely to be breastfeeding at six weeks than women with lower scores. The authors concluded that the LATCH assessment tool is a modest predictor of breastfeeding duration.

In their discussion, the researchers stated that the LATCH scoring system is a simple and useful tool, capable of predicting breastfeeding duration as early as the first 24 hours of life. Low LATCH scores indicate the need for active intervention, support, and post-discharge follow-up. Frequent evaluations, starting in the delivery room and continuing until discharge, are critical. In the present health care climate, where breastfeeding is being strongly promoted but early hospital discharge is the norm, the utility of this tool is.