# LATCH Score for the Identification and Correction of Breastfeeding Problems: A Prospective Observational Study

## TL;DR

This study shows that using the LATCH score system with counseling and hands-on support improves breastfeeding success in the early postnatal period.

## Contribution

The study demonstrates the effectiveness of LATCH score-guided interventions in improving breastfeeding outcomes in primiparous mothers.

## Key findings

- Poor LATCH scores decreased from 47.6% to 11.4% after 24-48 hours of support.
- LATCH score improvement was significantly linked to antenatal status, mode of delivery, and initial scores.
- LATCH assessment at 24-48 hours had high sensitivity and specificity for predicting breastfeeding improvement.

## Abstract

Background

Breastfeeding is fundamental to infant survival, growth, and development, offering optimal nutrition and immunological protection while conferring long-term health benefits to both infants and mothers. Despite strong evidence supporting exclusive breastfeeding, early breastfeeding difficulties related to improper latch, positioning, and maternal discomfort remain common, particularly in the immediate postnatal period. Early identification and correction of these problems are essential to ensure successful breastfeeding. This study aimed to assess breastfeeding effectiveness using the LATCH (Latch, Audible swallowing, Type of nipple, Comfort, Hold) scoring system in the early postnatal period and to evaluate the impact of LATCH score-guided counseling and hands-on lactation support on breastfeeding outcomes.

Methodology

This prospective observational study was conducted among 229 primiparous mother-infant dyads delivering at term in a tertiary care hospital in Karnataka, India. Breastfeeding effectiveness was assessed using the LATCH scoring system at 1-2 hours postpartum and reassessed at 24-48 hours following structured lactation counseling and hands-on support. Data were analyzed using SPSS version 26.0 (IBM Corp., Armonk, NY, USA), and associations were evaluated using appropriate statistical tests, with p-values <0.05 considered statistically significant.

Results

Most mothers were aged 21-30 years (171; 74.7%). Poor LATCH scores (0-3) were observed in 109 (47.6%) mothers at 1-2 hours postpartum, which reduced to 26 (11.4%) at 24-48 hours. Overall improvement in LATCH scores was noted in 202 (88.2%) mothers. Improvement in LATCH score was significantly associated with antenatal period status (p = 0.021), mode of delivery (p = 0.015), and initial LATCH score at 1-2 hours postpartum (p = 0.016). LATCH assessment at 24-48 hours demonstrated high sensitivity (96.1%) and specificity (99.0%) for predicting improvement in breastfeeding performance.

Conclusions

LATCH score-guided counseling combined with early postnatal hands-on lactation support significantly improved breastfeeding effectiveness within the first 48 hours postpartum. Assessment at 24-48 hours showed high diagnostic accuracy for identifying improvement in breastfeeding performance, supporting the routine use of LATCH scoring in postnatal care.