Reference — Maternal-Newborn
LATCH Score Reference
A structured way to watch a feed and find the weak link. Each letter scores 0–2 for a total of 0–10 — and the value isn’t the number, it’s the column that scored low, which tells you exactly what to fix.
Educational use only. The LATCH score guides assessment and teaching; it does not replace lactation consultation for persistent problems or clinical judgment about infant intake and weight. This material supports nursing education and exam review. It is not medical advice and is not a substitute for clinical judgment, institutional policy, or medical direction. Always follow facility protocols and current provider orders.
The Five Components
| Component | 0 | 1 | 2 |
|---|---|---|---|
| L — Latch | Too sleepy or reluctant; no sustained latch | Repeated attempts; holds nipple in mouth; some sucking | Grasps breast; tongue down; lips flanged; rhythmic suckling |
| A — Audible swallowing | None | A few with stimulation | Spontaneous and intermittent (<24 h old); spontaneous and frequent (>24 h) |
| T — Type of nipple | Inverted | Flat | Everted (after stimulation) |
| C — Comfort (breast/nipple) | Engorged, cracked, bleeding, severe discomfort | Filling; reddened/small blisters; mild discomfort | Soft; non-tender |
| H — Hold (positioning) | Full staff assist required | Minimal assist; staff helps then mother continues | No assist; mother positions baby independently |
Total 0–10. Lower scores flag where to intervene; the score is most useful tracked over feeds, not as a one-time pass/fail.
Reading the Score
It’s a coaching tool, not a grade. A low L points to latch technique (deeper asymmetric latch, reposition). A low A may mean ineffective transfer — watch weight and output. A low T (flat/inverted nipple) calls for latch tricks and possibly lactation support. A low C means treat the engorgement or nipple trauma and recheck the latch causing it. A low H just means the mother needs more hands-on teaching — expected early.
Pair the score with the objective intake signs — diaper output, weight trend, jaundice — since a baby can latch comfortably and still under-transfer.
NCLEX Pearls
- ✦LATCH = Latch, Audible swallowing, Type of nipple, Comfort, Hold — each 0–2, total 0–10.
- ✦The low-scoring component, not the total, tells you what to teach or treat.
- ✦Audible swallowing is the bedside sign that milk is actually transferring.
- ✦Comfort scores low with engorgement or nipple trauma — both usually trace back to latch.
- ✦Always confirm intake with diaper output and weight, not the LATCH score alone.
Related Resources
Standards & sources
Fact-checked Jun 20, 2026This page is written to align with American College of Obstetricians and Gynecologists (ACOG) · AWHONN · American Academy of Pediatrics (AAP) — newborn. It is an educational summary, not a citation of any single document — always verify specific doses, values, and protocols against current guidelines and your facility policy. How we source content →