Table 1 Grading system for infant’s body position, mouth attachment and effective suckling during breastfeeding for study conducted in HIs of Harar city, Eastern Ethiopia, 2017

• Baby body should be straight and slightly extended.

• Baby body close to the mother’s body

• Whole body supported.

• Baby facing toward the mother’s breast.

Criteria for grading baby position in relation to mother:

Grade

Score

• None of or only one out of four criteria have been fulfilled.

0–1

Poor

• Any two of the four criteria have been fulfilled.

2

Average

• All the four/three criteria for infant positioning is fulfilled by mother.

3–4

Good

• More areola is visible above the baby’s top lip.

• The baby’s mouth is wide open.

• The baby’s lower lip is turned outwards.

• The baby’s chin is touching or almost touching the breast.

Criteria for grading of correct attachment:

Grade

Score

• None of or only one out of four criteria have been fulfilled.

0–1

Poor

• Any two of the four criteria have been fulfilled.

2

Average

• Any three or all the four criteria have been fulfilled.

3–4

Good

• Slow sucks

• Deep suckling

• Sometimes pausing

Criteria for grading of effective suckling:

Grade

Score

• None of or only one of the three criteria have been achieved.

0–1

Poor

• Any two or the three criteria have been achieved.

2–3

Good