“…The Breastfeeding Observation Aid (28) was applied during breastfeeding, and six categories were evaluated: mother (healthy or ill/depressed, relaxed and comfortable or tense and uncomfortable, signs of bonding between mother and child or no eye contact between mother and child); baby (healthy or Figure 1. Neonatal Tongue Sreening TEST, Martinelli (27) sleepy/ill, calm and relaxed or restless/crying, trying to reach or root for the breast if hungry or does not reach or root for the breast); breasts (healthy or looking red/swollen/sore, presence of pain or discomfort, whether the breast was well supported with the fingers away from the nipple or on the areola); baby's position (head and body in line/neck and head twisted to feed, baby held/not held close to mother's body, baby's whole body supported/supported by the head and neck only, baby approaches breast, nose/lower lip or chin to nipple); baby's attachment (more areola seen above baby's top lip or below bottom lip, baby's mouth wide opened/not wide opened, lower lip turned outwards/lips pointing forward or turned in, baby's chin touches breast or not); and suckling (slow deep/rapid shallow sucks with pauses, cheeks round when suckling/cheeks pulled in when suckling, baby releases breast when finished/mother takes baby off the breast, mother notices signs of oxytocin reflex or not). The categories of this protocol indicate favorable and unfavorable behaviors, pointing to normal or difficult beginning of breastfeeding, that is, with or without signs of difficulties in breastfeeding.…”