Midwives are in a unique position to support mothers in the initiation of breastfeeding. In order to advise and support mothers effectively it is important that midwives have a sound understanding of the evidence base underpinning practice. Traditional explanations of breast anatomy are now considered incorrect and over the years many of the practices in relation to breastfeeding have changed. It is important that midwives acquire knowledge on interventions that help rather than hinder breastfeeding. This paper explores the latest evidence on the lactating breast, the process of lactation, sucking skills, post birth practices impacting on the initiation of breastfeeding, and supporting the natural process of breastfeeding.