Just the tip is never enough!
Today the topic is latch, and no, just the tip is never enough and leads to a shallow latch ;( pain for mom and poor milk transfer for baby.
The two most common phrases we hear working in lactation and breastfeeding support include “no milk” and “sore nipples.” Now, we’ll be addressing the “no milk” concern in the next blog series. This three part blog series starts out by addressing nipple soreness, pain, and discomfort during breastfeeding. Luckily we know, most times it’s all about that latch!
Especially in the early days, new mothers can run into problems breastfeeding. Sometimes a single problem develops, but more commonly a cluster of problems develop that all have the same cause. Four issues often occur together and include: sore nipples, engorgement, excessive weight loss and jaundice – and they are all too often the result of a poor latch. So how do we avoid the above cascade of problems? Get a good latch!
To start, make sure mom is in a comfortable position. Moms, you already have sore backs and bottoms, you don’t need sore shoulders from a tense breastfeeding position! We suggest a couch or comfortable chair that lets you put your feet up (a foot stool does wonders for the back!). Next, place your hand on your baby’s upper back and shoulders. Try to keep your hand off of her head. This way, when you bring your baby to the breast you allow her head to tilt slightly back, which enables her to open her mouth wider. Shallow latching is often due to a baby that was not able to extend their head and open their mouth fully. Now that you have one hand on your baby, use the other hand to grasp the breast. Make sure to keep your fingers away from the dark part of the nipple (the areola). Think of your grasp like an underwire bra, you want your hand to cup your breast like a C. With your hand in place, gently press your baby’s belly to your belly and direct her chin to the breast. Point your nipple towards her nose and wait for her to open wide. Make sure you wait for the wide open mouth! Like we said before, many shallow latches are due to a baby that has not opened wide yet. When she opens wide, bring your baby in towards you and help her top lip and gums up and over the nipple.
The first few sucks after latch-on are intense! Take a few deep breaths, then ease into the feeding… relax your shoulders. If you are still feeling pinching, biting or sharp pain after about 30 seconds of sucking, delatch and try again. The key to a good, deep latch is LOTS of breast tissue in your baby’s mouth. This also helps her get more milk as she can transfer more breastmilk when she latches deeply.
Now, it’s a myth there is absolutely no discomfort in breastfeeding. In the first week it’s likely your nipples will be sore, even with a good latch. And this makes sense! This is a new experience, occurring every hour during some parts of the day. What we don’t want to see is redness, blisters, bruising, cracks or abrasions on the nipple or surrounding breast tissue. If you do see these, try the latch tips above and email the nurses! Soon we will have secure web-based video consults available for latching problems, poor infant weight gain and more. We want moms and babies to feel supported breastfeeding, and much of that starts with learning how to latch. We also understand that there are many other factors that play into achieving a deep latch. These include: nipples that are already damaged, a baby that is too sleepy to latch, a baby with a short frenulum (tongue tie), a baby getting supplement at the breast, and more. If you are attempting to improve your baby’s latch-on we want to hear from you.
Below is the Latch-On Checklist that has been made available to the public from Lactation Training Resources. Follow the checklist below to get a deep latch!
Information for breastfeeding families
Check List for Essentials of Positioning And Latch-on Positioning
ü Hold head behind ears
ü Nose to nipple
ü Belly to belly Offer the breast
ü Sandwich hold
ü Stroke nipple from nose to chin rolling out lower lip
ü Bring baby to breast, not breast to baby Check the latch-on
ü Flanged lips, open mouth to 140o
ü No pain, no wedged or creased nipple
ü Chin touching breast, asymmetrical latch-on Assess milk transfer
ü Wide jaw excursion
ü Consistent sucking
ü Audible swallowing (after milk comes in)
*Used appropriately, unaltered from http://www.lactationtraining.com
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Biancuzzo, M. (1999). Breastfeeding the Newborn Clinical Strategies for Nurses. (2nd ed.). Herndon, VA: Gold Standard Publishing.
Hughs, V. (2015). Information for Breastfeeding Families. Retrieved from https://www.lactationtraining.com/resources/handou ts-parents?task=document.viewdoc&id=35