- Created: Wednesday, 12 April 2017 11:45
- Written by Donna Bruschi, IBCLC
What a "Good Latch" is...
(And is not!)
A good latch is a mouthful of breast that positions the nipple far back in the baby’s mouth, behind the hard palate. The baby’s face, nose, chin and both cheeks are evenly pressed against the breast. The baby’s cheeks are relaxed, not dimpled. When the baby sucks, their jaw moves from front to back, with a visible wave that starts at the chin and ends at the ear. You feel a rhythmic tugging on your nipple.
A good latch is comfortable, in the "I could do this all day" kind of way.
A good latch is not sucking on the nipple like a bottle nipple.
While your baby is nursing, watch their cheek. Sucking in and dimpling means that the baby needs better positioning.
Sucking only on the nipple won't provide much milk because breastmilk is not removed by suction, but by ejection which happens with compressing, massaging or 'milking' the breast and nipple together.
You might be suprised to learn that a breast pump doesn't work by sucking out milk. Yes, technically pumps suck, but they also release which causes a different response from your body.
Vacuum stretches, and then releases, your nipple stimulating a release of oxytocin, which signals the smooth breast muscle to contract, ejecting the milk. The diaphragm inside the bottle opens from the pressure of the milk to collect it in the bottle, then closes with the next suction cycle of the pump.
You may have difficulty ejecting milk when you are in pain, compounding low supply, weight gain and latch issues.
Here are some actions that aren't helpful and may cause more harm:
1. Latching and unlatching repeatedly will hurt your nipple and cause bruises, cracks or bleeding. Each time the baby clenches your nipple, it injures it more.
2. Focusing on whether baby's lips are "flanged" or "not flanged".
3. Pushing your baby's mouth or jaw open. This action triggers a fight response and your baby clenches their mouth tighter. Nobody likes being forced to have stuff put into their mouth. Your baby has probably already had this experience and is learning each time how to prevent it from happening again.
4. Touching your baby's face, top and back of head. All these touches trigger pushing and turning reflexes which moves baby away from your breast, not toward.
5. Hunching forward. This puts your baby in an unstable position and they will clench your nipple for stability, causing you pain and injury.
6. Using a Boppy, My Brest Friend or other nursing pillow. These are convenient once you and your baby learn how to nurse, but will get in your way right now.
How to get a "Good Latch.”
The easiest way to get a good latch is to lean back into a reclining postion, let the baby find your nipple, self-attach and relax into suckling and swallowing. This is also called 'the breast crawl,' 'biological nurturing' or 'laid back nursing.'
If you have tried that and it isn't working, there are probably some good reasons why. You can come back to it when your baby learns how to breastfeed a little better.
These instructions work for any nursing hold: Cradle, cross-cradle, football and side-lying.
Help the baby take the nipple in any of the dozen ways you've been shown. If it hurts, brace yourself until, and while, you make these adjustments in positioning and posture. As soon as you and the baby are positioned correctly it will stop hurting, or at least hurt much less. It may take 10 seconds or up to a minute. Each time you feed, good postioning will be more automatic.
1. With your baby attached to your breast, lean back into a reclining or semi-reclining position
2. Roll your baby until you are "belly-to-belly"
3. Pull the baby in close with most of their body pressing into you and your belly
4. Wait for the baby to start suckling. If it hurts, even if it hurts a lot, breathe through the pain until they start to suckle rythmically.
5. While the baby is focused on nursing, start to move the baby's body into alignment. You can make as many of these adjustments as you need for comfort.
- belly to belly (not belly up)
- ear, shoulder and hip aligned
- face pressed in with nose, chin and two cheeks all touching the breast
- chin level, not tipped or tucked
- spine straight, not in a side-to side "C"
- baby's hands on each side of their mouth, holding the breast
Gravity holds the baby in a stable position so your baby can relax. A relaxed baby opens their mouth, drops their lower jaw and allows a mouthful of breast and your nipple to be positioned deeply in their mouth. This eases nipple pain for you.
Still not comfortable?
Check your posture:
- Leaning back, fully supported by pillows or furniture
- Shoulders square and level, supported by the chair, bed or couch.
- Legs parallel, not crossed
- Feet resting on a footstool, ottoman, bed, pillows, coffee table or floor
- Arms resting on your belly or pillows
Posture for side-lying:
- Lie on side with a pillow under your head, behind your butt and between your knees
- Baby lies on side, belly to belly, facing you. Roll a receving blanket and tuck it behind their back.
- You will probably need to attach the baby while propped on your elbow, before sliding down onto your pillow
Still not comfortable?
This positioning and postural alignment improves 98% of all latches and reduces pain for most mothers. If it doesn't:
2. It may be that you or your baby have tension, injury or asymmetry strains, like back strain in you or jaw misalignment or tortocollis in your baby, from pregnancy and birth that can be relieved with some physical therapy, osteopathy, chiropratic, cranio-sacral therapy or massage.
3. There may be physical tethering of the tongue, lip or cheeks (tongue tie) that can be revised with scissoring or lasering by a qualified professional such as a pediatrician, ENT or dentist.
Reading articles is a great way to become more educated about breastfeeding. Because nursing your baby is a learned skill, you may find some coaching helpful. Please call or text Donna Bruschi at (845) 750-4402 if you would like additional help with your latch.