In Search of the perfect latch

Sugarbaby 1 week old. Photo by Kelli Elizabeth Photography

“I’m really scared of breastfeeding.”  Pregnant with her first my friend subconsciously rubbed her 34 week belly as I made dinner and we chatted.  Puzzled, I asked her why.  She said she googled and learned that it can be so painful, particularly if they don’t have a good latch.

“How do you get a good latch?” she asked me.  She went on to explain that she had read different blogs and forums about how hard it was to get a good latch, women with bleeding nipples, and babies not gaining weight.  She wondered what was the secret to a good latch and what if it didn’t happen for her.  It’s true that these issues do happen and probably far too often but here she was, weeks away from having her little baby, scheduled to take a breastfeeding class in the next couple of weeks, and worried that she was facing a world of pain if she couldn’t get this elusive latch and not find the secret for it ever to happen.

Earlier that same day I had coffee with a good friend, an IBCLC at a local hospital.  The topic of the elusive perfect latch came up and she surprised me by telling me that she thinks we make too big deal about the latch.

“If mom isn’t in pain and baby has plenty of soiled and wet diapers, why do we need to mess with anything?  Sure, if there’s a problem such as pain or a dehydrated baby then we need to fix what we can but so what if that bottom lip is curled in if it’s not bothering anything.”

In other words, if it’s comfortable and it’s working, it’s a good latch.  There is a wide range of normal.

I love this woman, she often says exactly what I’m thinking.

In general, if everything is working right, babies are ready to breastfeed and mom’s breasts are ready to feed.  It just works and we really don’t need to mess with it, it doesn’t have to be this complicated endeavor.  Maybe it will be difficult but we don’t have to expect trouble.  More often than not moms need support simply because breastfeeding isn’t so common in our society and women don’t see breastfeeding as a part of normal life making the learning curve steeper than it would be if seeing breastfeeding was commonplace.  There would be less stressing about the perfect latch if more women saw what it looks like when a baby is at the breast as they go about daily life.  Their moms, sisters, aunts, friends, coworkers, or even strangers breastfeeding would have already demonstrated a baby feeding well.  The wide range of normal would be seen and experienced.  Today a woman may never see another woman breastfeeding until she’s feeding her own baby for the first time.  Seeking out support she may look online or join a breastfeeding support group, seeing breastfeeding dyads in a very specific setting that she had to find.  If she is experiencing difficulty with pain or ineffective milk transfer for her baby, because she hasn’t been exposed to breastfeeding pairs, she may not even realize that the way her baby is latched could be what’s causing the problem or that it may even be a fairly simple fix.  When there are issues such as poor weight gain for baby or bleeding nipples the first thing to consider is a poor latch.  After I shared a few pictures of Sugarbaby’s latch on Facebook, there were several comments and I received several emails from moms stating that they never knew saw what a latch looked like and had endured pain in breastfeeding because they didn’t realize something was wrong.  Side note: if you are ever experiencing pain with breastfeeding that is more than a brief moment of discomfort or lasts beyond initial latch please seek out help, pain is usually an indication of a problem than can be corrected.  This doesn’t mean you’re doing something wrong, it just means you probably need help.

 I talked with my friend Star Rodriguez, IBCLC of Lactastic Services and WIC peer counselor for the following lists.

When do you need to consider latch issues and improving your nursling’s latch?

  •  When breastfeeding is painful beyond the initial latching.
  • When there is tissue damage to your nipples.
  • When there are weight gain issues for the baby.

What latch pointers can moms try?

  • Mom is in a comfortable position and has brought the baby to her level to her instead of leaning down to the baby.
  • Baby has wide open mouth.
  • Baby’s body is facing yours and baby’s arms are not pushing away at you.
  • It is best to let the breast fall naturally if possible.
  • If large breasted or when milk first comes in, it may be helpful to hold your breast with your hand.
  • Aim baby’s nose toward the nipple; if necessary to encourage a wider mouth, tickle the very top of the baby’s upper lip with your nipple.
  • Latch should be asymmetrical. Chin will touch the breast, nose will be unobstructed. You do not need to push your breast away from your baby’s nose in a good latch.
  • You will hear or see baby swallowing – short sucks/swallows at first, longer ones as milk starts to let down.
  • If using a nipple shield, ensure that the nipple and surrounding tissue is being pulled into the shield.

What can a mom do to try to improve a painful or ineffective latch?

  • If baby isn’t opening mouth wide enough, attempt to show baby by opening your own mouth wide.  Many babies will subconsciously mimic this.
  • Make a “breastwich” with your hand in the shape of a C behind the areola to help baby get a bigger mouthful.
  • Get baby as naked as possible for skin-to-skin or lightly dressed.
  • Hold baby securely, a snug, close hold will help.
  • Pull baby in quickly when mouth is open wide.
  • It is common to experience some discomfort at latch in the first few weeks of breastfeeding.  It should go away as the feeding continues.  If it does not end after around 30 seconds, you may need to remove the baby from the breast and reposition the baby.  Break the suction by placing your little finger into the corner of the baby’s mouth and trying to latch again.  Some lactation consultants can show you ways to fix a latch without taking the baby off the breast, but those are easier to learn from being shown rather than told.  You may need to put the baby in a different nursing hold or position.

When should a lactation consultant be called?

  • Repositioning doesn’t work
  • If there is sudden soreness after there has been painless nursing
  • If you feel stabbing or burning pain in breasts or at latch
  • If you have cracked or bleeding nipples
  • If your latch is not painful but your baby is not having a good amount of wet and dirty diapers

Check out these other resources on latch:

11 Common Pitfalls When Latching a Newborn

 

Latching and positioning resources

Latching: Thoughts on Pressing Baby’s chin down

 The Mother-Baby Dance

 

Coming soon a photo gallery of latched on babies and their mother’s commentaries on their latch experience illustrating the wide range of normal and potentially problematic latches. 

 

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Comments

  1. This is a great post ~ photos are wonderful!!
    My favorite part… “In other words, if it’s comfortable and it’s working, it’s a good latch. There is a wide range of normal.”

    • Brittany says:

      Same here. Every lactation consultant I met told me I was doing it wrong. Even though it didn’t hurt. They made me feel horrible so the first six weeks me and my daughter did a lot of crying.

  2. Elizabeth says:

    One possible addendum? When large busted you may need to hold the breast away from the nose even with a good latch, especially with a newborn and (personally anyway) more so with certain holds. At least I did, even with my boy of the instant perfect latch.

    • McAidenleigh says:

      I had to do that with both of my babies too until they were a bit older and had better head control. Also I have flat nipples, which made getting an initial latch occasionally difficult. I never had to use a nipple shield, but I did have to manipulate it around sometimes to get them to “poke out” before trying to get the baby on.

  3. tracie p says:

    great post! my georgia is 6 months old now and nursing like a pro, but it took 4 weeks to feel competent and i still had toe-curling pain. her mouth was small, therefore she was unable to latch properly–that damn mystical latch! the resulting domino fall was the vicious cycle of no withdrawal=less milk production=my-baby-is-not-thriving-have-to-supplement-with-formula-AAHHHHH!! you know THAT downward spiral. i really didn’t think it would happen for me, but i was not willing to give up.

    by 3 months we were on a roll and i thank god every day that we made it. to the point of the LC consultant, my nipples still look like lipstick sometimes but it works, we have no pain (unless she decides that it’s entertaining to stretch my nipple across the room), and she is thriving. i wish i could go back and give the 2-week-postpartum me a hug and say everything will be ok, but at least there are blogs out there like yours (wish i had found it sooner!) where others who were like me can get the encouragment they need.

    so great to hear that perfection isn’t required for success. please keep that message going! maybe some other poor new mommies out there will hear it and be able to stop crying!

  4. Britney W says:

    Thank you for posting this! I am going to share with one of my best friends who is expecting her first baby next year. I can’t wait for the gallery of images, and I hope that mine will be included. Due to an upper lip tie, my baby was never able to get her top lip to flange out around the nipple by herself, which made the first 6 weeks or so excruciatingly painful for me. I actually bought a manual pump and would offer her a bottle of expressed milk once or twice a day, just to get a little bit of relief. When I started doing that, I noticed that she would curl her top lip on on the bottle nipple too, and also had trouble getting her bottom lip to pop out on the bottle nipple (she was diagnosed at birth with a partially paralyzed bottom lip, which will never resolve). Because of the bottle I was able to correct her latch. Now, 15 months in, we are still nursing, and pain free at that! I do still have to manually adjust her lips with almost every latch, simply because she physically can’t do it herself (we never had the lip tie clipped, either. I couldn’t bring myself to do that to her). I want my story to give hope to other mothers who are struggling with breast feeding right now! It can be done- never give up on your worst day :)

  5. Sara B says:

    I never hear anybody say this, but I’m pretty sure nipple shape has a lot to do with whether or not you’re gonna have a painful phase. I have fairly flat nipples. I tandem nursed twins for about 16 months. It took them a couple of days to latch, and then it hurt like crazy every time they latched on for the first 3 months or so. The latch was fine, they grew big and beautiful. It only hurt for a minute each time, but it took a long time before it stopped happening altogether. So I guess I’m mentioning this because the fact that you are having pain does not mean your latch isn’t fine. It can just mean you’re not the perfect shape for doing this, and you’re gonna have to grit your teeth for a second until the baby (babies) rearrange your nipple to a more flexible arrangement. It does get better though, and it’s not a big deal compared to the joy of, well, everything else about it :)