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.